A Health Affairs blog post titled “Fixing Clinical Practice Guidelines” echoed several concerns I’ve discussed previously: practice guidelines are being produced in abundance but often have variable methodological quality, financial c…
Category: Oncology/Hematology
After a spouse’s death, a physician is showered with gratitude
I saw Kaitlin (identifying information changed) and her husband Brandon seven days before she died. Kaitlin’s cancer had been in remission at our last visit, but this day she looked awful. I estimated she had less than three months to live. As I …
Clinical trials advance medicine in the future. And help patients right now.
If you’ve ever used a medication to treat an illness, you have a clinical trial to thank for it. Every standard therapy used in medicine today once started as a clinical trial. And it is commonly understood that today’s clinical trials are shaping trea…
Explaining Peter Fonda’s lung cancer
Actor Peter Fonda, son of Henry Fonda and younger brother of Jane Fonda, passed away August 16 at his Los Angeles home. Fonda, who was 79, is probably best known for his role as Wyatt in Easy Rider, a movie he co-wrote, produced, and starred in. Fonda …
The costly decision of delaying surgery
It was a common enough reason for someone to have a CT scan. The order read, “Abdominal pain, colon cancer resected in January.” It was now March, only two months post-surgery. Yet the patient’s CT scan showed a number of large masses in the liver, con…
A nurse comes face to face with her son’s serious illness
Prior to my 10-year-old son being diagnosed with leukemia, I worked as a diabetes nurse educator at a local hospital. I had been an RN for over 15 years and was able to balance home life with work; I loved educating patients on how to deal with their d…
When Medicare stops covering a test without warning
There are two versions of “the conversation” we have with men: One is for teenage boys, and it is about wet dreams, sexually transmitted disease, unwanted pregnancy and at one point also about testicular self-examinations. Those have now been edited ou…
Convincing patients to stop cancer screening isn’t always easy
During my training to become a primary care physician, the importance of preventive cancer screening was ingrained in me. The idea of catching cancer at an early stage so we can better treat it made intuitive sense. But as I’ve learned over the years, …
What is low-value care, and why does it matter?
Doctors and policy wonks hear a lot these days about “low-value care.” What exactly is that, and should you care? The term refers to tests, medications, and procedures that add little to a patient’s health or well-being but which cost them or the syste…
A letter before the yearly checkup
Hey there, Dr. Brown. Just wanted to send a little note to warn you that I’m coming to see you soon for my yearly “checkup.” You and I both know that this is my annual opportunity to spew all of my worries on you and for you to reassure me that I’m not…
