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The Path to Primary Care, housing the homeless for public health, and popularizing the NNT

January 29, 2015

In order to bring you more of the news you want to read, RightCare Weekly summarizes and interprets three important articles and provides headlines linking to the many other articles and editorials you’ll find interesting. As always, RightCare Weekly presents articles related to moving our healthcare system toward the right care for all patients.

Join the conversation: Post your comments in our new section at the bottom of this page. 

 

Features:

  • As director of the Los Angeles County Department of Health Service, Mitch Katz, MD, has petitioned the federal government to allow the use of Medicaid funds for the provision of housing thousands of chronically ill homeless in his county. “Compared with healthcare,” says Katz, “social determinants like housing are greater indicators of patient health.” Katz believes housing is a medical necessity and the “most effective service” he can provide to the homeless population. Read more about his work. Better yet, come here him speak when he gives one of the many amazing keynote speeches at the third annual Lown Institute Conference, March 8-11 in San Diego. Registration closes on February 10; register now.

 

  • Karen Brown of New England Public Radio has created a long, in-depth exploration of “The Path to Primary Care,” which chronicles the struggles young physicians face in pursuing primary care. It covers a huge range of topics, including the hidden curriculum in medical education, the importance of social determinants in driving health, low pay for primary care doctors, new primary care residency programs like at Bay State Health, and primary care advocacy work from groups like Primary Care Progress. It’s an engaging, accessible overview of many of the challenges we face in reforming the healthcare system. Listen, and share it with your friends and family.

 

  • On the heels of President Obama’s call for “precision medicine” in his State of the Union address, Aaron Carroll and Austin Frakt in The Upshot re-examined the concept of the number needed to treat – the NNT. Most treatments only end up helping a small fraction of the people who take them, and that effect is magnified when treatments are used in populations that are less sick or otherwise less likely to benefit than the group where the drug was first tested. Tools like the NNT that can help patients understand the real benefits and risks of treatments are essential to improving medical decision-making and reducing overuse.

 

QUESTION: The recent measles outbreak at Disneyland has brought a lot of attention to the dangers of having children skip vaccines. See stories here, here, here, and here. While patient preferences are an important part of determining the right care, does that relationship change when certain choices cause serious public health concerns? When is it reasonable for the state to require vaccinations, regardless of a patient or parent’s belief? Please tell us what you think in the comments section at the bottom of this page.

 

Headlines:

Social determinants of health

 

Payment system

 

Overdiagnosis and overtreatment

 

Medical culture

 

Evidence-based policymaking

 

Shared decision making

 

End-of-life care

 

Medical education

 

Patient safety

 

Conflicts of interest

 

Pharma

 

Workforce

 

RightCare Weekly is made possible through the generous support of the Robert Wood Johnson Foundation