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Extraordinary Print E-mail
Written by Jordan Grumet, MD   
Thursday, 01 October 2015 00:00

He squeezed into the elevator just as the door was closing. There was a lightness about him, an excitement. His jacket was newly pressed and uncomfortably free of nicks or stains. He stood at attention with perfect posture. There was no sign that working at this early hour on a Sunday morning, nor even being awake, was something out of the ordinary. Extraordinary.

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Last Updated on Friday, 02 October 2015 12:55
Less Regulation in Healthcare. Please. Print E-mail
Written by Rocky Bilhartz, MD | KevinMD   
Tuesday, 22 September 2015 00:00

Pharmaceutical drugs cost too much. The new ones are always so expensive.
Hence, we need more regulations. And, the government should impose them. Set price limits. Cap drugmaker profits. This will make it better for all of us. The paternalism of our government should be the strongest when we are ill. Because we may need that medicine...
... Here's the bitter irony.
You could actually argue that the government is causing the problem.
Say what? How can that be?

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Last Updated on Thursday, 24 September 2015 12:57
Is obesity a disease, a disability, both, or neither? Print E-mail
Written by Skeptical Scalpel, MD   
Tuesday, 15 September 2015 00:00

In 2013, the American Medical Association recognized obesity as a disease. Dr. Peter Ubel, writing in his blog on the Forbes website, thought this was a bad idea. He feared that calling obesity a disease will result in people having less motivation to lose weight and cited a study which found that people who were told that obesity is a disease tended to be less concerned about their weight and when offered a sandwich for a hypothetical lunch, chose less healthy food.

Although he gave good reasons why obesity should not be considered a disease, he favored retaining the disease label because it would help reduce the stigma attached to obesity and build public support for programs to conquer obesity. I am not sure about that.

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Chronic Illness Spells Financial Burden, Even With Insurance Print E-mail
Written by Austin B. Frakt, PhD | News@JAMA   
Friday, 11 September 2015 15:01

The highly skewed distribution of health spending is a phenomenon well known to health economists. About 5% of the population accounts for half of spending and the most costly 1% accounts for one-fifth of it. Less widely known is the extent to which high spending persists over time, despite the important health policy and financing consequences that follow from it.

For many of those costly patients, their health coverage may provide inadequate protection against the burden of persistent and substantial medical expenses.

Two groups of costly patients engage the health system differently...

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Last Updated on Friday, 25 September 2015 19:08
Two Cheers for Medical Paternalism Print E-mail
Written by Bill Gardner | The Incidental Economist   
Friday, 04 September 2015 17:19

In the NEJM, Lisa Rosenbaum looks at communication between doctors and patients and, as she has before, suggests that real clinical practice is more complex than orthodox bioethics makes it out to be. Discussing cases, including her own, she asks

Might there, in fact, be such a thing in medicine as
Too Much Information?

a view which she attributes to our received understanding of informed consent.

Instead, Rosenbaum argues for a kind of paternalism, in which patients rest in a cognitive and emotional dependence on physicians. She's getting something right, but it's critical to get clear on what kind of paternalism we might accept.

Let's start with informed consent to treatment. Roughly, we have informed consent to medical treatment when a competent patient...

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Last Updated on Friday, 18 September 2015 16:32
If We Fight For It Print E-mail
Written by Jordan Grumet, MD   
Thursday, 03 September 2015 00:00

It occurred to me towards the end of our conversation that there was a large gaping hole. We had talked about physician burnout, career choices, and his current plans. He had drawn a map of his future. It originally shot like a straight arrow towards clinical medicine, but now veered precipitously. I took a moment to first clear my thoughts, and then my throat.

Medicine, I explained, is still as noble a profession as ever. Every day I dip my toes tentatively into the current that swirls around me. Often I am pulled violently into the depths. My body bumps and sways in the mass of humanity.

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Quality Improvement: 'Become Good At Cheating And You Never Need To Become Good At Anything Else' Print E-mail
Written by FHI's Week in Review   
Monday, 31 August 2015 00:00

David Himmelstein and Steffie Woolhandler in an August 27, 2015 HealthAffairsBlog post:
The Centers for Medicare and Medicaid Services (CMS) has trumpeted the recent drop in hospital readmissions among Medicare patients as a major advance for patient safety. But lost amidst the celebration is the fact that hospitals are increasingly "observing" patients (or treating returning patients in the emergency department) rather than "readmitting" them.

Read more in the current issue of FHI's Week in Review HERE>>

Last Updated on Wednesday, 02 September 2015 17:53
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