Category Archives: Healthcare

Big Medicine is Putting Small Practices Out of Business

How Big Medicine is Putting Small Practices Out of Business – MedPage Today – by John Machata, MD – Apr 2019

Recently, the CEO of a large health care network stated: “Market forces don’t apply to healthcare.”

What an idiotic statement! If this were true, CEOs wouldn’t be receiving astronomical salaries while their cost-cutting leaves everyone doing the real work broke.

These CEOs manipulate their corporations to generate the maximum profit (which is actually their job) and their calculations definitely depend on market forces to raise prices by eliminating competition.  Continue reading

Numbers and Statistics still Bedevil Medicine

Go figure: In era of Big Data, numbers and statistics still bedevil medicine | Patrick Malone & Associates P.C. | DC Injury Lawyers – JDSupraSep 2019 

Big data and numbers may seem to drive the world these days, but human factors can play a dizzying role when it comes to statistics and medical treatments.

For those fascinated by numeracy in health care, writer Hannah Fry, in a readable New Yorker essay, details how medicine and patients alike have been bedeviled by attempts to quantify life-and-death decision making.

Fry shows how errors in evaluating statistics could confuse authorities investigating if Harold Shipman, a British doctor who cared for the elderly, was merely unlucky or a stone-cold killer.   Continue reading

Absurdities Arising from Indiscriminate Use of Research

Breakthrough research reveals parachutes don’t prevent death when jumping from a plane | Association of Health Care Journalistsby Tara Haelle – Feb 2019

The goal of evidence-based medicine (EBM) is to base medical care only on the best evidence: rigorous randomized controlled trials (RCTs). In general, this seems to make sense, but as an overarching objective applied to all cases, it can become absurd.

It’s been 15 years since BMJ published the most rigorous type of study there is — a systematic review of randomized controlled trials — to assess the evidence for using a parachute to prevent death and major injury when jumping from a plane.

They had to conclude, “As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomized controlled trials.”   Continue reading

Not so Inactive: Excipients in Medications

Not so Inactive: Excipients in Medications May Trigger Adverse Reactions in Some Patients – MPR – Cassandra Pardini, PharmD – Apr 2019

Despite all the strange reactions I and others have had when our pharmacy gives us a different manufacturer’s version of a familiar medicine, many medical professionals still claim that different “versions” of medication are “exactly the same”. By now, there’s evidence that this simply isn’t true.

I’ve previously posted about how generics are often not “the same” as brand name drugs, but there can also be differences between different manufacturers’ versions of the same generic drug.

For sensitive people, these differences can be critical. Continue reading

The trouble with mice as behavioral models

The trouble with mice as behavioral models for Alzheimer’s – STATBy Adam Rosenberg – Apr 2019

It is becoming increasingly obvious that rodents cannot accurately model human diseases, let alone human behaviors.

I’ve always doubted the findings of pain studies that use rodents because these animals cannot possibly model what is claimed to be a bio-psycho-social syndrome.

There’s been a lot of talk about overinvestment in interventions aimed at amyloid in the weeks since Biogen discontinued a late-stage study of aducanumab, an experimental therapy for Alzheimer’s disease. Continue reading

Moral injury and burnout in medicine

Moral injury and burnout in medicine: a year of lessons learned – STATBy WENDY DEAN and SIMON G. TALBOT – Jul 2019

When we began exploring the concept of moral injury to explain the deep distress that U.S. health care professionals feel today, it was something of a thought experiment aimed at erasing the preconceived notions of what was driving the disillusionment of so many of our colleagues in a field they had worked so hard to join.

As physicians, we suspected that the “burnout” of individual clinicians, though real and epidemic, was actually a symptom of some deeper structural dysfunction in the health care system.   Continue reading

We Have Salamander-Like Ability to Regrow Cartilage

Humans Have Salamander-Like Ability to Regrow Cartilage in JointsDuke Clinical Research Institute Oct 2019

Here’s a promising development for one of the scourges of aging, osteoarthritis. Additionally, with EDS cartilage can be defective and deteriorate faster than the norm, so this could be very good news.

“Once cartilage is gone, it’s gone for good and there’s no replacement that we know of,” Luk said.

However…

Contrary to popular belief, cartilage in human joints can repair itself through a process similar to that used by creatures such as salamanders and zebrafish to regenerate limbs, researchers at Duke Health found.   Continue reading

Moral Failure And Health Costs

Moral Failure And Health Costs: Two Simplistic Spending NarrativesJeff C. Goldsmith – Oct 2015

This article brings up interesting ideas about the interrelated (and dysfunctional) pieces of the American healthcare system, but I can sum up the crux of the situation easily.

The medical care of our society has been taken over by corporate conglomerates which, by definition, are exclusively designed to create profits for their shareholders.

What to do about the seemingly inexorable rise in health spending has been the central health policy challenge for two generations of health economists and policymakers.    Continue reading

The Tyranny of the Randomized Controlled Trial

Should we beware the tyranny of the randomized controlled trial? | Association of Health Care Journalistsby Tara Haelle (@TaraHaelle) – Jan 2017

The intersection of scientific research, evidence and expertise can be a dicey one, particularly in an age in which evidence-based medicine is replacing the clinical expertise of practitioners.

In The New York Times Sunday Review, Jamie Holmes wrote about how the challenge of assessing the quality of evidence against expertise and less stringently conducted research can lead readers to confusion and frustration.

It can lead to a further distrust of science, Holmes suggested, noting the example of dental flossing in the wake of an Associated Press story that questioned the evidence in favor of the practice.    Continue reading