All eyes are on the tiny South American nation of Uruguay this week following its historic approval for the world’s first nationally controlled marijuana market. While the plan still needs to pass the Senate, there may be cause for optimism that the country of 3.4 million can make it work. The Uruguayan government, after […]
Category: US healthcare
Michael Barry: Aligning incentives to support shared decision making in the United States
Shared decision making (SDM) between clinicians and patients is riding high in clinical and health policy circles in the United States. SDM is featured in several sections of the Affordable Care Act, and has been included as an element in the Accountable Care Organizations and the Comprehensive Primary Care Initiative, supported by the Center for […]
Jane Parry: Why are we so resistant to calling sugar the enemy?
Sparing developing countries the fate of obesity associated diseases that plague the developed world is currently one of the most pressing global public health issues. Before we export wholesale the “follow the food pyramid, exercise, and eat no more calories than you burn” approach, it may be time to review how effective it actually is. […]
William Cayley: Continuity—in and out of hospital in the US
We’re seeing a resurgence in primary care in the US—or are we? In a recent post, Domhnall MacAuley comments on the way primary care seems to have “emerged from the shadows as central to the development of universal and sustainable healthcare in the US.” While the resurgence of primary care seems to get much press, […]
Jen Gunter: The great Kate wait is a lesson for maternal health providers and pregnant women alike
The press and much of the world, or so it seems, has been on edge waiting for the Duchess of Cambridge to go into labor and finally that day has arrived. The historic event spawned a flurry of articles, some very concerned that the Duchess was post dates. Reporters have been camped out for weeks […]
Krishna Chinthapalli: The birth and death of the Liverpool Care Pathway
Birth of the pathway A few miles west of Mont Blanc, eighty years ago, Marie Curie arrived at a sanatorium in the foothills of the Alps to spend her final days. But they were not pleasant: “At times [her daughter] had to leave the room, because she could not bear to see her mother in […]
Richard Smith: Race relations in Florida
Those of us outside the US think of holidays, sun, Disney, and orange juice when we think of Florida. We don’t even think of it as part of the slavery, blues, and cotton South, and so I was shocked to read in the magnificent, Pulitzer prize winning book, Devil in the Grove: Thurgood Marshall, the […]
Deon Louw: The doctor, the environmentalist, and the gospel of sustainable healthcare
Let’s be honest. Lester Brown sounds like the name of a musician from the Deep South. In fact, Brown is an acclaimed scientist and I had the pleasure of attending one of his lectures. He has 25 honorary degrees and has published more than 50 books on how human systems (e.g. food systems) react to […]
Ashley Graham Kennedy: Do medical titles harm the physician patient relationship?
It was 4 am in the emergency department (ER). An 83 year old woman had come into the ER after experiencing an episode of disorientation and shortness of breath earlier in the evening. The resident physician and I entered her room and he introduced himself to the patient. “Hello Ms Stanley, I’m Dr James.* I […]
Richard Smith: Is the New England Journal of Medicine anti-science?
About once a year a furious researcher writes to me complaining that the New England Journal of Medicine won’t publish a letter that strongly criticises, even demolishes, an article the journal has published. They write to me out of frustration, not because I have any influence over the Bostonian paragon, but because I’ve dared to […]