I’ve written in the past about a few long-term studies of bariatric surgery outcomes as a treatment for morbid obesity. They found that the incidence of diabetes is reduced in morbidly obese patients who undergo this surgery, and even reverses diabetes and hypertension in some cases. From a cost perspective, what...
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An article in Forbes recently questioned the value of patient satisfaction scores for both pay-for-performance schemes and as markers of quality and value in general. The article effectively exposed the inordinate sway Press Ganey has on the hearts and minds of hospital administrators. Press Ganey is an influential patient satisfaction survey...
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On Sunday, CNN will have two shows on healthcare. The first one starts at 7 ET/6 CT. Then there is a reaction show on how to fix healthcare at 9 ET/8 CT. Sanjay Gupta will be the host. But the real reason to watch is that one of his guests will...
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I must say, I’m very proud of the American Academy of Family Physicians for continuing to make statements about over-testing under the Choosing Wisely campaign umbrella. The Academy is more known for making wussy statements and taking wussy actions — the RUC wimp out being the prime example. So I salute...
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I imagine many of you have heard about the fantastic article in Time magazine called Bitter Pill, written by Steven Brill at: http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/ In a nutshell, it exposes the absurd system of chargemasters and bills the hospitals use to obfuscate their prices. It exposes the unconscionable reality that the uninsured, who...
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I recently received this email message from one of my residents who has moonlighted in a local commercial urgent care center. This message is reprinted with his permission just as I received it, except I removed the brand name. “Hey Dr. Young, I’m looking for some basic mentoring advice.  I’ve been moonlighting...
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Two recent studies should remind us of the limited usefulness of routine screening mammograms. The first study looked at 30+ years of breast cancer outcomes in the U.S. before and after routine mammography became common practice. It found that the rate of breast cancers that had not spread beyond the breast...
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The PPACA (Obamacare) includes provisions for hospitals and other entities such as physician groups to cooperate to make systems work better, save money, and share those savings between Medicare, the hospitals, and the other entities. These efforts are doomed to underperform for many reasons. One of the biggies is that these...
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It’s not too late. If you haven’t had a flu shot yet you can still get one. But what does it do for you? A Cochrane review in 2010 looked at all influenza vaccination trials in adults. In the background of the report, the authors reminded us that even if the...
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A friend of mine told me about her annual trip to the gynecologist (and no, I did not give her much of a hard time about this. I don’t want to repel too many friends as they make common personal health decisions). She was feeling a little sick that day and...
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