Brief Essays
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This Is What Happens When Medicare Minions Micromanage Microorganisms
Sepsis is a brutal killer. It often starts after a microorganism gets loose in your bloodstream, spreading to organs far and wide, releasing deadly toxins along the way. In response, your body releases toxins of its own, chemicals designed to kill the invading organism but that, all too often, damage your body, too, leaving you…
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Breast Cancer Chemotherapy – Here Is What Happened When Outrageous Prices Met The Free Market
Nine to twelve years. That’s about how long most drug companies have to make serious money on new products before their patent protection ends. Then, generic companies enter the fray and prices, typically, plummet. Yet, two decades after coming to market, Herceptin (a drug used to treat breast and stomach cancer) was still priced at…
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Two And A Half Decades Later, OxyContin Marketing Is Still Deadly
Purdue Pharma launched OxyContin in 1996, and soon began an aggressive marketing campaign for this powerful and addictive drug. The campaign is over, but its effects are still deadly. How do we know this? Because Purdue’s marketing wasn’t sprinkled evenly around the country. Instead, Purdue rolled out its campaign in different markets at different times…
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The Verdict Is In—Price Gouging Harms People With Gout
The patient arrived in my clinic, their right big toe the color of a spring strawberry. The lightest touch caused exquisite pain. Fortunately, I was able to prescribe a pill (an ancient medicine, actually) and the patient was better by the next day. Too bad that simple treatment is becoming unaffordable, through a maddening combination…
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Peak Pandemic–Guess What Was Killing More Young Americans Than Covid-19
Covid-19 killed approximately 60,000 young Americans between 15 and 54 years old in 2021. By any measure, that is an awful statistic, representing a staggering number of loved ones lost to the virus. But as awful as that statistic is, guess what killed even more young Americans.
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The Crushing Cost Of Tracking Healthcare Quality—One Hospital’s Story
A whole industry is devoted to measuring, tracking and even incentivizing the quality of American hospital care. Unfortunately, that industry is horribly inefficient, costing us billions of dollars. Quality measurement is inefficient in large part because there is no single source that hospitals (and provider systems, more generally) can use to track the quality of…
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Preventing Diabetes – What Medicare Administrators Could Learn From Shark Tank
The Medicare Diabetes Prevention Program is a lifesaver. Consisting of of at least 16 class sessions that provide practical training about healthy eating, physical activity, and other strategies for weight control, the Program reduces the chance that people at high risk for diabetes actually develop that life-threatening condition. However, the Program is floundering, with distressingly…
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Drugs Are Outrageously Expensive—Canada Found A Way To Fight Back
Latuda is a drug to treat schizophrenia. It costs about $4,000 per month in the U.S. In Canada, the price is closer to $500. Ibrance, a breast cancer drug, costs $10,000 more per month in the U.S. than in Canada. Why these enormous price differences?
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Getting What You Want At The End Of Life – Lessons From A Dying Man
Many people die in ways, and even in locations, that go against their preferences. They don’t want to be put on ventilators and, yet, spend their last days in intensive care units tethered to breathing machines. They don’t want cardiopulmonary resuscitation (CPR), and, yet, receive full-on “codes” when their hearts stop. Much of this unwanted…
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Spend Too Much On Your Medications? Help Is On The Way
How is a physician supposed to know which medicine is most affordable under which insurance plan? Fortunately, there are tools coming into use designed to help clinicians figure out patient-specific costs of any medication they prescribe. The tools (jargon alert!) are called RTBTs, for real-time benefit tools.
Here are some things, other than books and blog posts, that I wrote with a general audience in mind:
- “The Ulysses Strategy” – The New Yorker
- “Your New Liver Is Only a Learjet Away” – Forbes
- “How to Tell Someone That She Is Dying” – The New Yorker
- “A Simple Tweak Makes Calorie Labeling More Effective” – The Washington Post
- “Doctor, First Tell Me What It Costs” – The New York Times
- “Economics Behaving Badly” – The New York Times
- “How many calories are in my burrito? Improving consumers’ understanding of energy (calorie) range information” – Public Health Nutrition
- “Rant: Shared Decision Making in Medicine” – Psychology Today Magazine
- “CASES: A Fine Line Between Ask and Tell” – The New York Times
- “CASES: When Bad Advice Is the Best Advice” – The New York Times
- “DOCTOR FILES: When the Unknown Is Not So Bad” – Los Angeles Times
- “Dose Response” – The Sciences
- “eBay and the Brain: What Psychology Teaches Us about the Economic Downturn” – Scientific American
- “Animal Madness” – Worth
And here are some non-technical “academic” articles:
- “Healthcare.gov 3.0 — Behavioral Economics and Insurance Exchanges” – The New England Journal of Medicine
- “Why It’s Not Time for Health Care Rationing” – Hastings Center Report
- “Promoting Population Health through Financial Stewardship” – The New England Journal of Medicine
- “Full Disclosure — Out-of-Pocket Costs as Side Effects” – The New England Journal of Medicine
- “Sleepless in the hospital: Our own default” – ACP Hospitalist
- “Better Off Not Knowing” – Archives of Internal Medicine
- “Contracts With Patients in Clinical Practice” – The Lancet
- “Beyond Costs and Benefits” – The Oncologist
- “What Should I Do, Doc?” – Archives of Internal Medicine
- “Rationing By Any Other Name” – The New England Journal of Medicine
- “Doctor Talk: Technology and Modern Conversation” – The American Journal of Medicine
- “Is Information Always A Good Thing?” – Medical Care
- “Misimagining the Unimaginable” – Health Psychology
- “Beyond Comprehension”
If you’re interested in a complete list of my academic research, access a PDF of my CV here.