Volume 4 Issue 1 – November 2007
We Can Do Better—Improving the Health of the American People – An NEJM Special Article
SA Schroeder, NEJM, September 20 2007, Vol 357 (12), 1221-8
United States healthcare has been ridiculed for spending the greatest amount per capita yet achieving mediocre health results. In this special article, Dr. Shroeder of UCSF suggests that the greatest opportunities to improve health lie in improving personal behavior and addressing the health of the poor. He then speculates that lack of social advocacy for the poor and the laissez-faire health system encourages poor health outcomes.
Guilty, Afraid, and Alone—Struggling with Medical Error – A NEJM Perspective Article
T Delbanco and SK Bell, NEJM, October 25 2007, Vol 357 (17), 1682-3
Medical error creates an agonizing experience for patients, family members, and clinicians alike, and feelings of guilt or blame hinder closure and forgiveness. Dr. Delbanco describes cases of medical error and perspectives from all sides. He then suggests that honest and direct communication may be the best antidote, especially when doctors are paralyzed by shame or fear of legal repercussions, and patients and families struggle to understand their situation fully.
Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer – An NEJM Original Article
MH Mayrand et al., NEJM, October 18 2007, Vol 357 (16), 1579-88
The sexually-transmitted human papillomavirus (HPV) is a necessary factor in almost all cases of cervical cancer, and early detection can ward off serious complications. While the Pap smear is the most common test worldwide, testing for DNA of HPV may be superior in sensitivity. Dr. Mayrand and colleagues report the first screening round comparing DNA testing and Pap testing in parallel and finds DNA testing more sensitive for detection of cervical cancer.
Taking a Medical History in Las Terrenas
Cardiovascular disease (CVD) is a major public health problem in many developing countries, including the Dominican Republic. In this small nation in the Caribbean, widespread poverty makes it difficult for many families to maintain healthy diets or lifestyles, and this creates risk for CVD. In this article, Rachel Anderson describes her experiences as a medical student working on a cardiovascular health census in the Dominican town of Las Terrenas, in the northern province of Samaná.
Tutorials in Medicine: Managed Care Organizations
In the jargon-laden field of managed care organization, getting enough basic knowledge as tools to start understanding the field often seems daunting. In this second installment to series on the management of health care, we tackle the history of the industry’s development, the flavors of health maintenance organizations, and other aspects to this dominant model in the US health care system.
