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A Call for Cost Transparency Print E-mail
Written by FHI's Week in Review   
Monday, 23 April 2018 16:33

Mukul Mehra, MD, in an April 20, 2018 KevinMD post, insists doctors need and want cost transparency. "Physicians are the building blocks of value-based care, yet the cumulative human and financial costs of our decisions are mostly hidden from us," he states.

Read more in the current issue of Week in Review>> https://conta.cc/2FaVKGq

Last Updated on Monday, 21 May 2018 17:27
 
Why I Now Treat Hepatitis C Patients Print E-mail
Written by MD Whistleblower   
Tuesday, 17 April 2018 18:29

In a prior post, I shared my heretofore reluctance to prescribe medications to my Hepatitis C (HCV) patients. In summary, after consideration of the risks and benefits of the available options, I could not persuade myself - or my patients - to pull the trigger. These patients were made aware of my conservative philosophy of medical practice. I offered every one of them an opportunity to consult with another specialist who had a different view on the value of HCV treatment.

I do believe that there is a medical industrial complex that is flowing across the country like hot steaming lava. While I have evolved in many ways professionally over the years, I have remained steadfast that less medical care generally results in better outcomes. 

There was an astonishing development in HCV treatment that caused me to reevaluate my calculus.

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Last Updated on Tuesday, 17 April 2018 18:31
 
Take 2 Broccoli and Call Me in the Morning Print E-mail
Written by The Fit Physician via KevinMD   
Friday, 13 April 2018 16:09

We live in a pill-popping society. The first line treatment for many of the medical problems that walk through our doors is a medication. Have heartburn?  Forget about avoiding the foods that cause your symptoms - just take a pill.  New diagnosis of diabetes?  We give lip service to lifestyle modifications and then start patients on Metformin. Hypertension? Diuretics, ACE inhibitors, ARBs, beta blockers - take your pick, and I guess make the obligatory mention of weight loss.

I fully realize that there is a time and a place for medication. There are varied medical problems that can only be treated with medication, and there have been many life-changing discoveries on the pharmaceutical front. Heck, humanity owes a large part of our prolonged life expectancy to pills that we pop to treat chronic disease. I am not here to poo-poo taking pills.

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Sure, cancer mutates, but it has other ways to resist treatment Print E-mail
Written by Fabian V. Filipp | The Conversation   
Tuesday, 10 April 2018 16:35

Because of advances in drug design and precision medicine, researchers have been able to target certain molecules within a cell at the root of a particular disease and to develop specific therapies to undo their damages. Today, precision targeting combines therapy decisions with molecular insights to offer hope after a life-changing cancer diagnosis.

But there's a dark side to cancer-killing drugs designed to match distinct cancer mutations like a key into a lock. Some cancers that initially respond to targeted chemotherapy become treatment-resistant - and the drug itself may not be the culprit.

New research helps explain how therapy-resistant cancers arise, findings with important implications for the future of cancer therapy. It shows how hidden, subtle layers of regulation - epigenetics - control the activity of genes to produce drug-resistant surviving cells.

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Last Updated on Thursday, 10 May 2018 09:36
 
Sink the Two Canoe Argument Print E-mail
Written by Gary Kaplan, MD & C. Craig Blackmore, MD | NEJM   
Thursday, 29 March 2018 00:00

Physicians have defended the status quo in healthcare based on the fear of straddling both fee-for-service and value-based payment models. Two executives at Virginia Mason Health Care System believe that strategy is no longer valid.

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Last Updated on Friday, 30 March 2018 16:33
 
How to incentivize higher quality and lower cost in U.S. medical care Print E-mail
Written by Samuel Falkson | KevinMD   
Thursday, 01 March 2018 00:00

U.S. health care costs are high - over $3 trillion annually and about 18 percent of our GDP. Estimates suggest that our costs are rising. Concomitantly, we are entering an era of extreme biomedical promise, where research breakthroughs are translating into unprecedented clinical benefit. Luxturna from Spark Therapeutics, for example, remarkably restores vision loss in patients with a specific eye disease. With amazing innovations, however, come high price tags. At $850,000 per treatment, Luxturna carries the highest price for any medication in U.S. history. The introduction of expensive miracle treatments raises questions about how to pay for such therapies. Our health care system is already financially burdened, yet it seems unfathomable to restrict a sick person's access to breakthrough cures for fiscal reasons. How do we create a health care system that keeps pace with technological innovations?

Last Updated on Friday, 02 March 2018 16:38
 
5 things America can do today to reduce gun deaths Print E-mail
Written by Megan L. Ranney, MD, MPH | KevinMD   
Tuesday, 20 February 2018 18:50

Our country has had yet another school shooting. Seventeen more kids are dead, despite multiple warnings that the perpetrator was high risk. No one wanted this to happen. Across the political spectrum, Americans are appropriately asking what they can do to prevent another shooting. Yesterday many asked for a day to mourn. They said, "tomorrow we take action." Today is tomorrow. My liberal friends are calling to "ban all guns." My conservative friends are calling to "arm all teachers." Neither of these proposals is viable, and neither is likely to be effective. There are, however, things that we can all do now to reduce gun deaths... 

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Last Updated on Tuesday, 20 February 2018 18:56
 
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