Tag Archives: New England Journal of Medicine

Case of Caring

I have long been a fan of the “Case Records of the Massachusetts General Hospital,” which is published weekly in the New England Journal of Medicine. For many years, I made a point of recommending them to medical students and internal medicine residents as a model of concise yet comprehensive case presentations.No wasted words, no missing information, and none of the filler that trainees often added when they presented cases, such as “on heart exam….” or “the sodium was high at….”  As I always reminded them (often not as gently as I should have), if they were reporting a heart murmur, I knew it part of their examination of the heart, and if the sodium was 149, I knew that was high. Continue reading Case of Caring

Sham good!

The results of a really interesting clinical trial were just reported at the annual meeting of the American College of Cardiology and simultaneously published online before print by the New England Journal of Medicine . Continue reading Sham good!

Death of the stethoscope?

I felt a little sad when I read the “perspective” piece in the New England Journal of Medicine this week about the introduction of point-of-care ultrasound in medical education. Continue reading Death of the stethoscope?

Health Care Costs

There were 2 articles in the New England Journal of Medicine  this past week that caught my eye.  Although they appear to address very different subjects, I believe they have an important connection. Continue reading Health Care Costs

Evaluating Physician Performance

I was invited to give a talk about “patient satisfaction” at a recent OB/Gyn Grand Rounds. I have written previously that “satisfaction” is a pretty low bar, and so I spoke instead about the patient experience.  Continue reading Evaluating Physician Performance

The Oregon Medicaid Experiment: A Success or Failure?

A recent study in the New England Journal of Medicine (N Engl J Med 2013;368:1713-22) has been getting a lot of press lately, and not because it reported on a new blockbuster drug. Rather, it reported the results of an unusual – and unintended – experiment about the utility of Medicaid.

A little background: one of the cornerstones of the affordable care act (aka “Obamacare”) is the expansion of Medicaid eligibility to include more low-income individuals. Since Medicaid is a state-run program partially financed with federal funds (as opposed to the “fully federal” Medicare program), eligibility has traditionally varied widely by state with much more generous eligibility and coverage in states like New York (read “blue states”) than say, Alabama. Continue reading The Oregon Medicaid Experiment: A Success or Failure?