Hospitalization for Mental Illness Among Parents After the Death of a Child

When a physician loses a patient, the effects of stress and grief of losing a loved one on family members can sometimes be overlooked. This study reports the risk of clinical psychiatric disorders and hospitalizations among parents who have lost a child.

Overbilling vs. Downcoding: The Battle between Physicians and Insurers

In September 2004, a federal court case pitted "almost all doctors versus almost all major health maintenance organizations" on the issue of reimbursement for physician services. This case exposes a continuing conflict between physicians and insurers: physicians allege that insurers purposefully delay and reduce resimbursements, and insurers claim that physicians misreport and overcharge for their services.

A Potential Decline in Life Expectancy in the United States in the 21st Century

New considerations of increasingly prevalent conditions such as obesity and diabetes suggest a possible decline of the projected average lifespan in the future of the United States. These changes in projected lifespan may have many public-policy implications.

Images in Clinical Medicine: The Tale of Phineas Gage, Digitally Remastered

Two researchers use digital imaging to revisit the injury of construction worker Phineas Gage, one of the most closely-studied cases contributing to the study of neuroscience. Gage survived an explosion in which a 1.25 inch-wide metal rod was thrust through his skull and brain, resulting in a permanent change in his personality. The NEJM presents two digital video clips reconstructing the explosion and the resulting fractured skull.

A Day in the Life of Doug Kelling, General Internist

The Next Generation speaks with internist Doug Kelling on his path to internal medicine, practicing privately vs. working as a hospital employee, and his perspectives on contemporary health care.

Tutorial: An Introduction to Clinical Trials

A sound experimental design that minimizes bias and confounding is crucial for a clinical trial to provide valid information regarding the efficacy and safety of a new drug or treatment seeking approval. This second part of a two-part tutorial discusses the principles of randomization and blinding and introduces the statistical methods that interpret trial data into reliable conclusions.

Unraveling the Cox-2 Debacle

The recent controversies in the pharmaceuticals industry with regards to Cox-2 inhibitors such as Merck's Vioxx and Pfizer's two drugs, Bextra and Celebrex, may indicate some problems with the drug-approval process as a whole. Here, we present the views of one particular author, Dr. Marcia Angell, author of The Truth About the Drug Companies: How They Deceive Us and What to Do About It.