“Recent research has revealed substantial variability in hospital charity care and other financial assistance (FA) policies. This lack of standardization makes it much more difficult for patients and anyone assisting them (including clinicians) to ascertain their likely eligibility for free or discounted care. [..] Conventionally, nonprofit hospitals have covered essentially the full range of “medically necessary” services that health insurers typically cover. But we have noticed a troubling development: some hospitals now offer assistance only if care is urgently needed, thereby excluding a broad range of necessary care. Hospitals offer free and discounted care in several ways, as outlined in … Read More
How the new health secretary, Robert F. Kennedy Jr., is dismantling the agency. Excerpt – More and more, people seemed to clamor for things that were unproven, to question things that were and to express not only mistrust but outright hostility toward the doctors, scientists and civil servants trying to separate one from the other. That hostility was being nourished by exactly the kind of mis- and disinformation Kennedy was espousing. It was easy to paint the F.D.A. as a supervillain (an aggressive suppressor of sunlight, vitamins and exercise, to borrow Kennedy’s language), in part because the truth was so … Read More
“Humans weigh choices in a brain network called the valuation system. It’s where we identify the options we’re choosing between, calculate the likely reward for each and make a choice. Close-to-home rewards ignite the system that pushes us to act. But when the rewards are distant or vague — such as influencing a sweeping government policy or making a major life change — the brain struggles to see the payoff, and motivation falters. That’s why doughnuts can win out over our health goals and why we might binge-watch a show instead of going to a town meeting, even if we’d say that the latter … Read More
“While a small percentage (~1%) of parents reject all vaccines, most parents vaccinate their children according to the recommended schedule; even the majority of hesitant parents hold some ambivalence that can be influenced by trusted clinicians. Some parents express concerns about the number of vaccines given at once, while others fear potential long-term adverse effects. Additionally, medical mistreatment over generations and inconsistent access to health care contribute to distrust among some communities. What all these parents have in common, though, is that—like the clinician caring for them—they are trying to do what is best for their children. This is the … Read More
“There has been less focus on AI [artificial intelligence] trained on clinician data that health care systems and insurers could use to manage clinicians’ practice. But clinicians have reason to worry about becoming AI “data subjects.” Quantification of clinician practice could help health care systems improve quality of care and facilitate documentation to support transparency and utilization review, and physicians should take the lead in helping to achieve those aims (one of us holds equity in medical AI companies). But medical AI tools, including those that are introduced with a goal of improving patient care, also create a glide path … Read More
Once a suspect COVID treatment, now a cure for everything Excerpt – The idea that ivermectin could be a cancer-fighting agent does have some modest basis in reality: Preliminary studies have suggested that antiparasitic medications might inhibit tumor growth, and at least one ongoing clinical trial is evaluating ivermectin’s role as an adjunct to cancer treatment. That study has enrolled only nine patients, however, and the results so far show that just one patient’s tumor actually shrank, according to a recent scientific abstract. But these meager grounds for hope now support a towering pile of expectations. [..] a gaggle of … Read More
A new book reveals how health-care inequality fueled the spread of anti-science conspiracy theories. “Wellness is a $6.3 trillion industry, according to a 2024 report from the Global Wellness Institute, an industry trade group. That’s bigger than the GDP of Germany, and nearly four times the size of the global pharmaceutical industry. The real growth has been within the past 10 years—the GWI’s report calls it the “wellness decade.” And women represent most of its consumers. In a nation known for its relatively poor health, nearly everybody seems to be thinking about how to be healthy: According to a 2024 … Read More
“less than one third of physicians graduating from primary care residency programs plan on practicing primary care. Often-cited culprits of this workforce shortage include burnout, administrative burdens, income disparities between PCPs [primary care physicians] and specialists, and loss of autonomy amid a shift toward increased ownership of physician practices by health care systems and corporations. Increasingly, however, the shortage of PCPs is being exacerbated by another phenomenon: the evolution of primary care — long championed as a common good — into a private, free-market commodity. [..] most DPC practices operate entirely outside the insurance system, with patients paying a monthly … Read More
Besides being launched by Amazon alumni, General Medicine has close business ties to a senior Amazon health exec Excerpt – A new digital health care marketplace, launched last week, has a good amount of Amazon in its DNA. General Medicine, with $32 million in funding, came out of stealth with three former Amazon employees as co-founders and investors, a business model that could compete with Amazon’s One Medical — and behind the scenes, a current senior Amazon executive. The former employees, including the founders of PillPack — the pharmacy company that Amazon bought in 2018 for about $750 million and … Read More
Too often, doctors pursue ‘normal’ numbers instead of looking closely at the patient “Once we base our definition of disease on numerical abnormalities, we can change the numbers in a way that expands those who have the disease. This has been occurring in dramatic fashion the past 20 years, especially since Medicare (by congressional decree) relinquished the task of defining normal numbers to specialty medical societies. Hence the American College of Cardiology can change the definition of an abnormal cholesterol reading or abnormal blood pressure reading such that more people will be labeled with a diagnosed disease related to these … Read More