“I’ll propose in a moment what I believe are some achievable, common-sense solutions to the labor-shortage problem. But first, it helps to quickly understand why policymakers and industry leaders believe a crisis will come. It boils down to three elements. First, the number of older Americans is growing and will continue to grow – peaking in 2030 at roughly 56 million adults – and the impact on our health system will be enormous. A typical senior’s health is arguably more complicated than at any point in history, with many managing two or more chronic illnesses, and thanks to treatment advances … Read More
“Over several hours and multiple Zoom and phone calls in April, I spoke with Fauci about that: how he saw the full story of this historic public-health emergency and the role he played in it. At times, he was defensive, even combative, particularly when it came to episodes in which he felt that his own positions had been misconstrued and on the matter of gain-of-function research and the origins of the pandemic. But on the whole, he was reflective, even humble, especially about the way that Covid-19 exposed the limits of public health and, in his telling, kept surprising him … Read More
“Ozempic itself is technically a diabetes drug, but its active ingredient, semaglutide, has been approved by the FDA for weight loss under the brand name Wegovy, and can reduce a person’s body weight by up to 20 percent through a weekly injection. An even more powerful drug, known as tirzepatide, or Mounjaro, may soon be approved for weight loss, and a host of new medications are coming down the pipeline. All signs suggest that America is on the verge of a weight-loss revolution. But for people with obesity, semaglutide isn’t even the most effective weight-loss treatment around—not even close. Bariatric … Read More
“There is a long history of policy analyses of the use of the 3-day prior hospital stay rule. It was introduced very early in the history of the Medicare SNF [skilled nursing facility] benefit at a time when most nursing homes (NHs) offered primarily custodial care and extended hospital stays were common. To ensure an adequate medical evaluation, hospitalization was deemed critical, so direct admissions to SNF for medical treatment were considered inappropriate. Direct admissions from home to NHs were for custodial care and not post short-term care, and when long-stay NH residents became sick, the lack of available resources in … Read More
“There is little consensus about how to protect young people seeking treatment for eating disorders from harmful ideas about weight, or whether treatments for obesity and eating disorders can safely coexist at all within the medical system. And while the vast majority of eating disorder professionals would never prescribe weight loss to somebody recovering from an eating disorder, each clinician’s approach to treatment is affected by their individual beliefs about, and understanding of, obesity. The strong disagreements within the profession about how to best address obesity and weight stigma may leave patients susceptible to inappropriate or harmful care. [..] Clinicians … Read More
“When I first started out in addiction medicine to now, I thought that this made sense as a last-ditch approach [involuntary commitment]. But my thinking has changed as I’ve seen the clear evidence of its lack of benefit and heard stories and observed data indicating its harm. I also know intimately the feeling of powerlessness that comes with being a close family member to someone dealing with addiction. When I see medical professionals and loved ones reaching to involuntary treatment as a solution, I know it is out of a desperate wish to do something, anything, to respond to the … Read More
Excerpt – “Lessons From the Covid War: An Investigative Report,” which will be published Tuesday, was written by a consortium of scientific and public health experts, many intimately involved in the pandemic response. The group’s members originally came together to do the spade work for what they thought would be an eventual independent commission tasked with investigating the response to Covid. That inquiry, which they thought would mirror the well-regarded 9/11 Commission, never came into being. So the Covid Crisis Group, as they call themselves, have published their analysis of what went wrong and what needs to be done to … Read More
“Oral anticoagulation reduces thromboembolic events in patients with nonvalvular atrial fibrillation (AF); however, underuse of anticoagulation is a major issue in treating patients with nonvalvular AF at high stroke risk. Prior data from the American College of Cardiology’s (ACC) Practice Innovation and Clinical Excellence Registry (PINNACLE Registry) has found approximately 40% of patients are not receiving anticoagulants, with little change over time, despite the availability of the nonvitamin K antagonists. Studies examining the reasons for nonuse are sparse. Because underuse may relate to both physician prescribing and patient factors, some studies have looked at physician assessment of the risk of bleeding … Read More
“Was my brain hijacked by drugs — or was I willfully choosing to risk it all for a few hours of selfish pleasure? What makes people continue taking drugs like street fentanyl, which put them at daily risk of death? These questions are at the heart of drug policy and the way we view and treat addiction. But simplistic answers have stymied efforts to ameliorate drug use disorders and reduce stigma. Research now shows that addiction doesn’t mean either being completely subject to irresistible impulses, or making totally free choices. Addiction’s effects on decision-making are complex. Understanding them can help … Read More
“Cigarette smoking remains the leading preventable cause of illness and death in the United States. One in eight U.S. adults smoke, with the highest prevalence among some of the groups that are affected by the greatest health inequities. Although most people who smoke are aware of the associated health risks and want to quit, many are unable to do so because of nicotine dependence. [..] Although studies show higher rates of successful quitting among people who use a medication approved for smoking cessation by the Food and Drug Administration (FDA), only one third of people use evidence-based cessation treatments when … Read More