health care costs – Page 2

You’re Sick and I’m Not, Too Bad

February 16, 2010March 28, 2019 Elaine Schattner M.D.

“The insurance market as it works today basically slices and dices the population. It says, well you people with medical conditions, over here, and you people without them, over here…
– Jonathan Cohn, Editor of The New Republic, speaking on The Brian Lehrer Show, February 16, 2010*
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There’s a popular, partly true, sometimes useful and very dangerous notion that we can control our health. Maybe even fend off cancer.

I like the idea that we can make smart choices, eat sensible amounts of whole foods…

Posted in Essential Lessons, health care costs, Ideas, Medical Ethics, Policy, Public Health, RadioTagged chronic illness, empathy, health care costs, health care reform, health insurance, informed decisions, medical ethics, Public Health1 Comment

Looking Ahead: 7 Cancer Topics for the Future

January 4, 2010October 30, 2013 Elaine Schattner M.D.

Here’s my short list, culled from newsworthy developments that might improve health, reduce costs of care and better patients’ lives between now and 2020, starting this year: 1. “Real” Alternative Medicine. By this I don’t mean infinitely-diluted homeopathic solutions sold in fancy bottles at high prices, but real remedies extracted from nature and sometimes ancient […]

Posted in Future of Medicine, Health IT, Oncology (cancer), Science, Selected TopicsTagged alternative medicine, cancer immunology, cancer treatment, chemotherapy, e-health, Future of Medicine, health, health care costs, internet medicine, IT, palliative care, pharma, technologyLeave a Comment

Looking Ahead on Breast Cancer Screening

December 31, 2009December 31, 2013 Elaine Schattner M.D.

The risks and costs of breast cancer screening are exaggerated and misrepresented in the recent news…. My conclusion is that rather than ditching a life-saving procedure that’s imperfect, we should make sure that all doctors and radiology facilities are up to snuff.

We need to distinguish between errors in the measurement (cancer or not) and errors in decisions that we – patients and doctors – make after upon detecting a premalignant or early-stage malignancy in a woman’s breast.

Posted in Breast Cancer, cancer screening, Diagnosis, health care costs, Oncology (cancer)Tagged Breast Cancer, DCIS, decisions, false positives, health care costs, LCIS, mammography, screening controversy, Women's HealthLeave a Comment

A Bit More on False Positives, Dec 2009, Part 1

December 29, 2009October 25, 2011 Elaine Schattner M.D.

Why bother, you might ask – wouldn’t it be easier to drop the subject?

“Make it go away,” sang Sheryl Crow on her radiation sessions.

I’ll answer as might a physician and board-certified oncologist who happens to be a BC survivor in her 40s: we need establish how often false positives lead, in current practice, to additional procedures and inappropriate treatment…These numbers matter. They’re essential to the claim that the risks of breast cancer screening outweigh the benefits.

Posted in Breast Cancer, cancer screening, health care costs, Medical News, Statistics, Women's HealthTagged Breast Cancer, cancer screening, false positives, health care costs, mammography, mammography math, medical news, screening controversy, statisticsLeave a Comment

Another Take on Mammography

November 23, 2009October 12, 2011 Elaine Schattner M.D.

Three key issues have escaped the headlines: 1. The expert panel carried out a careful analysis using data that are, necessarily, old; 2. The recommendations don’t apply to digital mammography; 3. Mammograms are not all the same.

We need to set the bar higher for mammography…

Posted in Breast Cancer, cancer screening, Diagnosis, Medical News, Oncology (cancer), Women's HealthTagged Breast Cancer, cancer screening, health, health care costs, mammography, medical news, screening controversy, Women's HealthLeave a Comment

Getting the Math on Mammograms

November 20, 2009July 20, 2011 Elaine Schattner M.D.

But consider – if the expert panel’s numbers are off just a bit, by as little as one or two more lives saved per 1904 women screened, the insurers could make a profit!

By my calculation, if one additional woman at a cost of, say, $1 million, is saved among the screening group, the provider might break even. And if three women in the group are saved by the procedure, the decision gets easier…

Now, imagine the technology has advanced, ever so slightly, that another four or five women are saved among the screening lot.

How could anyone, even with a profit motive, elect not to screen those 2000 women?

Posted in Breast Cancer, cancer screening, cancer treatment, Diagnosis, health care costs, Medical Ethics, Medical News, Policy, Women's HealthTagged Breast Cancer, breast cancer screening, cancer screening, health care costs, mammography, mammography math, screening controversy1 Comment

To Screen is Human

November 17, 2009February 12, 2016 Elaine Schattner M.D.

Smack in the midst of October-is-breast-cancer-awareness-month, the Journal of the American Medical Association published a provocative article with a low-key title: “Rethinking Screening for Breast Cancer and Prostate Cancer.” The authors examined trends in screening, diagnosis and deaths from cancer over two decades, applied theoretical models to the data and found a seemingly disappointing result.

It turns out that standard cancer screening is imperfect.

The subject matters, especially to me. I’m a medical oncologist and a breast cancer survivor, spared seven years ago from a small, infiltrating ductal carcinoma by one radiologist, an expert physician who noted an abnormality on my first screening mammogram…

Posted in Breast Cancer, cancer screening, Diagnosis, Medical News, Oncology (cancer), Women's HealthTagged Breast Cancer, cancer medicine, cancer screening, decisions, health, health care costs, mammography, media on medicine, screening controversy, Women's HealthLeave a Comment

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