Monday, December 18, 2017

Twelve months of Common Sense Family Doctor: 2017's greatest hits

Although I don't rule out writing another post or two before the year is out, below is a recap of my favorites from each month, starting in January. I hope that you enjoy reading (or re-reading) each of them. Looking ahead to 2018, I am planning to launch a podcast version of Common Sense Family Doctor, featuring audio versions of selected blog posts and new content, such as interviews with health professionals and others who are revolutionizing family medicine and population health. Stay tuned!

January - Ethical foundations of health reform

As the patchwork U.S. health system seems primed to undergo another political upheaval, I think it's more important than ever to seek consensus on the destination for health reform before embarking on the journey.

February - Tom Price is a physician who doesn't understand cancer screening

Judging by a letter to then-HHS Secretary Kathleen Sebelius that he signed in 2011 objecting to the U.S. Preventive Services Task Force's draft recommendations on prostate cancer screening, Dr. Price either failed to learn anything in evidence-based medicine class or forgot everything he learned.

March - Does family medicine training led to high-value care?

One value-based health care intervention has borne fruit for the past 8 years in a row: attracting more medical students to the specialty of family medicine.

April - Safety net doesn't protect patients against low-value care

Safety net physicians were just as likely as other physicians to provide low-value services, underlining the importance of involving clinicians and patients in underserved practices in the Choosing Wisely campaign against medical overuse.

May - Fear-mongering in thyroid and breast cancer screening

The 40not50 campaign is insulting to women. It says that they can't be trusted to consider the medical evidence, have conversations with their primary care physicians, and make decisions about their healthcare that are right for them.

June - We shouldn't expect anyone to die in childbirth

Maternal mortality in the U.S. is largely a problem of social, economic, and geographic inequality rather than differences in health care, and we must look beyond hospitals for solutions.

July - Unequal treatment: disparities in how physicians are paid

The cause of these salary disparities - and the reason that more and more primary care physicians are choosing to cast off the health insurance model entirely - is a task-based payment system that inherently values cutting and suturing more than thinking.

August - How about ranking how well hospitals serve their communities?

Physicians and health executives have long believed that the responsibility of medicine is solely to provide health care, not social services or economic benefits outside of employment. But it's 2017, not 1967.

September - Ambition, rejection and leadership

Although I have fallen slightly short of my high ambitions, I will find other avenues to demonstrate leadership in medical publishing, evidence-based medicine, and population health.

October - What we choose to name a disease matters

The use of a more medicalized or precise term led patients to prefer invasive management options that were no better than more conservative choices.

November - Artificial intelligence will not make family physicians obsolete

Although Watson and its AI predecessors have made short work of the previously invincible Ken Jennings on Jeopardy! and vanquished world chess champions with ease, it is having a much harder time cracking medicine.

December - As hospitals downsize, what will replace them?

In my view, the role of policymakers should be to encourage a health care environment that makes it easy for hospitals and health systems to do the right thing.