Healthcare Workforce Shortages cannot be Resolved unless Self-Care is Taken Seriously

“Other industries, like travel, banking, entertainment, publishing, retail et al have built successful business models on the premise that their consumers—armed with needed information—engage directly in decisions and actions consonant with their self-interests. In so doing, fewer workers are required, replaced by technologies and online tools that are customized to their individual needs and preferences. In healthcare delivery circles, self-care is dismissed because diseases and treatments are deemed too complicated thus “consult your doctor” or “visit the ED” are the default. That’s the problem: the health system is staffed to the presumption that most consumers are incapable of acting rationally … Read More

We’re All Being Manipulated the Same Way

This piece was adapted from Ressa’s remarks at Disinformation and the Erosion of Democracy, a conference hosted by The Atlantic and the University of Chicago, on April 6, 2022. Maria Ressa is a contributing writer at The Atlantic, the CEO of Rappler, and a recipient of the 2021 Nobel Peace Prize. “really, this is like when 140,000 people died instantly in Hiroshima and Nagasaki. The same thing has happened in our information ecosystem, but it is silent and it is insidious. This is what I said in the Nobel lecture: An atom bomb has exploded in our information ecosystem. And … Read More

My first impressions of web3

“If we do want to change our relationship to technology, I think we’d have to do it intentionally. My basic thoughts are roughly: We should accept the premise that people will not run their own servers by designing systems that can distribute trust without having to distribute infrastructure. This means architecture that anticipates and accepts the inevitable outcome of relatively centralized client/server relationships, but uses cryptography (rather than infrastructure) to distribute trust. One of the surprising things to me about web3, despite being built on “crypto,” is how little cryptography seems to be involved! We should try to reduce the … Read More

Can Big Tech Be Disrupted? A conversation with Columbia Business School professor Jonathan Knee

“These companies [Meta (Facebook), Alphabet (Google), Amazon, Apple, and Microsoft] are so successful—and generate so much consumer data and cash—that it sometimes feels as if they can’t be stopped. Not only have they been on the cutting edge of technology, but now they also have the power of incumbency. Yet according to Jonathan Knee—who is a veteran investment banker specializing in media and tech, a Columbia Business School professor, and the author of The Platform Delusion: Who Wins and Who Loses in the Age of Tech Titans—even digital superpowers face threats, from start-ups as well as seasoned competitors. In this … Read More

What Caring for My Aging Parents Taught Me That Medical Education Did Not

“the what-I-wish-I-knew list about caring for my aging parents, medically and otherwise. [..] If you have the feeling that something may be an issue for your aging parents, it is almost definitely an issue. Do not put off something because it is likely to resolve itself; it will likely get worse, not better. As a pediatrician, I find myself frequently recommending to many of my patients and their parents to monitor their current condition and let me know if things change or get worse. This is in general the wrong approach for aging parents. It is better to deal with … Read More

Where Health Improvement Lags in Recent Decades—Pain and Mental Health

“The health of the US population has improved enormously in many areas but been stagnant in others. The biggest success may have been improvements for people with cardiovascular disease. Major cardiovascular events are declining in incidence, and cardiovascular disease risk factors are better controlled than they used to be. There are many elements behind this good news, the 2 most important being pharmaceuticals to treat cardiovascular disease and public health efforts to reduce smoking. Other areas of health in which there have been major improvements include lung cancer (associated with reduced smoking), breast cancer (stemming from improved treatment), and colorectal … Read More

Learning about End-of-Life Care from Grandpa

“I learned that the Centers for Medicare and Medicaid Services (CMS) had previously allowed codes for “adult failure to thrive” to qualify people for hospice and that in states that had legalized physician-assisted dying less recently than New Jersey had, those codes had been used to confer eligibility. But CMS recently removed those codes from hospice eligibility, and in any event, I could not find a New Jersey physician willing or sufficiently experienced to provide this service. I described another option to Grandpa: he could voluntarily stop eating and drinking. He’d never considered this possibility (which reminded me again how … Read More

Building Resilience: A Framework for Dealing with Stress and Adversity Across the Lifespan

“Though studies of resilience could fill a library, researchers have identified a shortlist of pillars and processes common to people who have overcome a difficult start in life and are able to cope when life becomes challenging. Among the factors most relevant to personal resilience are four pillars (awareness and self-reflection; personal skills that strengthen one’s identity; control over one’s life and fair treatment by others; and physical and mental health that results from physical activity, proper nutrition and good sleep hygiene) and three processes (living in diverse communities with abundant social support; experiencing safe spaces and leisure activities; and … Read More

In The Era Of Hygiene, ‘Clean’ Author Makes The Case For Showering Less

“[physician and health reporter James] Hamblin’s new book, Clean: The New Science of Skin, is a documentary survey of this pre-dawn moment in our understanding of the skin microbiome. [Emily Vaughn] Your book sets out to challenge some cultural norms about hygiene. What types of cleansing do you think are overdue for reexamination, and which are critical? [James Hamblin] There’s a distinction between “hygiene” and “cleansing rituals” that’s especially important in this moment. “Hygiene” is the more scientific or public health term, where you’re really talking about disease avoidance or disease prevention behaviors. Removal of mucus, vomit, blood feces … … Read More