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The Silent, Terrible Toll of Sexual Harassment in Medical Schools

It is hard for any physician to advance as a medical researcher. Competition for research funding is fierce; the rigors of publishing in prestigious medical journals are gargantuan. And women pursuing such careers face even bigger challenges, with many having to take on disproportionate burdens at home compared to their male colleagues (caring for kids, attending to chores), while receiving less effective mentorship than equally accomplished men.

Add to that the horrible, awful burden of being sexually harassed. I was part of a research team led by Reshma Jagsi of the University of Michigan, that reported on the frequency of sexual harassment experienced by early career medical researchers. I will tell you about our findings shortly. But first, I want to describe an email Dr. Jagsi received shortly after we published our findings. It was from a woman (who I will keep anonymous) who experienced sexual discrimination and harassment during her residency training (the period of time immediately following medical school). She was in a relatively small specialty, one where everyone knows everyone else. That made her feel like if she spoke up in any way about her treatment, word would get around the country about her difficult personality, and it could interfere with her career.

During residency training, her department chair held weekly poker games for residents and faculty, but only invited men. It was a guy’s night kind of thing, a seemingly harmless gathering except for its close connection to the workplace. If the department chair had invited non-employees over for poker – dudes he knew outside of the medical school setting – there would be nothing wrong with him holding a male only poker game. But by inviting colleagues and employees, while excluding the women in his department, he was erecting a barrier to their careers. Poker games and golf foursomes matter.

Quick side note. When Jagsi showed a draft of this essay to the anonymous woman I’m writing about, the woman worried that mentioning the poker game might give away her identity. In case you think you know who this woman is because you were her department chair, excluding her from a poker game – my guess is there are dozens of people reading this article who feel the same way. Men only, workplace-related poker games are so common as to be a bad cliché.

Sexual harassment of course is even more destructive than poker-related sexual discrimination. In this woman’s case, such harassment left her mired in self doubt.

To read the rest of this article, please visit Forbes.

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America Is Number…5 Out Of 5?

Here’s a picture from @RAdamsDudleyMD, one that, sadly, is consistent with many previous studies. The US doesn’t measure up in giving people access to medical care.

America Is Number…5 Out Of 5

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Did You Know That Obamacare Causes Diabetes? Here’s Why It Happens And Why It’s A Good Thing

Obamacare is a big, messy law with so many moving parts, it is often hard to tell how well it’s working. People debate whether it is killing jobs or creating them; they argue about whether it is lowering medical expenses or raising them. These debates often feel irresolvable because the law, being a national one, doesn’t allow for easy analysis. When an entire health care system changes in all 50 states simultaneously, it’s difficult to know what the world would have looked like if the law hadn’t existed.

That’s one reason the Obamacare Medicaid expansion is so interesting. You see, 19 states have refused to expand their Medicaid programs, leaving us with a kind of experiment – we can compare what happened in those 19 states with what happened in the other 31. That’s what Laura Wherry and Sarah Miller did in a study published in the Annals of Internal Medicine. In fact, that’s how we know that Obamacare causes diabetes.

Let me explain.

Wherry and Miller used data from the National Health Interview Study, looking at responses from people with incomes less than 138% of the federal poverty limit. In states that expanded Medicaid, all such people now qualify for healthcare coverage. But in states that didn’t expand, Medicaid eligibility is typically more stringent, as low as 75% of the federal poverty limit in some states. Wherry and Miller looked at data from before and after Obamacare expansions went into effect, to see how things changed in expansion versus non-expansion states.

To read the rest of this article, please visit Forbes.

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The High Price of Free Lunch

Once again: correlation does not equal causation. And it is possible that companies give lunches to physicians who are already inclined to prescribe their products, or who are already high prescribers. But why should we leave any of this up to doubt?!?

Physicians should not accept gifts from drug companies.

High Price of Free Lunch


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Rare Diseases Are Becoming Too Common. Sound Impossible? Here’s Why It’s Not

It is hard to make money treating rare diseases. There simply aren’t enough customers to generate many profits. That’s why the U.S. government passed the Orphan Drug Act in 1983, a law which created a series of incentives to encourage drug companies to develop treatments for rare or “orphan” diseases – conditions affecting less than 200,000 people in the U.S. Thanks to longer patent protection, tax reductions, and fee waivers, the orphan drug industry has become quite profitable.

Are rare orphan diseases now becoming too common?

In the 1980s, the pharmaceutical industry received orphan drug status for about 3 or 4 products per year, with most of these drugs being either the first treatments available for the diseases in question or major improvements over prior treatments. From 1983 through 2010, the pharmaceutical industry never received approval for more than 10 orphan drugs in a given year.

To read the rest of this article, please visit Forbes.


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Good and Bad News about Physician Pay

I’ve got some good news for all of you: there’s no racial disparity in pay among female physicians. African-American physicians in the United States make just as much money as Caucasian women. Unfortunately, this good news is largely a result of dismal news – neither group of women make as much as white male physicians. And of course, sadly, African-American male physicians lag behind white men, too:

Good and Bad News about Physician PayThese results come from a study in the British Medical Journal.

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Americans Love Their Healthcare But Hate Their Healthcare System — Here’s Why


There’s lots to love about American healthcare. We have some of the best clinicians in the world, as evidenced by the huge number of people who come to the U.S. from other countries when they are sick. Yet the American people are less satisfied with their healthcare system than are citizens of the majority of other developed countries.

Why do people in the land of the Mayo Clinic and Mass General Hospital hate their healthcare system so much? In short, many Americans are upset that they cannot afford to make use of all this high quality care when they need it.

(To read the rest of this article, please visit Forbes.)

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Don’t Blame Obamacare for High Insurance Costs

Many people have warned us that Obamacare will drive up the cost of healthcare insurance, but recent evidence suggests that the problem is bigger than that. According to the Commonwealth Fund, healthcare insurance costs are rising even more quickly outside of the Obamacare exchanges than inside them:

Don't Blame Obamacare for High HC Costs


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Out Of Control Healthcare Spending

Wondering where all your spare cash is going lately? Probably to healthcare:

Out Of Control Healthcare Spending


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Do You Overeat? Blame Childhood Stress

Lots of us eat when we are stressed. But did you know that even when we are not currently under stress, the amount of food we eat might be influenced by the stress we experienced as children? That’s the conclusion Sarah Hill, a psychologist at TCU, wants us to draw from several studies she ran with colleagues from the Universities of Arizona and Minnesota. In the research, Hill brought college students into her lab and left them in front of snack food while they were taking a break between two parts of a research study. She then looked at how much food people ate during this break, as a function of whether they experienced significant financial stress as a child – e.g. whether they reported “having enough money for things growing up.” Hill also asked people how long it had been since they ate and whether they were hungry. She found that among people with more privileged backgrounds, the amount of food they ate depended largely on how hungry they were. On the other hand, for those from less lofty socioeconomic backgrounds, they ate the same amount of food regardless of their hunger, a.k.a. their “energy needs:”

Do You Overeat Blame Childhood Stress 1

In an even more convincing part of her research, she brought people to the lab after all of them had fasted.

To read the rest of this article, please visit Forbes.

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