Health care

What’s the evidence for evidence-based medicine?

Monique Tello, MD, MPH

Contributing Editor

The history of medicine is filled with remedies that were relied upon for hundreds of years until they were eventually proven ineffective or possibly even dangerous, while legitimate practices and treatments were disregarded or ridiculed until evidence outweighed skepticism. The bottom line is that medical interventions — from tests to treatments — should neither be recommended nor condemned without considering and weighing the evidence. A future post will discuss what physicians look for when evaluating “the evidence.”

White coat syndrome or white coat logo syndrome? The pitfalls of doctor shopping by “brand”

Branding has the power to influence people, but it should not necessarily be a significant, or the only, factor when it comes to health care. Picking a physician based on the name of their hospital does not always correlate with quality of care, and it could even cost you a larger copay.

Does your doctor’s gender matter?

Robert H. Shmerling, MD

Faculty Editor, Harvard Health Publishing

A recent study involving over one million Medicare enrollees found that these older patients had more successful outcomes when under the care of a female physician verses a male physician. A thorough reading of the study seems to support that gender made the difference, but the takeaway is that it’s important to understand the differences between how women and men practice medicine and why these might be important. Most likely each gender has something to learn from the other.

Racism and discrimination in health care: Providers and patients

Monique Tello, MD, MPH

Contributing Editor

It is sadly true that people of color cannot necessarily expect to receive the same quality of medical care in this country as whites. And unfortunately, discrimination by patients toward doctors is another problem that the medical community needs to address. To overcome the racism and discrimination that lead to health care disparities, doctors and patients need to identify and manage our own implicit biases.

Making health decisions in the face of uncertainty: Let your values be your guide

One of the biggest challenges for doctors and their patients is making decisions without complete certainty, so they must work together to determine the point at which the risk of further testing ceases to be acceptable. A patient’s personal values and health goals are important factors in health decisions, especially in the face of uncertainty.

Keeping the human connection in medicine

As the practice of medicine evolves, electronic medical records can simplify care and help make it more thorough, but the tools that help make doctors more efficient, have real consequences for how doctors interact with their patients, and one another. Doctors must work harder to maintain good communication and relationships with their patients and colleagues.

Online symptom checkers: You’ll still want to call a doctor when something’s wrong with you

Monique Tello, MD, MPH

Contributing Editor

Researchers compared the diagnostic accuracy of human doctors with various symptom-checking services available online, but online diagnostics won’t be replacing humans anytime soon. While the doctors weren’t perfect, they consistently did better than the computer programs. The study investigators suggest that eventually such programs might be able to help physicians to improve their diagnostic accuracy.

Medical errors: Honesty is the best policy

Monique Tello, MD, MPH

Contributing Editor

Medical errors are responsible for several hundred thousand deaths per year, and the tendency has been to keep quiet about them. Doctors and institutions should embrace greater openness about errors in order to learn from them and improve healthcare for everyone.

New blood test for colon cancer screening: Questions remain

Celia Smoak Spell

Assistant Editor, Harvard Health Publishing

In April, the U.S. Food and Drug Administration (FDA) approved a new screening test for colon cancer, making it the first blood-based test for this type of cancer. While this test does make it more convenient for people to get screened for colon cancer, it is also less exact than the current screening methods. It is important to discuss your risk factors and screening options with your doctor.

Buying into generic drugs

Matthew Solan

Executive Editor, Harvard Men's Health Watch

Generic versions of drugs are just as effective as their name-brand counterparts, and they cost less than the brand names. Although there are various reasons why your doctor might not always recommend switching to the generic version, it is important to speak with your doctor about the cost of your prescriptions and ask if there is a generic version available.