A friend of mine loves telling the story of the quintessential teacher’s pet—a grammar school classmate of his in New York City. As he tells it, while the rest of the kids went out for recess, this particular boy usually stayed inside, peering at a book. At one point, the teacher admonished him to go outside and play with the rest of the class. He politely refused, and even asked if there were some assignment she could give him, for extra credit.
Author Archives: Michael D. Shaw
The term “overdiagnosis” came into vogue in 2011, with the publication of best seller Overdiagnosed: Making People Sick in the Pursuit of Health, by MDs H. Gilbert Welch, Lisa Schwartz, and Steve Woloshin. As lead author Welch explains in his introduction: “While the term sounds like it means simply ‘excessive diagnosis,’ it actually has a more precise meaning. Overdiagnosis occurs when individuals are diagnosed with conditions that will never cause symptoms or death.”
Last week’s story on this topic generated plenty of interest (despite the lack of posted comments), so we continue our coverage…
The title of this piece is taken from a mordant lyric in Richard Fariña’s 1966 folkie love song “Children of Darkness.”
A few weeks ago, I had an appointment with my dermatologist–an old school guy, well-loved by his patients. He’s straightforward, no-nonsense, and has long office hours. You know the type: The one you hope will never retire. As I was led to the examining room, I noticed something not too common these days–shelf after shelf of medical records in manila folders. When the doc came into the room, I commented that he did not appear to be an early adapter of electronic health records (EHRs). He replied that it was definitely worth the Medicare reimbursement penalty (starting in 2015) to not be involved with them.
Last week, many newspapers ran some version of a Washington Post piece entitled “The U.S. government is poised to withdraw longstanding warnings about cholesterol.” Reporter Peter Whoriskey lavishes more than 1800 words on a story that is well-summarized in his first two paragraphs:
According to the Federal Trade Commission, “When health care markets are competitive, consumers benefit from lower costs, better care, and more innovation.” On a superficial level, this sounds good, but the devil is in the details. A huge detail is that the health care consumer rarely pays directly for the services, and has little say over how they are performed. Likewise, the notion of what constitutes “better care” and “innovation” are hotly debated. Ironically, those two precepts often lead to higher cost, with questionable benefits to outcome.