�鶹Ů��

Hillary Clinton and Donald Trump agree that Medicare bureaucrats should be unleashed to negotiate lower prices with drug companies, and predict billions of dollars in savings as a result. In this political era when any common ground between these two adversaries should be venerated, it is a shame that we must point out that they are both wrong. (Geoffrey F. Joyce and Neeraj Sood, 8/12)

As a leader in the Republican Party for the past 40 years, I’ve been involved in the development of 10 party platforms. Party platforms are important because they are more than a list of policies. Instead, they are a statement of the very different world views that explain those policies. This year’s Democratic and Republican Party platforms provide a useful example of differing world views on an issue that will dramatically impact the health and well-being of every U.S. citizen: biomedical research. (Newt Gingrich, 8/11)

Of all the hundreds of questions I have asked patients over the years, there was one I never asked: Are any firearms kept in or around your home? The Health and Public Policy Committee of the American College of Physicians has recommended that this question be added to the litany of queries doctors ask our patients during routine visits. Do you smoke? Do you practice protected sex? Have you had your flu vaccination? Are any firearms kept in or around your home? (Jerald Winakur, 8/11)

The FDA’s website explains that the agency “has performed extensive research and reviewed hundreds of studies about BPA’s safety,” which has led to the conclusion that “current approved uses of BPA in food containers and packaging are safe.”   Yet despite nearly 50 years of determinations that the chemical is safe, the agency and companies that use BPA continue to come under fire from environmental groups, food activists and other critics. (Henry I. Miller and Jeff Stier, 8/11)

Because I am a doctor, my friend Sophia told me the following story. “I go to a walk-in clinic with neck pain and a low-grade fever. I never go to the doctor. I know something is seriously off. ‘Would you test me for strep?’ I ask. ‘You’re overreacting. You just have a cold,’ this young doctor says. Would he have liked to hear me make a bigger deal about how badly I felt? I almost had to beg for a strep test. When it comes back positive, I’m so angry, I can barely speak to him. He was incompetent. Or trying to save money. Or maybe he was just lazy. He was certainly unkind.” Her doctor, apparently, was a lousy diagnostician. But more than that, she was put off by his attitude. What stuck in my mind weeks later was her choice of the word “unkind.” (Michael Stein, 8/11)

Twenty years ago, we described the emergence of a new type of specialist that we called a “hospitalist.”1 Since then, the number of hospitalists has grown from a few hundred to more than 50,000 — making this new field substantially larger than any subspecialty of internal medicine (the largest of which is cardiology, with 22,000 physicians), about the same size as pediatrics (55,000), and in fact larger than any specialty except general internal medicine (109,000) and family medicine (107,000). Approximately 75% of U.S. hospitals, including all highly ranked academic health centers, now have hospitalists. The field’s rapid growth has both reflected and contributed to the evolution of clinical practice over the past two decades. (Robert M. Wachter and Lee Goldman, 8/10)

Medical specialization dates back at least to the time of Galen. For most of medicine’s history, however, the boundaries of medical fields have been based on factors such as patient age (pediatrics and geriatrics), anatomical and physiological systems (ophthalmology and gastroenterology), and the physician’s toolset (radiology and surgery). Hospital medicine, by contrast, is defined by the location in which care is delivered. Whether such delineation is a good or bad sign for physicians, patients, hospitals, and society hinges on how we understand the interests and aspirations of each of these groups. (Richard Gunderman, 8/10)

Precision medicine aims to be a transformative paradigm that moves away from the “one-size-fits-all” approach in which treatments work for some people but not others. To the average American, especially one who has cancer, precision medicine sets a high expectation of a more targeted, and so more effective, treatment. But all too often the science underpinning these targeted therapies has not been up to snuff and the result has been greater uncertainty about optimal treatment — just the opposite of what precision medicine intends to do. (Spencer Phillips Hey, 8/11)

The federal Drug Enforcement Administration has just issued a helpful reminder to all Americans. In denying a petition to loosen restrictions on marijuana, the agency repeated that the drug has “no currently accepted medical use” in the U.S. This may come as a surprise, given that 25 states already allow doctors to prescribe marijuana to treat maladies from PTSD to Alzheimer’s disease. Yet the truth is, research has yet to find firm evidence that marijuana can alleviate physical suffering. (8/12)

