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The medical decision is sick but not hopeless…

What follows is my latest post on | Medscape Cardiology. It’s weird; the post is one of my favorites, but it’s not made the most read list–at all, not even fifth place. There are thoughtful comments but it’s simply not popular among doctors.


Imagine this scenario: A learned professor comes to your office as a patient. She brings information downloaded from PubMed and various other sources. What are your sensations? If, after getting care from you or your team, would this professor feel compelled to write an essay about paternalism and power imbalance in the healthcare decision?

In her 2013 essay in the Atlantic, Thinking About Pregnancy Like an Economist, Emily Oster, then an associate professor at the University of Chicago, objects to the state of pregnancy care. I am not an expert in obstetrics, but her point, and mine, applies to most medical decisions. Be sure, obstetrics is not the only area of healthcare mired in anachronism.

Prof Oster is an economist who read a lot about pregnancy. That information, taken together with her expertise in statistics, transformed her into a (very) informed patient. She is not a medical doctor, but she acquired much of the same information medical doctors had. That became a problem. And that it was a problem is the issue we should discuss.

To read the rest of the post, click on its title, Doctor Doesn’t Always Know Best.


One reply on “The medical decision is sick but not hopeless…”

I love your posts, John, but I can no longer go on the page. It is flooded with scrolling and pop-up ads for drugs. When I followed your link above to Medscape it was very difficult to find the post. At one point a giant ad for Zontivity popped up and blocked my screen until I clicked it away.
Is there any way you can post the full article on your (thankfully) ad-free blog?

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