Big Med

Big Med
Author: David Dranove
Publisher: University of Chicago Press
Total Pages: 344
Release: 2022-11-18
Genre: Business & Economics
ISBN: 022682392X

There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.

Med Head

Med Head
Author: James Patterson
Publisher: jimmy patterson
Total Pages: 197
Release: 2010-04-01
Genre: Young Adult Nonfiction
ISBN: 0316084980

Discover the story of one teenager's struggles with OCD and Tourette's Syndrome-and how he was able to overcome extraordinary setbacks. Cory Friedman knows how it feels to have a body that won't stop moving, to be really different from everyone else, to be made fun of every day, to be totally reckless, to never relax, to be shut out of everything, to break free and take control. James Patterson's Against Medical Advice riveted adults with the page-turning drama of one teenager's courage, sacrifice, and triumph in confronting an agonizing medical condition. Now this deeply personal account of Cory Friedman's intense struggles with Tourette's Syndrome and Obsessive Compulsive Disorder-as well as depression, anxiety, and alcohol addiction-is available for teen readers.

Complementary and Alternative Medicine in the United States

Complementary and Alternative Medicine in the United States
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 360
Release: 2005-04-13
Genre: Medical
ISBN: 0309133424

Integration of complementary and alternative medicine therapies (CAM) with conventional medicine is occurring in hospitals and physicians offices, health maintenance organizations (HMOs) are covering CAM therapies, insurance coverage for CAM is increasing, and integrative medicine centers and clinics are being established, many with close ties to medical schools and teaching hospitals. In determining what care to provide, the goal should be comprehensive care that uses the best scientific evidence available regarding benefits and harm, encourages a focus on healing, recognizes the importance of compassion and caring, emphasizes the centrality of relationship-based care, encourages patients to share in decision making about therapeutic options, and promotes choices in care that can include complementary therapies where appropriate. Numerous approaches to delivering integrative medicine have evolved. Complementary and Alternative Medicine in the United States identifies an urgent need for health systems research that focuses on identifying the elements of these models, the outcomes of care delivered in these models, and whether these models are cost-effective when compared to conventional practice settings. It outlines areas of research in convention and CAM therapies, ways of integrating these therapies, development of curriculum that provides further education to health professionals, and an amendment of the Dietary Supplement Health and Education Act to improve quality, accurate labeling, research into use of supplements, incentives for privately funded research into their efficacy, and consumer protection against all potential hazards.

Clinical Practice Guidelines We Can Trust

Clinical Practice Guidelines We Can Trust
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 217
Release: 2011-06-16
Genre: Medical
ISBN: 030921646X

Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.

Unequal Treatment

Unequal Treatment
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 781
Release: 2009-02-06
Genre: Medical
ISBN: 030908265X

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

The New York Times Book of Medicine

The New York Times Book of Medicine
Author: Gina Kolata
Publisher: Union Square & Co.
Total Pages: 698
Release: 2015-04-21
Genre: Medical
ISBN: 145490206X

Today we live longer, healthier lives than ever before in history—a transformation due almost entirely to tremendous advances in medicine. This change is so profound, with many major illnesses nearly wiped out, that its hard now to imagine what the world was like in 1851, when the New York Times began publishing. Treatments for depression, blood pressure, heart disease, ulcers, and diabetes came later; antibiotics were nonexistent, viruses unheard of, and no one realized yet that DNA carried blueprints for life or the importance of stem cells. Edited by award-winning writer Gina Kolata, this eye-opening collection of 150 articles from the New York Times archive charts the developing scientific insights and breakthroughs into diagnosing and treating conditions like typhoid, tuberculosis, cancer, diabetes, Alzheimers, and AIDS, and chronicles the struggles to treat mental illness and the enormous success of vaccines. It also reveals medical mistakes, lapses in ethics, and wrong paths taken in hopes of curing disease. Every illness, every landmark has a tale, and the newspapers top reporters tell each one with perceptiveness and skill.

Finding What Works in Health Care

Finding What Works in Health Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 267
Release: 2011-07-20
Genre: Medical
ISBN: 0309164257

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Improvised Medicine: Providing Care in Extreme Environments

Improvised Medicine: Providing Care in Extreme Environments
Author: Kenneth V. Iserson
Publisher: McGraw Hill Professional
Total Pages: 593
Release: 2012-04-05
Genre: Medical
ISBN: 0071770011

Deliver quality healthcare in the most challenging field conditions Full of practical clinical pearls and proven strategies, this indispensible guide shows you how to operate outside your comfort zone and devise effective treatment solutions when the traditional tools (medications, equipment, and staff) are unavailable—or when you need to provide care outside of your specialty. Improvised Medicine is a must for anyone who plans to work in global, disaster, or other resource-poor settings. FEATURES: Simple-to-follow directions, diagrams, and illustrations describe practical techniques and the improvised equipment necessary to provide quality care during crises. Contains improvisations in anesthesia and airway management, dentistry, gynecology/obstetrics, infectious disease/laboratory diagnosis, internal medicine, otolaryngology, pediatrics and malnutrition, orthopedics, psychiatry, and surgery. Also includes basic disaster communication techniques, post-disaster forensics, a model hospital disaster plan, and innovative patient-transport methods. LEARN HOW TO: Make an endotracheal tube in seconds Perform digital-oral and blind-nasotracheal intubations Make plaster bandages for splints/casts Give open-drop ether, ketamine drips, and halothane Use subcutaneous/intraperitoneal rehydration/transfusion Make ORS and standard nutrition formulas Clean, disinfect, and sterilize equipment for reuse Warm blood units in seconds inexpensively Take/view stereoscopic x-rays with standard equipment Quickly and easily stop postpartum hemorrhage Fashion surgical equipment from common items Evacuate patients easily for high-rise hospitals Make esophageal and precordial stethoscopes Quickly improvise a saline lock Make ECG electrode/defibrillator pads and ultrasound gel