“Two innovations — Ethyl and Freon, conjured by one man [Thomas Midgley Jr.] presiding over a single laboratory during a span of roughly 10 years. Combined, the two products generated billions of dollars in revenue for the companies that manufactured them and provided countless ordinary consumers with new technology that improved the quality of their lives. In the case of Freon, the gas enabled another technology (refrigeration) that offered meaningful improvements to consumers in the form of food safety. And yet each product, in the end, turned out to be dangerous on an almost unimaginable scale. The history of any major … Read More
The New England Journal of Medicine’s Lisa Rosenbaum speaks with University of Pennsylvania’s internal medicine physicians Paula Chatterjee (also a health services researcher) and Atheen Venkataramani (also a health economist and founder of Penn’s Opportunity for Health lab) about the role of values in health care, social determinants of health and what physicians can do to improve U.S. health care. An excerpt of the audio interview: [Rosenbaum] Atheen, I know that you also had a formative experience, I think when you were a resident at MGH. Can you talk a little bit about that and how that experience informed your … Read More
Excerpt – The U.S. approach to data sharing stands in stark contrast with standards now in place in other parts of the world, including Europe’s General Data Protection Regulation (GDPR). More importantly, it goes against what people say they want, which is to freely share their data for scientific or research purposes that help others, but also to share in the upside when their data are highly valuable, such as when they help lead to the discovery of a multibillion-dollar drug. [..] But unlike money, no global infrastructure exists to govern, manage, and watch data transactions, and no collective institutions exist to … Read More
“Roughly one in five American adults has a mental illness. An estimated one in twenty has what’s considered a serious mental illness—major depression, bipolar disorder, schizophrenia—that profoundly impairs the ability to live, work, or relate to others. Decades-old drugs such as Prozac and Xanax, once billed as revolutionary antidotes to depression and anxiety, have proved less effective than many had hoped; care remains fragmented, belated, and inadequate; and the over-all burden of mental illness in the U.S., as measured by years lost to disability, seems to have increased. Suicide rates have fallen around the world since the nineteen-nineties, but in … Read More
“In 2021, I interviewed Ted Chiang, one of the great living sci-fi writers. Something he said to me then keeps coming to mind now. “I tend to think that most fears about A.I. are best understood as fears about capitalism,” Chiang told me. “And I think that this is actually true of most fears of technology, too. Most of our fears or anxieties about technology are best understood as fears or anxiety about how capitalism will use technology against us. And technology and capitalism have been so closely intertwined that it’s hard to distinguish the two.” [..] We are talking so much … Read More
Lessons in longevity from Seventh-day Adventists Excerpt – “Seventh-day Adventists believe God made the body as a temple to hold the soul,” says Hans Diehl, a best-selling author on health and nutrition, and a lifelong Adventist. [..] “We believe that taking care of the body is proper. It’s honouring God,” he says. Devout followers eat mostly plants—vegetables, fruits, nuts, legumes and whole grains. Some eat animal products, but most do so sparingly. [..] One Seventh-day Adventist community, Loma Linda, California, has been dubbed a “Blue Zone”—an area of the world with a large share of centenarians—by two researchers, Michel Poulain … Read More
“The PHQ-9 became a means for time-crunched primary care doctors, under pressure to see more and more patients in shorter appointments, to dole out prescriptions with barely a conversation. Despite its prevalence, data suggesting that PHQ-9 has actually improved outcomes is ambiguous at best. Meanwhile, mental health outcomes for patients are dismal and only getting worse, with depressive symptoms and suicide climbing ever higher. A combination of good intentions and straightforward business savvy lies behind the PHQ-9. Pfizer invested hundreds of thousands of dollars in its development [..]. The company naturally hoped its investment would pay off with increased Zoloft … Read More
“The high cost of health insurance and health care services now affects not only the uninsured but also middle-class Americans with employment-based health insurance (ESI), enrollees in the Affordable Care Act exchanges, and Medicare beneficiaries. A popular concept in health policy discussions is the “iron triangle”: here, here, here, here, and here. These authors posit that it is impossible to increase access and quality of care while simultaneously reducing spending. That idea warrants further scrutiny. [..] evidence suggests that failure to improve affordability is primarily due not to a mathematical “iron triangle” constraint, but an “iron curtain” of stakeholders who are aware of promising alternatives but oppose their … Read More
I have been framing the future of health care as diagnosis through face-to-face interactions for making a diagnosis (and getting the patient to buy-in to the treatment plan) and ongoing maintenance or surveillance using telemedicine with supporting technologies. This article has forced me to reconsider how we might deploy artificial intelligence to support patients and clinicians during the triage and diagnosis stages of a medical journey. “Symptom checkers serve two main functions: they facilitate self-diagnosis and assist with self-triage. They typically provide the user with a list of potential diagnoses and a recommendation of how quickly they should seek care, … Read More
“The twenty-two-member council is a nonpartisan, multidisciplinary expert working group under the leadership of cochairs William Frist [former US Senate majority leader] and Margaret Hamburg [former commissioner of the Food and Drug Administration]. This report contains the council’s recommendations. [..] The goal of the recommendations in this report is to achieve higher-value health care spending and growth in the US. The mechanism for achieving this goal involves four levers: The council examined literature and received input from experts in its inquiry into drivers of spending and growth that met the following criteria: a meaningful amount of money is potentially at … Read More