It Should Scare Us That Tuition Is A Tiny Amount Of Medical School Revenue

Medical school is expensive. Tuition for private medical schools average more than $60,000 per year. That’s tuition, folks; not tuition, room, and board. At the University of South Carolina, out-of-state tuition is more than $90,000 a year.

But don’t assume your local medical school depends on tuition dollars for its financial well-being. The contribution of tuition towards medical school revenue is a tiny fraction of what it once was.

To read the full article, please visit Forbes.

Science Isn’t Meant To Be Followed

President Trump has taken a pointedly anti-scientific approach to the Covid-19 pandemic. When he is not hiding data, gagging public health experts, or touting unproven cures, he is downplaying the toll the virus is taking on people’s lives.

In the face of such indifference to facts, it is understandable that many people, including both Republican and Democratic governors, contend that politics should stand aside while science leads us out of this mess. For instance, a pact among Eastern states promises to coordinate their pandemic response in a manner “driven by data and experts, not opinion and politics.” A pact of western states put it even more tersely, vowing that “health outcomes and science – not politics – will guide these decisions.”

Unfortunately, that belief reveals a deep misunderstanding of the proper role of science in guiding public policy-making. Science cannot lead us out of the pandemic. Whatever paths we take to navigate COVID-19 need to be chosen through political processes. The true role of science is to illuminate these pathways, guiding our policy choices by showing us what’s at stake.

As an analogy, consider the role of science in helping a person newly diagnosed with advanced cancer. As a physician who studies medical decision-making, I would never recommend this patient choose a treatment without help from medical science. But science alone doesn’t always point to an obvious choice. Perhaps one chemotherapy has a small chance of curing the cancer but a risk of serious side effects, while another, gentler chemotherapy will slow down, but not cure, the cancer. This patient faces a difficult trade-off between chance of cure and likelihood of experiencing miserable side effects. In this situation, the best choice isn’t a matter of science, but instead hinges on a value judgment: on how an individual patient weighs the pros and cons of the alternatives.

Like a patient stricken with illness, the United States needs to decide how to treat the COVID-19 pandemic, with every pathway forward confronting us with tragic trade-offs. What can science do to help us navigate these trade-offs?

To read the full article, please visit Forbes.

Smoking Cigarettes (My Circumstances Made Me Do It)

Rates of cigarette smoking have dropped substantially in the US over the past few decades. But lots of Americans still smoke, and the burden of tobacco-related illness does not fall evenly across our population. That is tragic under normal circumstances, with tobacco use leading to heart attacks, strokes, cancers, and emphysema, to name but a few relevant illnesses. In the face of the Covid-19 pandemic, it’s even more tragic, because tobacco smoking significantly increases the lethality of the virus.

So why isn’t tobacco use evenly spread across the population? In part, it’s because the more challenges a person faces in life, the more likely they are to smoke.

To read the rest of this piece, please visits my column on Forbes.

A Shameful American Fact: Enormous Racial Disparities In Death Rates From Lupus

Photo Credit: Getty

I recently came across a disturbing picture. I know that life in America is unfair. That access to medical care is uneven. That the chance of living a long life is often heavily influenced by socioeconomic disparities. But this figure still astonished me. It shows mortality for people suffering from Systemic Lupus Erythematosus, better known simply as lupus.

Lupus is systemic: it strikes practically every part of the body.

It is an autoimmune disorder: people’s own immune systems attack their vital organs.

It is chronic: people diagnosed with lupus generally require lifelong treatment with powerful and expensive immunosuppressants (medicines that dampen their immune systems).

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