Practicing Medicine Against the Evidence: The Case of Implantable Defibrillators
Cardiology is famous for producing more evidence about our clinical strategies than any other medical field. These clinical trials, in which patients are randomly assigned to various treatment...
View ArticleObamacare And Price Controls
If they survive judicial and legislative challenges, the Patient Protection and Affordable Care Act’s big ticket health insurance reforms – the individual mandate, Medicaid expansion, creation of...
View ArticleObamacare Deficit Debate is a Red Herring
The Congressional Budget Office (CBO) opines in a January 6 letter to Speaker Boehner that repeal of Obamacare would increase the projected federal deficit by $230 billion through 2021, with detailed...
View ArticleWhy Doctors Still Don't Know Which Heart Drugs Work Best
I'd like to let you in on a little secret in medicine. We know a lot less than you might think about the effects of medications and, in particular, how they compare with each other. Last week an...
View ArticleSaving One Mother at a Time
More than 25 years ago, my mentor, Allan Rosenfield, raised eyebrows in the global health community when he persuasively argued that although “maternal health” and “child health” were always lumped...
View ArticleFixing Medicare's Failed "Physician Compare" Website
The launch of Medicare's Physician Compare website at year-end should have been a watershed event in the long campaign for health care transparency and patient empowerment. Instead – and it pains me to...
View ArticleWhy Aren't The Uninsured Protesting In The Streets Like The Egyptians?
Maybe the uninsured could learn something from Egyptians and the Arab street. At a time when landmark health reform granting most of the uninsured access to medical care for the first time in their...
View ArticleHealth IT: A Tale of Three Watsons
If you want to see the future of health information technology, take a look at the dueling visions of two Thomas Watsons that are on display this month in a game show and a trade show. The...
View ArticleGet Football Out Of Our Universities
(In which I take on the football-industrial complex, and get myself in trouble) The Super Bowl is over, finally. The college football* season is over too. Now we can be spared the breathless,...
View ArticleWatson: A Computer So Smart It Can Say, "Yes, Doctor"
Game Show Watson wants to be a doctor. Well, almost.
View ArticleSupreme Court Saves Childhood Vaccines -- And Public Health
Unbeknownst to most people, the Supreme Court heard a case last week that, had they ruled differently, might have destroyed the vaccine system in the United States. On February 22, the court ruled 6-2...
View ArticleMedicine's Drip of Uncertainty
Many people assume that medicine has accumulated much knowledge about how best to treat patients and improving care is just a matter of applying what we know. If only it were so.
View ArticleIt's time to destroy the U.S. smallpox reserves
The eradication of smallpox was possibly the greatest victory of science over disease in the history of mankind. Thanks to a determined, worldwide vaccination effort, led by the World Health...
View ArticlePharma Be Aware: The Next Killers
When it comes to perceptions of danger, there’s a fundamental disconnect about what scares us most. As Steven Levitt and Stephen Dubner note in their now classic book Freakonomics, parents who are more...
View ArticleChinese Medicine Infiltrates Scientific Publishing
So it turns out that Chinese Medicine has its own journal, published by BioMed Central, a large scientific publisher. The Chinese Medicine journal promotes, according to its own mission statement,...
View ArticleBreakthrough Heart Valves: How Will Patients Decide?
Breakthroughs in medicine do not always produce a new approach that completely overshadows the older way of treating disease. In fact, such landmark advances are quite rare. More commonly, new...
View ArticleMedicare's ACO Regs Recall MAD's Squamish Rulebook
After sitting through a 90-minute webinar by a Washington law firm on Medicare’s new draft regulations for Accountable Care Organizations (ACOs), I realized why they sounded familiar. In their...
View ArticleWhy Medical Schools Should Not Teach Integrative Medicine
Pseudoscience is insinuating itself into our medical schools across the nation, going by the name "Integrative Medicine." Integrative medicine is just the latest buzzword for a collection of...
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