Adam Grant interviewed Harvard psychologist Dan Gilbert. An excerpt: “[Grant] here’s so many demonstrations of these affective forecasting failures. If you were to choose your top three, what are your favorites? [Gilbert] [..] Certainly one of the mistakes that’s caught my attention the most is our inability to imagine adaptation. My friend Danny Kahneman used to say, when you ask somebody how they would feel if they were blind, they imagine going blind. But the day you lose your eyesight, probably a very, very bad day. But it’s not like all the hundreds and thousands of days that will follow, … Read More
All posts by Anupam
“Many countries and 10 U.S. states allow voluntary assisted dying for those who are terminally ill. In some jurisdictions, assistance is also permitted for those who have an incurable condition that causes them unbearable suffering. But allowing relatively healthy people to end their lives because they see their lives as completed is more controversial. Professor Kahneman traveled to Switzerland because it allows competent adults with a firm wish to die to legally receive assistance in dying, whether or not they are residents. [..] “Other people happen to respect it [Kahneman’s work] and say that this is for the benefit of … Read More
“On April 5, 2021, a landmark change in health care occurred: the 21st Century Cures Act, known as the Cures Rule, took effect, requiring clinicians to give patients real-time access to their health data via patient portals. This was intended to empower patients by granting access to their medical information, enabling them to take an active role in their care, and ultimately improving health outcomes. However, as with many policy changes, the reality has proven more complicated. While the shift aimed to democratize health care information, its consequences—both for patients and clinicians—are more nuanced than anticipated. The promise of transparency … Read More
“Ruane and colleagues1 address a pressing and timely issue: the intersection of olfactory impairment (OI) and aging-related outcomes. [..] The growth in the prevalence of older adults brings substantial societal, economic, and public health implications, making the detection and prevention of risks in this group essential. Olfaction appears to be a unique canary in the coal mine. [..] At 6 years, dementia emerged as the predominant mediator, accounting for 23% of the OI-mortality association, followed by frailty at 11% and malnutrition at 5%. By 12 years, however, the influence of dementia and malnutrition waned, leaving frailty as the sole significant … Read More
“Nearly 1 in 7 working-age US adults had experienced long COVID by late 2023, and socially disadvantaged adults were over 150% more likely to have persistent symptoms, two new studies find. [..] [First study] An age- and sex-adjusted model of 2022 data from 154,430 participants estimated that those vaccinated against COVID-19 had a 14% lower risk of protracted symptoms than their unvaccinated peers, but a fully adjusted model found no difference in risk. In comparison, a fully adjusted model of 2023 data from 220,664 respondents found a higher risk of long COVID among the vaccinated than the unvaccinated. Risk factors … Read More
“Primary care doctors now spend, on average, two hours a day filling out patients’ electronic health records. From 2009 to 2018, EHR length has increased by 60 percent. And yet most of this work is simply documentation, not problem-solving or reasoning. Why take doctors away from their patients or hire other teams of humans, like medical scribes, to transcribe and enter all this data, when AI can now do it instead? [..] they listen in on the conversation between a patient and physician, create a transcript, then organize the information from the transcript into the standard format doctors use, generating … Read More
From an editorial commenting on a recent prostate cancer screening trial using polygenic risk scoring to stratify patients: “After decades of undergoing epidemiologic study, prostate cancer remains an enigmatic disease; the only established risk factors are older age, family history of prostate cancer, and African ancestry (apart from uncommon cases among men with variants in the genes associated with hereditary breast cancer and the Lynch syndrome). Of interest, then, is a study of a polygenic risk score as an adjunct to screening, the results of which are reported by McHugh et al. in this issue of the Journal. Currently, screening … Read More
“Opioid overdose continues to be the leading cause of death due to injury in the US. Recent data from the Drug Abuse Warning Network estimated 882 000 emergency department (ED) opioid-related visits in 2023, a rate of 263 per 100 000 visits, with the highest rates among Black individuals (425 per 100 000). Access to treatment with medications for opioid use disorder, specifically buprenorphine, continues to be challenging for patients in active addiction, and these disparities by race are widening. [..] In many states, rural patients with opioid use disorder have worse outcomes than urban patients. Rural hospitals are also less likely to … Read More
“VBP [Value-Based Payment] was ushered in by the Affordable Care Act (ACA), but it is best understood as a rebranding of the larger managed care paradigm that took hold during the 1980s. Managed care delegates total-cost containment to insurance companies and large provider groups, tasking these private-sector “risk-bearing entities” to restrict spending. Spearheaded by health maintenance organizations, the rise of managed care promoted now-familiar utilization management tactics, such as prior authorization and narrow provider networks. It also promoted capitation or risk-based payments—what we call VBP today. Unlike FFS [fee-for-service], insurance companies would incentivize providers to manage utilization by making them … Read More
“In her tightly argued essay “Online Gambling and the Problem of Sin Markets,” [Rachel] Lu confronts a dilemma over the regulation of the market for so-called vices—sex, drugs, and gambling, with a primary focus on the latter. The obvious inclination—and the trend that seems to be the dominant one in the twenty-first century United States—dictates that pleasurable activities should be basically unchecked, subject entirely to the whims of the market. But, Lu argues, unchecked sin markets provide too many incentives for sellers to prey on and exploit vulnerable or addicted users. An unfettered marketplace ultimately creates negative externalities that will … Read More