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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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 had the distinct pleasure working with family physician colleagues in Sweden recently. It was a similar experience to a trip I made to Britain about 5 years ago that I also wrote about. I got to spend some time watching one of my colleagues care for her patients in her...
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Two recent reports extoll the virtues of the Patient-Centered Medical Home (PCMH) and direct primary/concierge care. One is the annual report of the Patient-Centered Primary Care Collaborative. The other is a study of a network called MD-Value in Prevention (MDVIP). Before I continue, let me be clear that there are positives...
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According to an article in Health Data Management, the Center for Brain Health at NorthShore University Health System in the Chicago area will use the organization’s electronic health records (Epic) and “advanced analytics” to “get ahead” of the onset of Alzheimer’s Disease. Many of the typical health scare tactics are in play...
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The best primary care-based research comes out of Europe, where countries have medical research budgets that actually fund primary care research. The U.S. has no equivalent funder. Therefore, American family physicians must often look overseas for answers to their daily clinical questions. Does screening for diabetes make any difference? A recent study...
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Do you like to take pills? I don’t. I bet most family physicians would say they have some patients who should be better at taking pills and some who love taking pills too much. For people who don’t like taking pills, what would a trade-off look like? If you were given...
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A study was recently published in the New England Journal of Medicine about the cost-effectiveness of treating hypertension based on the most recent JNC 8 guidelines. This study particularly caught my eye, because previous cost-effectiveness analyses found that screening and treating for hypertension did not save money. The upfront costs of...
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Recent news stories touted a 22% drop in cancer death rates that has “spared the lives” of over 1.5 million people over the past two decades. The American Cancer Society (ACS) was attributed as explaining this drop as caused by U.S. smoking habits, extra attention to cancer prevention, improvements in various...
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