Recently while driving to work, I was bemused (or should I say, dismayed) to pass yet another presidential campaign poster promising to “make America great,” just as I was hearing on the radio a story about the worldwide 2016 Social Progress Index, which rates the US as 19th overall on measures of social and environmental performance […]
Category: William Cayley
William Cayley: What happened? A US doctor on Brexit
What just happened? Sitting in my clinical office in rural Wisconsin, the outcome of the “Brexit” vote seems quite far away—yet the day after 23 June’s vote, the shock and surprise emanating from the news stories is almost palpable. While I can’t claim to know much about the inner workings of British domestic politics, as I’ve […]
William Cayley: Whither the communication of evidence in the social media world?
Notwithstanding the epistemological inconsistency inherent in discussions of “my evidence” vs “your evidence” (after all, if “evidence” is not about an objectively verifiable shared reality, then it’s not evidence”), I appreciate the call by Douglas Badenoch and André Tomlin to “dramatically improve the way important new evidence is communicated to the people who need it […]
William Cayley: Evidence based medicine—are we really there yet?
“People almost invariably arrive at their beliefs not on the basis of proof, but on the basis of what they find attractive.” Blaise Pascal Can we make evidence based medicine work if we don’t understand the evidence? I appreciated this week’s BMJ analysis piece by Margaret McCartney et al, which gave recommendations for ways to make […]
William Cayley: If it ain’t broke, don’t fix it
“If it ain’t broke, don’t fix it.” One commonly hears the mournful refrain that American healthcare is “broken”—whether demonstrated by reports “hospitals have been gaming the system to make their re-admission numbers look good,” the paradox that our escalating healthcare expenditures produce only average life expectancy outcomes, or (what may seem more mundane to policy […]
William Cayley: Will mid-level practitioners replace primary care physicians?
I recently asked whether, in light of the relative drop in the number of trainees entering family medicine in the US compared to other specialties, we can continue to find ways to bolster the strengths of primary care, both in medical education and practice—since we know that primary care “helps prevent illness and death.” Some […]
William Cayley: What’s in the future for US family medicine?
Once again, after waiting with bated breath, hope, and anxiety, medical students and residency programs alike have received the results of the annual residency “match.” After months of seemingly endless interviews and paperwork, and the submission of preference lists to the computer based algorithm at the National Residency Matching Program (NRMP), we finally know what […]
William Cayley: Single payer healthcare—is it here already?
Despite all the hand wringing and arguments over single payer healthcare in American social debates past and present, what most observers seem to miss (but patients and doctors know very well) is that we already have a long established single payer system of healthcare financing in the US—our healthcare is already paid for by the ubiquitous […]
William Cayley: Complexity and care
Words that sound wonderful can come back to haunt you. As a case in point, I recently responded to Elizabeth Wortley’s eloquent blog “Please refrain from using that kind of language” with the question: What if we decided to try to become “experts” in treating the difficult (patients)? That sounds great in a conversation, but those […]
William Cayley: Out with the old (and practical) and in with the new (and techie)?
Out with the old and in with the new? Improvements in the quality and portability of electronic diagnostic equipment have led to increasing discussion of late over the possible demise of the stethoscope. News outlets for the general public and for medical professionals have noted the growing debate over whether portable and handheld ultrasound, as […]