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: US healthcare
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 […]
Shelby Quast: Is cosmetic labiaplasty in adolescents just FGM under a different name?
Labiaplasty in girls younger than 18 has become increasingly popular in the US in recent years. According to the American Society for Aesthetic Plastic Surgery, the number of girls aged 18 and younger having cosmetic genital surgery increased by 80% between 2014 and 2015 (from 222 girls in 2014 to 400 girls in 2015). While some surgeries […]
Shared appointments: Medical utopia or dystopia?
In simple supply and demand terms, there are now more people living with chronic disease than there are doctors and other professionals around to help them. So how can the practice of medicine respond to this particular challenge? Here in the United States, there is growing interest in exploring the potential value of shared medical […]
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 […]
Jeanne Lenzer: The Backstory—Is US healthcare a frontier for a new civil rights movement?
When the Lown Institute first signaled its plan to build a “movement” four years ago, it seemed to be an unlikely group to succeed. The founding conference was attended largely by academic doctors—and no matter how concerned doctors are about what is happening to healthcare, movements are only successful when driven by the people who […]
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 […]
Suzanne Gordon: The future of the Veteran’s Health Administration
By the end of this year, the US will have a new president as well some new members of Congress. The results of the 2016 election will not only effect the further implementation of the Affordable Care Act (Obamacare), but the future of the country’s largest healthcare system—the Veteran’s Health Administration. That’s because most of […]
Jeanne Lenzer: The Backstory—How I got the Cuba HIV story wrong
I recently reported on the World Health Organization’s announcement that Cuba was the first country in the world to halt mother-to-child transmission of HIV, an accomplishment praised by WHO’s director-general, Margaret Chan, as “one of the greatest public health achievements possible.” As I sat in the semi-circle of doctors who treat pregnant women in Matanzas, […]