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The Mammogram Post-Mortem

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Steve Novella whimsically opined on a recent phone call that irrationality must convey a survival advantage for humans. I’m afraid he has a point.

It’s much easier to scare people than to reassure them, and we have a difficult time with objectivity in the face of a good story. In fact, our brains seem to be hard wired for bias – and we’re great at drawing subtle inferences from interactions, and making our observations fit preconceived notions. A few of us try to fight that urge, and we call ourselves scientists. Read more »

*This blog post was originally published at Science-Based Medicine*

Do People Really Want More Control Of Their Healthcare Costs?

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Over at The Corner, Ramesh Ponnuru theorizes that people want more control over how they spend their health care dollars:

[Ezra] Klein’s argument is that if employees understood that the employer’s alleged share of their health-care costs are really part of their wages — and if they saw it on their paychecks — they would be more supportive of cost control. I agree with that. But I assume he means (based on his examples in this op-ed) that they would be more supportive of cost controls imposed by HMOs or Congress. I think they would be more inclined to favor turning over control of health insurance from their employers to themselves, and making the cost-quality trade-offs for themselves with their own money. Under the status quo, those trade-offs are made by other people and the fact that it’s the employees’ money is obscured.

It sounds nice in theory.  But in practice it seems to be exactly wrong.

Here’s why. Read more »

*This blog post was originally published at See First Blog*

Will Healthcare Reform Mandates Punish The Poor?

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A reader wrote;” I am getting tired of you telling me how bad the healthcare reform bill is.”

I am tired of writing about the bill. I feel compelled to try to clearly explain the harmful potential of the bill to an unsuspecting public.

Most Americans agree the country needs healthcare reform.

Many intelligent people believe President Obama is on the right track. They believe he is going to provide universal healthcare coverage, affordable healthcare cost, and improve the quality of medical care.

Few in the mainstream media are discussing the real impact of President Obama’s Healthcare Reform Plan.

President Obama cannot accomplish his goals with this bill. He is going to increase federal spending and taxes for every American’s not just the wealthy. Read more »

*This blog post was originally published at Repairing the Healthcare System*

Another Reason To Reform Employment-Linked Healthcare

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Free Agent Nation.jpgAn article by Paul Davidson in this morning’s USA Today reminded me of another reason why we need health care reform in the United States, or at least a move away from employment-linked health coverage: temporary employees may soon comprise 25% of the national workforce.

An encouraging jobs report Friday underscored the growing prominence of temporary workers who some experts predict could constitute up to a quarter of the workforce in a few years.

A big reason employers shed a far-less-than-expected 11,000 jobs last month is that temporary staffing agencies found slots for 52,000 additional workers, the most since 2004, the Bureau of Labor Statistics (BLS) said.

Temp workers don’t draw full health benefits from most employers and must therefore seek high-cost personal policies or pray that their spouse has family health coverage. Read more »

*This blog post was originally published at Terra Sigillata*

Are Free Drug Samples A Good Idea?

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Most doctors have a closet in their office filled with various pharmaceutical samples. The pharmaceutical industry has had “drug reps” or account reps or pharmaceutical sales staff making the rounds on doctors offices in every city and town across the United States for decades. The industry spent $33.5 billion promoting drugs and sending reps to doctors offices with samples in 2004. That is a lot of samples!

Most of us thought we were doing the right thing for our patients when we accepted drug samples. I was able to give patients a month (or more) free to make sure it worked and that they tolerated it. Other patients had no insurance and I supplied them with all of their medication for free from my sample closet. I had a good relationship with the rep and they kept my office stocked with the medication my patients needed. It seemed like a win-win for everyone. Read more »

*This blog post was originally published at EverythingHealth*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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