Your (500) Physician(s) Will See You Now

The day of solo practitioners is coming to an end . In its place will be gaggles of gastroenterologists and flocks of physicians. Mega practices are becoming the norm in American medical care.

Here’s a few pictures of this trend, somewhat dated (they only go through 2015) but still quite revealing.

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

Mirror, Mirror, On The Wall, Who’s The Happiest Cancer Patient Of All?

It is not a mirror you can easily use when trimming your beard or flossing your teeth. Because if you face it and aren’t smiling, this is what you see:

Nothing but an opaque, glass surface. That’s because the mirror, designed by Berk Ilhan, only becomes reflective when the person facing it smiles:

Ilhan designed this mirror for cancer patients, hoping it would encourage them to smile and, therefore, make them feel happier. There’s no randomized control data on its effectiveness yet. But it’s possibly a brilliant way of making people with cancer—heck, maybe all of us—smile a little more.

Would Jesus’ Politics Be More Like Trump’s Or Nancy Pelosi’s?

To my liberal friends, Donald Trump’s polices are a moral abomination (not to mention, his own personal behavior which, of course, I just mentioned). To my conservative friends, Donald Trump and his policies are, quite literally, a godsend (as the press secretary made clear). Flip the topic to Nancy Pelosi, and you’ll find a similar divide. It is hard to distinguish what we think of her policies from our views of the morality of her liberal ideology.

These differences in moral attitudes lead to maddening conversations when people from opposite sides of the political spectrum find themselves debating politics. Would those disputes be more productive if we all took a step back and asked what God thinks of these policies? Sadly, no, as shown by a profound study led by one of my academic heroes, Lee Ross from Stanford University.

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

Shameful Nation

Want to go bankrupt from medical bills? You should move to the United States, where that fate is WAY more possible than in other wealthy countries:


Medicaid Reform Ain’t Easy

All the Republican health care bills that have so far failed to pass through Congress have tried to reduce Medicaid spending, by limiting the amount of federal money going to states to cover this population. That might be popular among some conservative voters, who think Medicaid is a handout to healthy but lazy young people who don’t want to work. It would be hard for that to be more wrong. The majority of Medicaid spending goes to elderly and disabled people:

When your mother develops Alzheimer’s, and can’t afford a nursing home, it is usually Medicaid that picks up the tab. When your neighbor experiences a traumatic brain injury and can no longer work, it is Medicaid that pays his healthcare expenses.
Cut Medicaid, and it is these people who will suffer.

Doctors Without Appointments

Jill Ladkin was already having a terrible autumn. It began with a seizure that put her in the hospital with what seemed like scores of unfamiliar physicians attending to her state of health. The brain scan revealed a mass in the lining of her brain, a location usually signifying a benign tumor; but, given her seizure, the tumor was hardly what you would call a harmless growth. The surgeon had a theory of what was going on; the neurologist had a different theory. The resident, a trainee, was not even convinced that Ladkin’s seizure was a consequence of the tumor. But Ladkin’s primary care physician soon clarified the situation, telling the resident to stop speculating about some non-tumor potentially causing her seizures. “Occam’s razor,” he said, reminding the resident to never look for a second diagnosis when one diagnosis suffices. “She has a f#@$%’g brain tumor.”

That is the kind of doctor he was. Her primary care physician did not content himself with only her primary care needs, like checking her cholesterol and making sure she got her annual flu shot. Nor did he defer to specialists when she got seriously ill. Instead, he got right down into the thick of the details. There in the hospital, he settled by Ladkin’s side and helped her figure out what to do about her tumor. He looked over her scans, pulling up medical articles about seizure-causing meningiomas. Ladkin was used to such attention; he had been her primary care doctor for 15 years, never once making her feel like he did not have all day to address her needs. They debated the pros and cons of her treatment alternatives and settled on a course of therapy – surgery followed by radiation. He said he would follow up with her in his clinic, once she had recovered from the surgery.

That is when Ladkin’s autumn got even worse. After she left the hospital, she called into the office to confirm a follow-up appointment with her primary care doctor and learned that he no longer worked at that office. He disappeared, retiring from medical practice for reasons Ladkin never discovered.
(To read the rest of the article, please visit Forbes).

Great Coverage of Our Calorie Count Research

Cass Sunstein just posted a really nice write-up of the calorie count research I was lucky enough to conduct with Steven Dallas (now a law student at Duke) and Peggy Liu (a marketing Professor at University of Pittsburgh).  Thought I’d give you a flavor of the write-up:

A provision of the Affordable Care Act that is strongly supported by Donald Trump’s administration requires calorie labels at U.S. chain restaurants. The basic idea is that if consumers are informed, they will reduce their calorie consumption — and improve their health.

Unfortunately, it isn’t clear that calorie labels are doing much good. Some studies find that consumers are not influenced by them. They eat what they like, and they don’t care about calories. While other studies do find a real impact on people’s behavior, specialists question whether and to what extent the labels are promoting healthier eating.

New research finds that a small and simple fix might make a big difference: Put the calorie labels on the left side of menu items, rather than the right. That’s an intriguing finding, because it has implications for design choices by the private and public sectors in countless domains.

To read the rest of this piece, please visit Bloomberg.

Come Work With Us!

Our Medical Decision Making Research Group is looking for an Associate in Research to join our team.
Please see the job description below and the link to apply.
The Associate in Research (RA) will support investigators on multiple research projects related to patient decision making and health communication. The RA will contribute to the research process in both operational and scientific ways. In particular, the RA will help design studies; pilot test studies; gather and compile research data; visit local retailers for the conduct of experiments; perform data entry; do preliminary data cleaning and analyses; draft, proofread, and edit research documents, including manuscript sections, presentations, and reports; maintain a reference library in EndNote; and facilitate the human subjects (IRB) approval process by preparing and submitting accurate documents in a timely fashion, in accordance with all regulations. This position will also support project investigators by conducting literature searches and doing other tasks for the creation and submission of project-related reports and manuscripts. Most importantly, the duties and responsibilities of the position will grow in accordance with the interests and talents of the RA. We want this job to be fun and challenging!

If You Want to Avoid a C-Section Choose Your Hospital Wisely

photocredit: Getty

We have an epidemic of C-sections in the US, now accounting for almost 1 in 3 births. That represents a 50% increase since the mid-90s, despite all the advances we’ve seen in obstetrical care.
Sometimes C-sections are critical to saving the life of either baby or mother. But C-sections are major surgical procedures, with commensurate risks. They are also 30% more expensive than vaginal deliveries.
(To read the rest of this article, please visit Forbes.)