This is the second in a series of conversations I had with some open-minded colleagues who also deeply want to seen meaningful change in the U.S. healthcare system. The person I primarily responded to mentioned a chapter in Pursuing the Triple Aim. Here is what I wrote back to him: I...
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I’m in an email group that is all in agreement that the U.S. healthcare system is exorbitantly expensive and needs reform. We come from wildly different backgrounds. The variety of perspectives is wonderful. However, a claim of some of the contributors is that aggressive medical therapy of cardiovascular disease (CVD) chronic...
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The topic today is some of the older diabetes treatments. I’ll cover some of the newer agents–jardiance, ozempic, trulicity, and so on–next month. The cost-effectiveness literature covers individual drugs and overall goals such as “intensive glucose control” or “goal of normoglycemia.” Before I get into the details, I will try to...
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Since diabetes was the disease that started me on this journey, I’ll get into it now. I’ll break this huge issue into smaller posts. Since I went into great detail about the methods of the literature with the hypertension post, I’ll keep these shorter. Screening for and preventing diabetes does not...
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I’m on an email group whose members are heavy into the money side of healthcare. They are fighting back against our exorbitantly expensive healthcare system. The members of this group know a lot about the macro-economics of healthcare—overall spend, spend by major categories, some cross-national comparisons—and the finance of healthcare—carve-outs, loss...
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A very smart person in the healthcare benefits space wrote that family physicians can’t influence much the top 25 most costly DRGs in hospitals. Here was my response: There are many reasons this isn’t true. But it’s understandable that a benefits or administrative person would have no inkling of this, because...
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The Texas Lieutenant Governor, Dan Patrick, was recently lambasted by much of the press for his comments in an interview he did on the Fox network. He said that he is 69 years old and he was willing to take the chance that he could be infected from the COVID-19 virus...
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My thanks to Al Lewis of quizzify.com for bringing this story to my attention. It seems that a 57-year-old woman who had a history of a double mastectomy for breast cancer was told by her employer that she had to get her annual screening mammogram or she would be fined each...
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Flu season is about to be upon us. I’ve written about this before, but it’s been a few years, so I thought I’d update some of the evidence (with my thanks to Juan Gervas, MD for compiling a nice list of relevant studies). This, in the face of the recent CDC...
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Hello again!  I haven’t written anything in a while. No big worries. I moved recently (same town, same neighborhood), but the remodel of the new house has been a mis-adventure and I’ve been living out of boxes and breathing dust for over a month. Things are kind of finally settling down....
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