A Conference on Bioethics and Humanities, and Future Planning

The tone, overall, was intense. Intellectual, brain-stimulating… By contrast to other medical meetings I’ve attended, there was little glitz, scant makeup and limited Wireless. Perhaps the most surprising aspect of the ASBH conference

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A Case for Slower Medicine

Anger is an understandable reaction to a system that dehumanizes patients, that treats bodies as containers of billable ailments and broken parts. But most doctors go about their daily work with good intention – to heal.

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Why I Support Health Care Reform

Profit is not what medical care is about, or should be about. What we need is a simple, national health plan, available to everyone, with minimal paperwork and, yes, limits to care.

Posted in Essential Lessons, Future of Medicine, health care costs, health care delivery, Medical Ethics, PolicyTagged , , , , , , , 2 Comments on Why I Support Health Care Reform

Quote of the Day: On Death Panels and the Insurance Industry, From Dr. Donald Berwick

Dr. Donald Berwick left his position last week as head of CMS. He said this, as quoted in the WSJ’s Washington Wire, yesterday: “Maybe a real death panel is a group of people who tell health care insurers that is it OK to take insurance away from people because they are sick or are at […]

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On Reducing Cancer Care Costs by Resetting Expectations, and Hope

Today we should move forward on the list published in the NEJM on Bending the Cost Curve in Cancer Care. We’re up to point 7 in our discussion, what’s 2nd in the authors’ proposed changes in attitudes and practice: “Both doctors and patients need to have more realistic expectations.” This point follows closely from the […]

Posted in Books, cancer treatment, health care costs, Medical Ethics, Oncology (cancer)Tagged , , , , , , , , , , 4 Comments on On Reducing Cancer Care Costs by Resetting Expectations, and Hope

The Trouble With Placebos

The latest NEJM features a big story about a small trial, with only 39 patients in the end, on the potential for placebos to relieve patients’ experience of symptoms. This follows other recent reports on the subjective effectiveness of pseudo-pharmacology. My point for today is that placebos are problematic in health care with few exceptions. First, […]

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On Admitting Nice, Ethically-Minded People to Med School

This week the Times ran a leading story on a new med school admission process, with multiple, mini-interviews, like speed dating. The idea is to assess applicants’ social, communication and ethical thinking (?) skills: …It is called the multiple mini interview, or M.M.I., and its use is spreading. At least eight medical schools in the United […]

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Reducing Costs by Holding Back on Chemotherapy for Cancer Patients Who are Frail

This is the fourth in a series of posts on Bending the Cost Curve in Cancer Care, by Drs. Thomas J. Smith and Bruce E. Hillner, in a recent NEJM health policy piece. The authors’ third suggestion: to limit chemotherapy to patients with good performance status, with an exception for highly responsive disease, is surely one of the most […]

Posted in cancer treatment, Economics, health care costs, Medical Ethics, Oncology (cancer), PolicyTagged , , , , , , , , 5 Comments on Reducing Costs by Holding Back on Chemotherapy for Cancer Patients Who are Frail

Don Berwick, Head of CMS, on the Value of Patient-Centered Care

A few weeks ago I had the opportunity to hear Dr. Don Berwick speak at the annual meeting of the Association of Health Care Journalists. Berwick now heads the Centers for Medicare & Medicaid Services. When he spoke in April, on transparency and how we might simultaneously cut costs and improve care, I thought his […]

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On Pleasant Behavior And Being A Patient in the Hospital

Dr. Wes has a short post today, How to Optimize Your Care While Hospitalized that got me thinking. He writes: …A lone doctor listening to some highly experienced and capable nurses, reflecting on their work: “If the patient’s nice, it’s a lot easier to want to go back in that room with them. Their reputation […]

Posted in health care delivery, Life as a Doctor, Life as a Patient, Medical Ethics, Patient-Doctor RelationshipTagged , , , , , , , , 6 Comments on On Pleasant Behavior And Being A Patient in the Hospital
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