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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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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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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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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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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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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A quick quiz before we start today’s lesson. What do we call a tree that grows from acorns? What do we call a funny story? What sound does a frog make? What is another word for a cape? What do we call the white part of an egg? On that last question, were you tempted […]
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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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I joined two other, much smarter, colleagues in calling for the use of behavioral economics and decision psychology to improve the design of the websites people use to purchase health insurance in the U.S. That article came out today in the New England Journal of Medicine. Here is a taste: In October 2013, the Affordable […]
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In a recent Health Affairs article, David Asch and I wrote about how hard it can be to stop screening aggressively for things like breast and prostate cancer even when the evidence suggests we are doing more harm than good. Well, journalist Steven Petrow has a nice piece in the Washington Post looking at the […]
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