Posted in Access to healthcare, CDC, Disease Prevention, Education, Evidence-based Medicine, FDA, News From Washington, outcomes, outcomes measurement, Patient Choice, Patient Safety, Uncategorized, Unsettled Science

FDA to Study Hydroxychloroquine for COVID-19 | MedPage Today

The drug is currently approved for malaria and also for rheumatoid arthritis and systemic lupus erythematosus, which is its main use in the U.S. It’s therefore available to be prescribed off-label, and some clinicians have already said they’re using it on COVID-19 patients. But neither Hahn nor other task force members addressed whether enough hydroxychloroquine is on hand to treat large numbers of coronavirus cases. Convalescent plasma is another treatment the FDA is considering for COVID-19, said FDA Commissioner Stephen Hahn, MD.

Convalescent plasma and the immune globulin that it contains is another possible treatment the agency is considering, Hahn added. “FDA’s been working for some time on this,” he said. “If you’ve been exposed to coronavirus and you’re better — you don’t have the virus in your blood — we could collect the blood, concentrate that and have the ability, once it’s pathogen-free, to give that to other patients, and the immune response could potentially provide a benefit to patients. That’s another thing we’re looking at; over the next couple of weeks, we’ll have information and we’re really pushing hard to try to accelerate that.” Such treatments have been effective in Ebola, for example.

Source: FDA to Study Hydroxychloroquine for COVID-19 | MedPage Today

Posted in Education, outcomes, outcomes measurement, Patient Safety, Policy Issues, Prevention, Protocols, Uncategorized

Are medical errors really the third most common cause of death in the U.S.? (2019 edition) – Science-Based Medicine

The claim that medical errors are the third leading cause of death in the US has always rested on very shaky evidence; yet it’s become common wisdom that is cited as though everyone accepts it. But if estimates of 250,000 to 400,000 deaths due to medical error are way too high, what is the real number? A study published last month suggests that it’s almost certainly a lot lower and has been modestly decreasing since 1990.

https://sciencebasedmedicine.org/are-medical-errors-really-the-third-most-common-cause-of-death-in-the-u-s-2019-edition/

Posted in Dependency, Economic Issues, Education, Free Society, Liberty, outcomes, outcomes measurement, Philosophy, Policy Issues, Uncategorized

If Only Economics Was as Easy as Rocket Science – Foundation for Economic Education

Gary M. Galles is a professor of economics at Pepperdine University. His recent books include Faulty Premises, Faulty Policies (2014) and Apostle of Peace (2013). He is a member of the FEE Faculty Network.

However, as America’s founders attested so vehemently, rights are at the core of social interactions and government, violations of which can justify revolution. And unlike the physical sciences, where the goal of language is precision, in the social sciences, the language (and thus analysis) is often quite vague and inconsistent (e.g., current versions of “social justice” are inconsistent with the traditional meaning of “justice”), making clear communication, much less clear analysis, far harder.

What is the upshot of all this? Economics is not like physical sciences, and reasoning and analogies based on them are often misleading in economics. Further, they can be dangerous to society, particularly in the mouths of those who wish to subject others to their command and control. That is why Friedrich Hayek wrote,

“The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.”

In other words, economics is a science whose principles and logic tell us why we cannot know enough to control people, even if we do know enough to control rockets.

https://fee.org/articles/if-only-economics-was-as-easy-as-rocket-science/

Posted in Access to healthcare, Doctor-Patient Relationship, Healthcare financing, Medical Practice Models, Organizational structure, outcomes measurement, Patient Choice, Patient Safety, Policy Issues, Protocols, Uncategorized

How Chaos at Chain Pharmacies Is Putting Patients at Risk | New York Times

They struggle to fill prescriptions, give flu shots, tend the drive-through, answer phones, work the register, counsel patients and call doctors and insurance companies, they said — all the while racing to meet corporate performance metrics that they characterized as unreasonable and unsafe in an industry squeezed to do more with less.

“I am a danger to the public working for CVS,” one pharmacist wrote in an anonymous letter to the Texas State Board of Pharmacy in April.

“The amount of busywork we must do while verifying prescriptions is absolutely dangerous,” another wrote to the Pennsylvania board in February. “Mistakes are going to be made and the patients are going to be the ones suffering.”

Posted in Economic Issues, Education, emotional intelligence, Organizational structure, outcomes, outcomes measurement, Philosophy, Uncategorized

Watch “Why Did I Say “Yes” to Speak Here? | Malcolm Gladwell | Google Zeitgeist” on YouTube

Fascinating research reveals a phenomenon of Elite Institution Cognitive Dissonance (EICD).

The data demonstrates that the effects of Relative Deprivation, as predictors of success, applies predictably to students at elite and non-elite institutions.

Take-home: Your place within your immediate hierarchy matters more than your place within the universal hierarchy of rank order.

Posted in Access to healthcare, Economic Issues, Education, Evidence-based Medicine, Health Insurance, Medicaid, Medical Costs, outcomes, outcomes measurement, Patient Safety, Philosophy, Poverty, Prevention, primary care, Protocols, Uncategorized, Unemployment

Bridging the Gap Between Where the Quality Metric Ends and Real Life Begins—A Trusting Relationship |JAMA NETWORK

Jennifer E. DeVoe, MD, DPhil

JAMA Intern Med. 2020;180(2):177-178. doi:10.1001/jamainternmed.2019.5132

My teaching session with the medical student at the end of the day included a discussion about patient care decisions and recommendations that go beyond ticking quality boxes and following the latest guidelines. Initially, I felt as if I was rationalizing my delivery of suboptimal care and began to doubt myself. 

However, the quality reports I receive each month do not capture the complexity of many patients’ lives.4 These reports fail to reflect the individualized and shared decisions made between a patient and her physician who have known each other for 15 years; the proprietary quality score calculation formulas do not adjust for the healing power of relationships.5 Amid the mounting evidence that primary care saves lives,6 our health care system does not (yet) have a population health analytics tool that captures and tracks the progress that she and I have made together in more than a decade. When will we create better systems with capabilities to measure the emergency department visits that were prevented, the stable housing that was obtained, the increased resiliency she has built into her life, her feelings of empowerment to be a better parent, the reduction in her self-destructive behaviors, and the trusting relationship we have built over time?

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2757531?guestAccessKey=15c869b5-37d4-42f4-9feb-12bdc314dbe6&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=etoc&utm_term=020320&appId=scweb