TagGawande

Reading of the Week: Gawande’s New Yorker Essay on Primary Care (and, Yes, Mental Health)

From the Editor

How is health care changing?

To answer that question, we look this week not to a medical journal, but to The New Yorker. We consider an essay not on new drugs or imaging, but on the quiet rise of… primary care.

Primary care and the future

Dr. Atul Gawande writes a long essay on the virtues of primary care. Considering how medicine has shifted from acute care to chronic illness, he describes the importance of primary care, drawing on his own training and thinking – and the cardiac issues of his son.

Though this essay doesn’t directly consider mental illness, it is very relevant.

DG Continue reading

Reading of the Week: Dr. Gawande and ‘Low-Value Care’

It was lunchtime before my afternoon surgery clinic, which meant that I was at my desk, eating a ham-and-cheese sandwich and clicking through medical articles. Among those which caught my eye: a British case report on the first 3-D-printed hip implanted in a human being, a Canadian analysis of the rising volume of emergency-room visits by children who have ingested magnets, and a Colorado study finding that the percentage of fatal motor-vehicle accidents involving marijuana had doubled since its commercial distribution became legal. The one that got me thinking, however, was a study of more than a million Medicare patients. It suggested that a huge proportion had received care that was simply a waste.

The researchers called it “low-value care.” But, really, it was no-value care. They studied how often people received one of twenty-six tests or treatments that scientific and professional organizations have consistently determined to have no benefit or to be outright harmful.

So begins Dr. Atul Gawande’s recent essay in The New Yorker, which I have chosen as this week’s Reading.

It asks a simple question: what can we do about this?

Dr. Atul Gawande

Dr. Gawande, a general surgeon at Brigham and Women’s Hospital, is a prolific writer; he is a frequent contributor to The New Yorker and has penned several bestselling books, including Being Mortal and The Checklist Manifesto.

In this piece, Dr. Gawande focuses on overtreatment. Indeed, the title is a good summary: “Overkill.” Continue reading