Newton’s law goes to the hospital

To every action there is always opposed an equal newton_third_lawreaction.” Philosophiae Naturalis Principia Mathematica, 1687.

When Newton penned his laws of motion in the late 1600s, he was surely not thinking of surprise hospital inspections.  (Hospitals date back to 350 BCE, but hospital inspectors did not come about until 1951 when the Joint Commission on Hospitals was born.)  Nevertheless, his law can clearly be seen at work there: Medicare patients who had a hospital stay during an inspection week had a significantly lower risk of dying in the following 30 days, compared to similar patients who stayed during a non-inspection week.  (JAMA Internal Medicine paper.)  Continue reading

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Butterflies & Birth Control

Which of the following seems least ridiculous?chaos_theory

  • A butterfly flapping its wings can set off a hurricane.
  • Birth control pills and patches cause depression.

Clearly, the birth-control-pill-depression connection seems plausible yet it is very similar to the butterfly example.  It is a change in one thing that will travel over, under, around, and through many other complex systems, and lead to significant change in yet another system. (Kudos if you recognized the hurricane example from chaos theory.)  Continue reading

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NIH Budget Cut – Just what the doctor ordered?

The proposed 20% cut to the National Institutes of Health budget would spark much less furor if we clearly differentiated “health” from “medical care”.  More medical care – more advanced, more techy, more whatever – does not bring nih_researchmore health or longer lives, and it never will.  Continue reading

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More choices, less happiness

On a hot summer ice-cream-craving day, would you choose the shop that has ice_cream_choicesthree flavors of ice cream or the one with three dozen?  If you want to be satisfied with your choice, you go to – surprise – the one with three flavors.

Having too many choices leaves us with regrets. “Well, the one I took was okay but what about the other 35 that I didn’t?” (For a terrific book about choice architecture, see Nudge: Improving Decisions About Health, Wealth, and Happiness.)

It works for ice cream, and for more complex products – such as (wait for it!) health insurance.  Continue reading

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It that-must-not-be-named

There is a creeping, stealthy (some might say sinister) movement that just might change the face of health insurance in the United States.  It will continue as long as we do not say its name aloud, like Lord What’s-His-Name at Hogwarts. hogwarts

The not-so-well-hidden health policy revolution is the concept of opening Medicare or Medicaid to all people.  A recent Atlantic article, “A Political Opening for Universal Health Care?” makes the scandalous assertion that the time may be ripe for this idea.  Even Republicans might be supportive, as they make good on their promise to repeal the Affordable Care Act.  Continue reading

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The Jetsons Meet Alternative Medicine

Don’t get me wrong – I can enjoy a kale mango turmeric smoothie as much as the next guy.  But I’m no hipster when it comes to alternative medicine.  The real name for it should be “unstudied medicine”, and the reason it is not studied comes down to dollars and cents:the_jetsons

No one makes enough money from apple cider vinegar (melts away extra pounds! cures heartburn!) or whatever else to fund a solid, scientific study. 

Continue reading

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Tinkerbell Meets Health Policy

Tinkerbell is rescued from near death by the audience clapping their hands showing their faithful belief in her.  The “Tinkerbell effect” describes things that tinkerbellexist only because we agree to believe in them –like the value of dollar bills or the rule of law or, perhaps these health policy nuggets:  Continue reading

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Small & Exciting or Big & Boring

Two hot investments for you to consider:

  • Start-Up Ace’s product adds 10 or more years of longevity for most people and a very broad group of people are candidates. It improves not only the person’s health status, but also their children’s.  No harsh side effects.
  • Rising Star Biomed’s product adds 10 months of longevity to a small group of people. Side effects are so harsh, many people discontinue mid-stream.

diplomaOne of these is an exciting cancer drug.  The other is a ho-hum program to encourage teens to graduate from high school.  The reason we jump to the cancer drug is not just the profit motive.  It is baked into our very human nature: Continue reading

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“Stop Smoking” stopped working

The link between lung cancer and smoking was confirmed in the 1940s.  The surgeon general’s warning was put onto cigarette packs in 1966.  And the deluge of stop-smoking messages has only grown ever since.  So, why do three times as stop_smokingmany adults with less than a high school education (30%) still smoke compared to as adults with a college education (10%)? The Stop Smoking campaigns don’t speak their language.  Continue reading

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As easy as 1, 2, 250000

Counting is not Sesame Street easy in population health science.  Case in point: count_draculain 1999, a study concluded that medical errors in the United States hospitals were killing 98,000 people a year, the equivalent of two jumbo jet crashes per day.  Recently, a new study upped the estimate to 250,000.   Never fear  — Count von Count is here!        Continue reading

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