Why do we never consider unintended consequences? Whether we are thinking of legislation or physician led guideline panels, or governing bodies (like ACGME), the lack of consideration of unintended consequences remains mind numbing.
Let me provide some examples.
Please read this articles about how the war on drugs has fueled the hepatitis C epidemic. One could also argue that this war damages more young people than the drugs themselves.
Many illicit ...
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1. NSAID Use Raises Heart Risk in Arthritis. atients with rheumatoid arthritis and other inflammatory musculoskeletal diseases continue to be treated with nonsteroidal anti-inflammatory drugs (NSAIDs), even with their high risk for ischemic heart disease.
2. Mom's Worrying Linked to Kid's Asthma. Adolescents with asthma reported worse symptoms of breathlessness when they had anxious mothers, and the ...
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As someone who professionally closely tracks the debate over the transformation of the American health care clinical delivery system, I did not learn much new from the New York Times article: The $2.7 Trillion Medical Bill. I did find the article’s approach useful in explaining how the wide variations in price for procedures contribute to the unnecessary high cost of American health care.
Although the article did document many procedures ...
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Today I am going to write about how the US could save up to 10% on its healthcare bill.
The US spends more on health care than any other nation, $8,500 per person per year. Multiply that by 300 million people and try to grasp the vast sum of $2,5 trillion.
A lot of changes are taking place with the intent to save healthcare dollars. So far, many of those changes have ...
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Hospitals that are already struggling financially to stay afloat face significant challenges in the coming months and years under some of the provisions of Obamacare.
Under the Affordable Care Act's Hospital Readmissions Reduction Program, hospitals that readmit certain patients within 30 days of discharge could face significant penalties.
The question is whether hospitals really have that much control over factors leading to readmission and whether they are really at fault.
Some readmissions are ...
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I sometimes explain to medical students that they are entering a profession being transformed, like coal to diamonds, under the pressure of a new mandate.
“The world is going to push us, relentlessly and without mercy, to deliver the highest quality, safest, most satisfying care at the lowest cost,” I’ll say gravely, trying to get their attention.
“What exactly were you trying to do before?” some have asked, in that wonderful way ...
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Doctors are trying to rationalize our current story line: the loss of autonomy and pay cuts are a necessary evil for the greater good. We're taking one for the excess-health care cost team. We're willing to take this personal sacrifice for our fellow man and woman. It is the noble thing to do. It will be good for America's healthcare system if we do our part, work harder ...
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An important article was recently published in the New England Journal of Medicine, titled The Oregon Experiment — Effects of Medicaid on Clinical Outcomes. This study provides a rare look at the effects of expanding Medicaid coverage (specifically, Oregon Health Plan, Oregon’s version of Medicaid) to a population of previously uninsured patients. Having practiced medicine in Portland, ...
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An excerpt from The Upstream Doctors: Medical Innovators Track Sickness to Its Source. There’s a story widely known in public health circles about three friends and a river. I retell it this way:
Three friends approach a wide, beautiful river leading to a waterfall. The idyllic scene is shattered by the cries of a small child in the water, flailing his arms while struggling to stay afloat. He’s fast approaching the ...
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In an ad-hoc poll among classmates, I recently inquired about the most important date (in 2013) to a 2nd year medical student. The overwhelming majority cited their respective USMLE Step 1 exam dates as most important, followed closely by the season finales of ABC’s Scandal and Grey’s Anatomy. While the top three responses all are worth their respective weights, the one date that should bear the most gravity in the minds ...
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-Eric Topol, MD, author of The Creative Destruction of Medicine
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Past 6 Months
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