This Viewpoint discusses the phenomenon of physicians talking about patients with their partners and spouses, and the tensions between balancing patient privacy with having a personal outlet and support for processing challenging clinical experiences.
This Viewpoint discusses the 2019 Box v Planned Parenthood US Supreme Court ruling that upheld an Indiana provision mandating that abortion facilities bury or cremate fetal remains, characterizing the law as a “targeted restriction” law intended to place undue burden on abortion providers and patients and incrementally reduce access to abortion and related reproductive health services.
This Viewpoint discusses the challenges of communicating uncertain prognosis to patients and offers a framework and language that go past mortality statistics—addressing range of time left, loss of independence, and the unpredictability of outcomes—that embraces uncertainty and might help empower patients to plan for their quality-of-life goals.
This Viewpoint uses recent US state legislation mandating investments in primary care to discuss the lack of evidence supporting assumptions that primary care spending will save downstream health care costs, the reasons why that might be, and implications for policy, payment, and practice reforms.
This Medical News article discusses the Adolescent Brain Cognitive Development study with its director, Gaya Dowling, PhD.
This Medical News article examines how vacationing might affect the risk of developing metabolic syndrome, which increases the risk of heart disease, stroke, and diabetes.
This Viewpoint discusses methodological challenges to conducting reliable dietary research relative to processes and standards in place for drug discovery and development, and proposes modifications to the conduct of dietary research to improve its transparency, quality, and reliability.
This Viewpoint summarizes recommendations from an International Society for Stem Cell Research task force charged with developing professional standards of patient consent for stem cell–based interventions offered outside a clinical trial given the spread of unregulated stem cell clinics offering unproven therapies.
This Viewpoint uses Dinerstein v Google, a class action complaint in Illinois alleging that an academic medical center violated patient privacy by giving timestamped electronic health record (EHR) data to Google for development of their novel EHR system, to review the ways privacy laws like HIPAA are based on outdated technologies and data transfer standards and to call for a rethinking of data sharing governance appropriate to contemporary infrastructure and expectations of interoperability.
This JAMA Insights Clinical Update reviews what is known and not known about the efficacy and safety of cannabis and cannabinoids for managing medical conditions, distinguishing between FDA-approved indications, nonapproved indications supported by high-quality emerging evidence, and current claims and uses for which there is inadequate evidence.
This Viewpoint discusses the how changing opt-in to opt-out policies for organ donors may impede US donation and recommends to increase efforts in recruiting individuals to become donors to meet the need of helping people who need transplants.
This Viewpoint reviews the molecular basis of sickle cell disease (SCD), the history of treatments for the disease, and recent progress toward curative therapies including HSCT and gene therapy and editing, emphasizing that research and innovation needs to take into account patient priorities and perspectives given the history of research mistreatment of minority groups most affected by SCD.
This Viewpoint reviews conventional ways of assessing performance of machine learning models to diagnose or predict outcomes, but emphasizes that if machine learning is to improve patient care the models must be evaluated for their utility in improving clinical decisions taking into account the range of decisions clinicians can take, the cost and efficacy of those options, and the likelihood that patients will follow the recommended decisions.
This Quick Uptakes discusses a recent study that compared the long-term physical health effects of childbirth vs abortion among women with unwanted pregnancies.
This Medical News article examines the increasing incidence of herpes zoster ophthalmicus—shingles of the eye—and the need for more widespread vaccination against shingles.
This Viewpoint argues that to redeem the loss of life from the opioid epidemic the health care community should move forward clearly recognizing the perils of applying simple solutions to complex problems, of accepting unproven therapies into practice, of not teaching physicians addiction science, and of the potential deadliness of financial conflicts of interest.
This Viewpoint argues for separation of physician performance measurement from RVU production as a means to refocus physicians away from billing toward patient-centered values that could improve patients’ experience, reduce potential harms from the overtreatment that RVUs incentivize, and improve physicians’ work life and satisfaction.
In 2019, the US Food and Drug Administration approved esketamine for treatment of major depressive disorder unresponsive to other therapies when given in a health care facility because of its transient effects on vital signs and feelings of dissociation it can produce acutely. This Viewpoint discusses likely barriers to use of the new treatment option given that the drug is expensive, many psychiatrists work in solo or small group settings, do not accept commercial insurance, and may be reluctant to invest in the costly infrastructure necessary to provide it and monitor patients as required after its administration.
This Viewpoint summarizes what is known about greenhouse gas emissions and pollution generated by health care activities in high-income countries, calls for cooperation between stakeholders (physicians, hospital administrators, regulatory bodies, specialty societies, policy makers, industry) to reduce the environmental footprint of their collective activities, and calls for funding of environmental sustainability science to inform the effort and optimize resource and waste management.
In this Viewpoint, Drs Anthony Fauci and Andrea Lerner discuss the rise of injection of opioids in the rural US as an emerging risk factor for HIV infection among traditionally low-risk communities, and calls for interventions to prevent IDU-related HIV transmission—needle-exchange programs, opioid use disorder treatment programs, and increased availability of preexposure prophylaxis (PrEP)—as a means to end the HIV epidemic in the US.
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