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Diabetes and Other Screenings

0
April 20, 2015

The best primary care-based research comes out of Europe, where countries have medical research budgets that actually fund primary care research. The U.S. has no equivalent funder. Therefore, American family physicians must often look overseas for answers to their daily clinical questions. Does screening for diabetes make any difference? A recent study funded by the...
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Fee for Service Brain Freeze

3
April 1, 2015

A lot of healthcare system pundits including the current leadership of the American Academy of Family Physicians feels that fee-for-service payment is the root of all healthcare waste. Obviously, I disagree. Their line of thinking is based on the existing evidence that there are too many joint replacements, cardiac stents, cardiac tests, etc., because...
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A Different View on the Value of Statins

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March 25, 2015

Do you like to take pills? I don’t. I bet most family physicians would say they have some patients who should be better at taking pills and some who love taking pills too much. For people who don’t like taking pills, what would a trade-off look like? If you were given the option of...
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Treating Hypertension is Nearly Useless

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March 8, 2015

A study was recently published in the New England Journal of Medicine about the cost-effectiveness of treating hypertension based on the most recent JNC 8 guidelines. This study particularly caught my eye, because previous cost-effectiveness analyses found that screening and treating for hypertension did not save money. The upfront costs of the doctors’ visits,...
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Heart Association Scare Tactics Revealed

1
March 1, 2015

patients The American Heart Association (AHA) recently proposed new guidelines for all doctors to screen and treat for high cholesterol. For doctors and patients to follow this would result in a large increase in the number of Americans taking statins. One of the things I like about the new proposal is that there is no...
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More Exaggerations of the Benefits of Screening

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February 18, 2015

Recent news stories touted a 22% drop in cancer death rates that has “spared the lives” of over 1.5 million people over the past two decades. The American Cancer Society (ACS) was attributed as explaining this drop as caused by U.S. smoking habits, extra attention to cancer prevention, improvements in various cancer treatments, and...
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Harvard Professors are Beginning to Feel the True Cost of Healthcare

2
February 2, 2015

I love opportunities for a good snarky belly laugh. I got one recently. A report in the New York Times by Robert Pear talks about how several key Harvard faculty have, for years, advocated for national healthcare reforms that turned into Obamacare. As a result (among many other issues that the U.S. refuses to...
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Bad Family Medicine

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January 25, 2015

As much as I have given the ologists and other members of the dysfunctional U.S. healthcare system a hard time in previous posts, it’s only fair that I call out bad family medicine as well. I have a great example. I recently saw patient who is relatively new to the area who had seen...
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Higher and Higher Deductibles

1
January 11, 2015

A recent report in USA Today disclosed the range of deductibles in the silver health insurance plans under the federal exchange of Obamacare. The authors concluded that in regions with less competition, the costs were higher. Families that make more than 250% of the federal poverty level — about $60,000 for a family of...
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Rare Humility by the News Media on Cancer

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January 8, 2015

A lot of media outlets reported a story from the journal Science that found that the majority of cancers are not the result of environmental toxins or inherited genetic defects, but are caused by totally random mutations in cells that divide rapidly and often. Good for them. The U.S. media so often uses phrases...
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