Brilinta, at $6.50 per pill, twice a day, reduces cardiovascular events more than generic Plavix, which costs 50 cents per pill, once a day. But only a little: 20% relative or 2% absolute risk reduction. The event risk was 10% with the more expensive drug and 12% with the one that costs 82% less. Put differently, if 100 patients were treated with Brilinta for a year, at a cost ...

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Let me warn you — I own guns. I love to shoot. And I’m a strong supporter of the Second Amendment. This may seem hypocritical coming from a doctor, but don’t shoot me figuratively speaking, of course — before I make my case. Any mass killing is a horrifying event. Any senseless death is riveting. Obviously, this goes without saying, but as a doctor whose purpose is to save lives, ...

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Why is U.S. health care so costly compared to other developed countries? A recently published report provides some insights. In a study of 11 countries, Harvard researchers found that while the United States has the highest health costs relative to its GDP, its use of services is average. More specifically, the U.S. ranks lower than nearly every other country in doctors’ visits, hospitalizations, hospital days, and consultative services. The difference is ...

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Hospitals serve as the economic lifeblood of their communities. They are the second-largest source of private-sector jobs in the United States, employing 5.4 million Americans who, together, embrace a virtuous mission to heal and help others in need. And yet, every year, more and more of them are forced to shut their doors. With soaring costs, eroding margins and mounting pressure from competing providers, the American hospital industry is on life ...

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Now that the children have shouldered their muskets and taken aim -- figuratively speaking, of course -- against the gun lobby, maybe we can interest them in another partisan conflict that’s even more sweepingly about their survival: climate change. Not to minimize the horrific consequences of school shootings, but there are many more lives at stake from climate calamities. Threats from sea level rise, flooding, wildfires, and storms are multiplying ...

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STAT_Logo I was on my honeymoon in Colombia when I first became aware of the true extent of my post-traumatic stress disorder. My husband and I were walking across a smooth, granite platform to take a closer look at a fountain in downtown Cartagena. As we neared the structure, mist from the fountain’s jets dampened the ground ...

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I need your help. I'm trying to figure out how to get rid of something that's terribly broken in our process of taking care of patients, and I can't do it alone. It's time to kill the referrals process, get rid of them altogether. Every day, a huge proportion of the messages we receive through the electronic health record are requests for us to "put in a referral." Patient has low back pain, has ...

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A hundred years ago, the practice of medicine was just that: the practice of professionals specially trained to alleviate suffering and heal the sick. Doctors had a fiduciary responsibility to put the needs of their patients before their own. A small town doctor might be paid for his efforts in chickens — living or cooked. Flash forward. Medicine is big business. Trillions of dollars are spent every year in the health care ...

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By their nature, fee-for-service reimbursement schemes incentivize procedures over prevention. This creates a serious moral hazard: If you keep your patient panel healthy through early interventions and exhaustive lifestyle counseling, then there are fewer profitable procedures to do. On the other hand, if you let your patients become critically ill, then you will be rewarded handsomely for all of the (now) medically necessary procedures and tests that you can perform ...

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A casual reader scanning the headlines would rightly infer a direct cause-and-effect relationship between pharmaceutical company payments and the number of opioid prescriptions written based on this headline displayed prominently on the CNN homepage. What follows is nothing short of a character assassination of the medical profession, portrayed as complicit drug pushers in bed with the pharmaceutical industry. Rather than a reasoned look at the history of causes of the ...

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