According to the U.S. Food and Drug Administration, 90% of people worldwide, and 80% in the US, consume caffeine in some form every day. The average adult has an intake of about 200 milligrams, or roughly one cup of coffee per day. As one of those few non-coffee-drinking adults–probably rarer still among emergency medicine providers–I was intrigued by today’s New YorkContinue reading “Coffee: to drink or not to drink”
Author Archives: Marion Sills
Social determinants of health and pay-for-performance readmissions measures
In an article released by JAMA Pediatrics today, my co-authors and I show that social determinants of health (patient factors such as health insurance, poverty and other sociodemographic measures) are risk factors for readmissions-related penalties for children’s hospitals. Without adjusting pay-for-performance (P4P) measures for social determinants of health (SDH), hospitals may receive penalties partially related to patient SDH factors beyondContinue reading “Social determinants of health and pay-for-performance readmissions measures”
Readmissions revisited
I am reposting a post by Garret Johnson and Zoe Lyon, both research assistants for Dr. Ashish Jha at the Harvard T.H. Chan School of Public Health (who also has a great post on risk-adjustment for readmissions. The post eloquently explores an issue I’ve visited in a recent post: the importance of understanding the diverseContinue reading “Readmissions revisited”
Guns, Drugs and Cars
This week’s JAMA released a comparison of major causes of injury death and how they contribute to the gap in life expectancy between the US and other high-income countries. Here are their findings: Men in the comparison countries had a life expectancy advantage of 2.2 years over US men (78.6 years vs 76.4 years), asContinue reading “Guns, Drugs and Cars”
How Performance Metrics Fail Healthcare
A recent New York Times article calls attention to the unintended consequences of healthcare performance metrics. (Disclaimer: I am am favorably disposed to cite any piece that quotes Avedis Donabedian, one of the fore-parents of health quality research methods.) With widespread use of the electronic health record, gathering data for performance metrics increasingly overshadows clinical care. AContinue reading “How Performance Metrics Fail Healthcare”
Your Team Made the Super Bowl? Better Get a Flu Shot
As an emergency medicine physician, popular spectator events such as the Super Bowl usually mean little more than a temporary slowing in the rate of patient arrivals, especially among males, a phenomenon described in several countries in addition to the U.S. A recent Upshot post shows that the impact of widely popular spectator events extendsContinue reading “Your Team Made the Super Bowl? Better Get a Flu Shot”
Is it ethical to incentivize “wellness”?
In an essay on medical ethics, Harald Schmidt explores the question: is it right for employers and health plans to offer incentives to employees/members to pursue health care that is not informed by evidence? He uses as his example several large insurers paying young (younger than 50, even younger than 40 years), low-risk women to obtain mammograms. The evidenceContinue reading “Is it ethical to incentivize “wellness”?”
Can U pls look @ this?
The pediatrician-author-mom Perri Klass wrote a piece in this week’s Well column that will bring knowing smiles to many providers and parents reading this post. She writes about how many unofficial telemedicine consults she fields involving photos of various rashes, injuries and other physical findings taken by parents and/or teens with their mobile devices. She usesContinue reading “Can U pls look @ this?”
Rising death rates in young white adults due to overdoses
A New York Times analysis of CDC data released this week showed that, in contrast to falling death rates among black and Hispanic adults, drug overdoses are driving up the death rate of young white adults in the United States to levels not seen since the end of the AIDS epidemic more than two decades agoContinue reading “Rising death rates in young white adults due to overdoses”
The WSJ as purveyor of evidence on echinacea and flu
An article in this week’s Wall Street Journal‘s Health column–Can Echinacea Melt Winter’s Colds and Flu? –is illustrative of some limitations of the media’s role as a purveyor of scientific information. Specifically, the writer opted to highlight two scientifically flawed trials, without mention of a 2014 Cochrane Database Systematic Review on the topic, a review that encompassed 24Continue reading “The WSJ as purveyor of evidence on echinacea and flu”
Marion R. Sills, MD, MPH 