Streams

A Researcher’s Quest to Understand Health Care

Monday, February 28, 2011

Dr. John E. Wennberg explains why the medical care Americans receive depends on their physicians and hospitals as much as it does on medical science or patient choice. His book Tracking Medicine: A Researcher’s Quest to Understand Health Care chronicles his 40-year study of medical variation across the country and its effects on the health of the individual patient, and discusses the nation’s long-term economic prospects.

Guests:

Dr. John E. Wennberg
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Comments [12]

Debra Goldman from Montclair, NJ

Very interesting discussion of healthcare but LOVED your shout-out about your back and physical therapy. I am not taking credit for your success(it ws at the beginning of my carreer) but I treated you many many years ago in the NY Downtown hospital.
Thank you Leonard!

Feb. 28 2011 12:49 PM
mc from Brooklyn

It's supply and demand turned on its head. Instead of more supply driving down demand, more supply drives up demand.

Feb. 28 2011 12:38 PM
Greta from Columbia University Health Education student

I think that an important issue to note when discussing choices by patients and doctors on risky surgeries and screening is the understanding of statistics and odds ratios, relative and absolute risks.

See this paper: Gigerenzer, G., Gaissmaier, W., Kurz-Milcke, E., Schwartz, L. M., & Woloshin, S. (2007). Helping doctors and patients make sense of health statistics. Psychological Science in the Public Interest, 8, 53-96.

Gigerenzer and colleagues point out that both doctors and the general public are not well-versed in statistics. For example (numbers are hypothetical), if the statistic says "Colonoscopy reduces the risk of dying from the disease by 25%," this is a relative risk and makes the procedure seems a lot more beneficial than if it were reported as an absolute risk. The above statistic as an absolute risk could be something like: the procedure reduces your risk of dying from 4 in 10,000 to 1 in 10,000.

Feb. 28 2011 12:37 PM

I wish there were more practising doctors such as this guest. He comes across as compassionate and practical.

Feb. 28 2011 12:36 PM
Jamison from Fort Green

why can there be such a wide rang of price for the same medical procedure, and will we ever see a day that set price will be implemented?

Feb. 28 2011 12:33 PM
mc from Brooklyn

@Richard: was that because the procedure was not covered or because the patient had trouble finding a provider to do those services?

Feb. 28 2011 12:33 PM
anne from Long Island

The question is really how do medical teams find the time to help patients become well-informed? Because doctors are so rushed - usually for reasons having to do with how they are paid - they are rarely willing or able to explain options and the underlying reasons for those options.

Feb. 28 2011 12:32 PM
Richard Pierce from Park

Would your guest comment on HIV care. A friend of mine moved to MA and was surprised to find that things we considered routine, like regular rectal exams, were almost unheard of and access to these exams was limited. Thanks. Richard

Feb. 28 2011 12:30 PM
ericf


have patient to patient variations been accounted for?

Feb. 28 2011 12:23 PM
mc from Brooklyn

J. Brown is right about advertising and its effect on patients. And then there are the drug and device makers.

Feb. 28 2011 12:22 PM
J. Brown from NJ

The discussion regarding women and hysterectomies is over simplified. When a woman comes to me with a benign problem and hysterectomy is an option, I make it clear to her that this is one in a series of treatment options, including no treatment. Medical management for uterine bleeding is always my first line of treatment. And hysterectomy is not the only surgical method that can be used for treatment. If a woman is living with bleeding daily, and has multiple visits to the ER for bleeding and has needed blood transfusions due to blood loss, hysterectomy is a valid, and often, the best option for a patient.

Also, patients often drive the demand for medical procedures. I have patients come to me requesting a procedure that they did not need, and had no pathology, because they saw an advertisement for a procedure. They did not know what it was, just thought they might need it.

Feb. 28 2011 12:20 PM
mc from Brooklyn

Yayy, yayy!! Thank you for having Dr. Wennberg on your show. We need to hear a lot more from him and others who have studied regional differences.

Feb. 28 2011 12:20 PM

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