In short, this new rule means that Medicaid will incentivize health care providers for diagnosing Alzheimer’s disease earlier and recommending community-based services and support. Most importantly, the proposed rule allows the person receiving the diagnosis to access community resources, plan for his or her future and ultimately maintain independence by staying in home longer. (Brandon Geib, 8/11)

While many of us need help as we get older, care options for those afflicted with Alzheimer's or other forms of dementia are much more limited and constrained even further by health insurance rules that favor medicalized care over supportive programs that might actually lessen the need for medical intervention. This was the situation my family and I faced when my beloved wife Nancy was diagnosed with Alzheimer's disease. (John Ottoboni, 8/11)

Scientists at NewLink Genetics, a biopharmaceutical company located in the Iowa State University Research Park, as well as researchers at the Nanovaccine Initiative, coordinated by Iowa State University, are working to develop vaccines and nanovaccines — particles that are 23 times smaller than a red blood cell. This research has the potential to save thousands of lives. If some within the federal government have their way, however, their innovative findings and products may never even make it out of the lab. (Dan Culhane, 8/11)

In America and across the globe, about 7,000 new medicines are in development. There's no question that many of them will save lives. Unfortunately, the United Nations is working to degrade the innovation ecosystem that makes such breakthroughs possible. In 2015, UN officials convened a powerful new panel to study ways to improve impoverished countries' access to lifesaving medicines. By all indications, that panel will soon push to weaken intellectual property protections on medicines. (Paul R. Michel, 8/12)

African Americans and particularly African-American men continue to be perceived as being violent when they are not. This phenomenon is not simply a belief system but also appears to be an overriding perceptual reality that directs the behavior of caretakers and law enforcement officers. (William Lawson, 8/11)

Tennessee is part of the "stroke belt,” a collection of 11 states that is notorious for its high stroke mortality rates. In the Volunteer State, stroke accounts for thousands of deaths every year.The good news is that a new stroke surgery has emerged in recent years as an effective, minimally invasive treatment for many people who have experienced a severe ischemic stroke — a stroke caused by a blood clot in the brain. (Blaise Baxter, 8/11)

Facts about women’s health won out over fiction in June, when the Supreme Court, even without examining the Texas legislature’s motives, struck down its regulations aimed at closing abortion clinics. Now the question is whether facts about human development will be adequate on their own to overcome fiction in what will probably be the next front in the abortion wars: fetal pain. Whole Woman’s Health v. Hellerstedt is a turning point in Supreme Court jurisprudence, not just because it turned the tide in the face of 300-plus abortion restrictions passed by state legislatures in the past 5 years alone.1 It also signaled a refreshing willingness to test a law’s justifications against its actual effects. In the context of women’s reproductive rights, and abortion rights in particular, such willingness has potentially far-reaching effects for measures that interfere with physician judgment and the doctor–patient relationship, including waiting periods, prohibitions on the use of necessary techniques, and requirements for medically unnecessary procedures. (R. Alta Charo, 8/10)

For decades, University of Washington has operated the federally-sponsored Birth Defects Research Lab (BDRL)— a taxpayer-funded fetal organ and tissue procurement service. The BDRL operates similarly to companies like StemExpress, Advanced Bioscience Resources, and Da Vinci Biologics: as a middleman go-between for abortion clinics and end-users of aborted baby parts. (David Daleiden, 8/11)

Visualize a long line, more than 500,000 people long. Look closer. They are all female. You’ll see lots of girls, some new born. What you can’t see is the many who have had their genitalia mutilated. Those who haven’t are in danger. This imaginary queue represents real people, the number of women and girls in the United States who were “at risk of or had been subjected to female genital mutilation/cutting (FGM/C) in 2012.” (Joe Davidson, 8/11)

Fear and death. That’s what I remember most, though not necessarily in that order, from the nightmare when Ebola struck my hometown.Two years ago this week, the World Health Organization declared that the Ebola epidemic ravaging Liberia was a “public health emergency of international concern.” By then it had already overwhelmed Redemption Hospital in Monrovia, where I was the outpatient supervisor. (Emmanuel Lasanah, 8/11)