The Question Isn't Whether We Are Overdiagnosing Cancer, But How Much

Medical experts now agree that as a result of aggressive screening programs, we have an epidemic of cancer overdiagnosis in the United States. With mammograms finding tiny cancers and PSA tests discovering unpalpable prostate cancers, we are now unearthing some cancers too early for our own good. What do experts mean by “overdiagnosis,” you ask? […]

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If You Look for Cancer, You'll Find It

What would you like first: the good news or the bad news? Let me start with the bad. Life expectancy among patients in the U.S. with thyroid cancer lags behind that in Korea. In fact, the vast majority of patients diagnosed with thyroid cancer in Korea are cured of that illness, a statement I can’t […]

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Millions To Be Made On…Generic Drugs?

It is well accepted among health economics wonks that the lion’s share of pharmaceutical company profits come when these companies hold exclusive rights to their products. Once their blockbuster pills go “generic,” competitors enter the marketplace and profits plummet. Consider captopril, a groundbreaking heart failure medication introduced in the early 80s by Bristol-Myers Squibb under […]

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The Hidden Psychology of Antibiotic Prescribing

Experts in decision psychology and behavioral economics have conclusively shown that humans, those silly creatures, are not always rational decision makers. They let unconscious forces influence their thinking, and not always for the better. But of course, doctors aren’t human. Right? Well, here is some evidence of just how human we doctors are. The odds […]

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Podcast on the Challenge of De-adoption

Here is a podcast I participated in, put out by folks at GWU. A quickish interview on the challenge of getting doctors to stop doing things they ought to stop doing. You can also listen to it on iTunes, or on Stitcher.

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The High Price of Affordable Medicine

In the old days, blockbuster drugs were moderately expensive pills taken by hundreds of thousands of patients. Think blood pressure, cholesterol and diabetes pills. But today, many blockbusters are designed to target much less common diseases, illnesses like multiple sclerosis and rheumatoid arthritis or even specific subcategories of cancer. These medications have become blockbusters not […]

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The Lost Art Of Not Ordering A CAT Scan

She didn’t talk like a stroke victim. “I…I…I…k…kkk…can…can…can’t…t…t…t…talk.” She struggled with her words, struggling on early syllables, only to then spurt out full and correct words. “N…N…N…No.” Recognizing this unusual speech pattern, the neurologist Allan Ropper, author of Reaching Down the Rabbit Hole, expertly queried the patient and her loved ones, and determined she had […]

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