health policy

For the vast majority of people who live in the developed world, infectious disease is an afterthought.

Sure, we still catch colds and (if we're old or immunocompromised) can die of influenza, pneumonia, or food poisoning. Antibiotic resistance is scary -- and directly responsible for about 23,000 deaths in the U.S. each year -- but it hasn't quite become the apocalypse we all feared. In general, the microbial world is just not something the average person has to think about very much.

That luxury of modern life is due to the strong defense provided by the "pillars" of our public health system. According to Dr. Michael Osterholm, these...

Several years after the ACA ("Obamacare") passed, healthcare costs continue to rise in America. The question of why – and, perhaps more importantly, how much of these costs should be covered by the government – continue to spark intense political debate.

New research funded by the Gates Foundation and led by Joseph Dieleman of the University of Washington may shed some light on this issue. The researchers investigated global patterns of healthcare spending, and their results are published in The Lancet.

For their investigation, the team analyzed healthcare spending (which was adjusted for inflation and purchasing power) in 184 countries from 1995 to 2014. Then, they conducted regression analyses, with the general aim of making two broad determinations: (1) Given...

We have entered dangerous times in my beloved medical profession. Non-doctor health professionals, backed by powerful lobbies, are increasingly interested in the easing of certain practice restrictions. New titles like “clinician” or “advanced practitioner” or “provider” are masking a stark reality - people will be able to practice medicine without ever having to attend medical school, perform rigorous residencies or be comprehensively and extensively trained as physicians.

This is not to diminish the powerful benefits of nurses. Far from it. But nurses are not doctors and the people most likely to get medical treatment from people who are not doctors are among the poorest that health care reform was supposed to improve. We shouldn't cave into it. From an ethics perspective...

Soda taxes are many things. Obnoxious. Unscientific. An example of government overreach. The one thing they aren't is racist, yet precisely that case was made by Seattle Times reporter Gene Balk1

His argument goes like this: Blacks and Hispanics consume more sugary beverages than whites and Asians, while whites and Asians drink more diet beverages than blacks and Hispanics. Because the tax does not apply to diet beverages, it is racist. 

Supporting data provided by the Seattle...

Few things are more exciting than saving the world. James Bond and Superman have done it. Now, Facebook founder Mark Zuckerberg and his wife Priscilla Chan want to do it, too. It's a sufficiently sizable goal for a couple with a sufficiently sizable ego. And their goal will be best accomplished by spending their money on boring stuff.

The duo (Z-Chan? Chuckerberg?) recently announced their intention to "cure, prevent or manage all disease within our children's lifetime." But according to Nature News, the first grants will...

Obamacare was always about health coverage, not health care. Whatever destiny awaits its future iteration —albeit repeal, replace, repair, what have you, Trumpcoverage would be a better suited name than Trumpcare

If the highest quality of medical care persists in being of unequal consideration to access where continuity of care is permitted to fragment further and individual choice of physician be ever limited, then we all lose no matter the new enactments.   

Whatever your political affiliation, all we hear about from both sides of the aisle are the two aspects of Obamacare that we all desire to keep: not penalizing those with pre-existing conditions and covering young adults under their parents plans until age 26. Bravo to those who...

This week a meta-analysis in JAMA Surgery looked at Prevalence and Causes of attrition among surgical residents [1] Here are the highlights:

•    There were nineteen studies of American surgical residencies, involving about 20,00 residents

•    Attrition rate was about 18 percent with a range of 4.4 to 43.6 percent.

•    The primary causes of attrition were ‘uncontrollable lifestyle,' followed by ‘chose another specialty’ – this data did not lend itself to further statistical analysis.

•    The preponderance of attrition was at the end of post-graduate years-one year (PGY-1) (48 percent ) and two (28 percent).

•    Only 20 percent of the residents leaving continued in general surgery residencies; anesthesia, plastic surgery, radiology and...

Excited to report that a new study in Health Affairs provides us with another metric that we have previously known and repeatedly been shown in the literature (and in medical practice):  Life expectancy and well-being are positively linked.  

If you have ever practiced medicine, then you are used to constant email or text alerts from hospitals, the Centers for Disease Control and Prevention (CDC) or the Department of Health, to name a few.  Most say urgent or emergent in the header.  Since patient results and inquiries are nonstop, being tethered to the phone is a modern reality for the practicing physician.  Often, while running between patients, procedures, facilities and electronic medical...

A study by the UK National Cardiac Arrest Audit (NCAA) echoes previous global data that hospital survival is reduced for those admitted on weekends and at night. (1) 

Specifically, it concludes “IHCAs (in-hospital cardiac arrest) attended by the hospital-based resuscitation team during nights and weekends have substantially worse outcomes than during weekday daytimes.  Organizational or care differences at night and weekends, rather than patient case mix, appear to be responsible.”  

Translation:  The skeleton crew available during these shifts is being stretched thin and cardiovascular and alternative monitoring or lack thereof is inconsistent dependent upon location within a facility and between institutions.  Witnessed versus unwitnessed events are directly related to...

I was blind, but now I see.  

I read an article by an economics student where the author suggests Johnson & Johnson and new contact lens legislation are teaming up to deprive consumers of choice and the ability to get their contact lenses.

Relax, the free market is safe and optometrists are also not in cahoots with ophthalmologists (nor are they the same). 

Let’s break it down, as I underscore the importance of not being so readily convinced by everything you read.  In 2004, The Fairness to Contact Lens Consumers Act passed.  In summary, it insisted prescribers give patients copies of their contact lens prescriptions so they can...