An epidemic of incidentalomas, “hopeium” in prostate cancer ads, and David Martin on his “Aha!” moment

November 13, 2014

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.



  • A new paper in this week’s New England Journal of Medicine documents the stunning growth in rates of thyroid cancer, driven not by an actual increase in the prevalence of disease, but by widespread overdiagnosis of thyroid cancer. Thyroid tumors are often classic “incidentalomas,” abnormalities detected during an unrelated test. Such incidentalomas, especially thyroid cancer, would not cause symptoms if left untreated, but they routinely provoke follow-up testing and treatment. The treatment for thyroid incidentalomas can cause serious harm, including damage to nearby glands and vocal chord paralysis. Gil Welch, MD, writes in a related New York Times op-ed that the pattern of overdiagnosis should make us skeptical of the infinite virtues of early detection, and that instead we ought to pay more attention to “epidemics of medical care.”


  • Every hospital seems to be doing it. Advertising. According to a New York Times piece from last year, it is estimated that hospitals with more than 400 beds spent $2.18 million on advertising in 2010. Not only are these costs deemed wasteful, but the ads can be dangerous when outlandish, baseless claims are made to lure new patients. In a Forbes piece this week, Benjamin Davies, MD, singles out prostate cancer services advertising that appeared in two well-regarded New York publications. Davies generally has no issue with ads that are true, evidence-based and “horribly honest.” But he blasts claims from two ads: 1) the CyberKnife is regarded as “the biggest advance in prostate cancer treatment in a decade,” and 2) that organic produce contributes to good cancer care. Stay tuned for Part 2 of Prostate Cancer Advertising: Lies and the Damn Lies.


  • In his blog post, Lown Institute Vice President David Martin, describes finding his ‘aha’ moment after working in healthcare for more than 15 years. It was when he arrived at Lown and realized that so much of the healthcare that is delivered to patients has little or no benefit, and is based not on science, but profit. Potential solutions for curbing this abuse of trust will be front and center for discussion by health policy leaders, clinicians and patient advocates during the upcoming third annual conference, scheduled for March 8-11 in San Diego.



  1. We can’t wait to hear Dr. Diane Meier’s keynote at our annual meeting! You don’t want to miss Road to RightCare: Engage, Organize, Transform, March 8-11 in San Diego. There’s still time to take advantage of early bird registration (ends December 1). Here’s a video of Dr. Meier talking about the importance of communication skills and preparation when having difficult conversations with patients. For another preview of the conference, check out our video of highlights from last year.



Screening and overdiagnosis

  1. Are you suffering from over diagnosis and over treatment? – Prof. Dr. BM Hedge, Moneylife.IN
  2. The disease called “Diagnosis” – Prof. Dr. BM Hedge, Moneylife.IN
  3. Some patients are getting colonoscopies too often – Liz Kowalczyk, Boston Globe
  4. Medicare Costs For Breast Cancer Screenings Soar, But Benefits Remain Unclear – Magaly Olivero, Hartford Courant
  5. Lung Cancer Screening Can Be Cost Effective, Study Reports – Dennis Thompson, HealthDay
  6. Medicare Proposes Paying for Lung Cancer Screenings for Older Longtime Smokers – Sabrina Tavernise, New York Times
  7. Missing Out: 8 Million U.S. Women Skip Cervical Cancer Screening – Maggie Fox, NBC News


King v. Burwell

  1. King v. Burwell: The new Supreme Court case that could gut Obamacare, explained – Adrianna McIntyre, Vox
  2. Prediction: SCOTUS will find for the King plaintiffs – Bill Gardner, The Incidental Economist
  3. The weird scaremongering in the latest Obamacare lawsuit – Adrianna McIntyre, Vox


Hospital consolidation

  1. Hospital Consolidation Isn’t the Key to Lowering Costs and Raising Quality – Austin Frakt, JAMA Forum
  2. Partners pays a price after bid for South Shore Hospital – Robert Weisman and Scott Allen, Boston Globe
  3. Judge Appears Skeptical About Partners HealthCare Deal – Martha Bebinger, WBUR
  4. Time to pass the baton – Paul Levy, Not Running a Hospital blog


End-of-life and assisted dying

  1. Mixed medical views on Brittany Maynard’s choice to die – Deborah Kotz, Boston Globe
  2. The Brittany Maynard effect: How she is changing the debate on assisted dying – Marcia Angell, Washington Post op-ed
  3. Becky Liddicoat Yamarik on Palliative Care and End-of-Life Medical Issues – Russ Roberts, Econtalk podcast
  4. Making time for griefwork – Paul Levy, Not Running a Hospital blog


Healthcare delivery

  1. One doctor’s old-fashioned idea to cut health care spending: house calls – Jeff Guo, Washington Post
  2. Delivering World-Class Health Care, Affordably – Vijay Govindarajan and Ravi Ramamurti, Harvard Business Review
  3. Kidney Dialysis Company Expands Into The Hospital Business – Eric Whitney, Kaiser Health News
  4. Why Don’t More People Want to Donate Their Organs? – Tiffanie Wen, The Atlantic


Medical evidence

  1. Balancing the Patient Experience with Evidence-Based Medicine – Paul Marantz, MD, MPH, Huffington Post


Payment system

  1. To lower health costs, change the ways doctors get paidBoston Globe editorial
  2. Designing Smarter Pay-for-Performance Programs – Aaron McKethan, PhD and Ashish K. Jha, MD, MPH, JAMA



  1. A quarter of Latinos lack health insurance, a year after Obamacare launched – Teresa Wiltz, Washington Post


Patient records

  1. Medical Records: Top Secret – Elisabeth Rosenthal, New York Times
  2. Patient-data-access advocates remain frustrated but hopeful of benefits – Darius Tahir, Modern Healthcare



  1. The world’s most effective HIV prevention drug hasn’t lived up to its potential – Heather Boerner, Washington Post


Patient communication

  1. How To Get Doctors To Email Their Patients – Leah Binder, Forbes


Patient safety

  1. Medical Errors Drop When Docs Communicate Better at Shift Changes – Steven Reinberg, HealthDay
  2. C-section rates continue to decline in the US – Elizabeth Palermo, LiveScience
  3. Retesting Breast Cancer Axioms – Jane E. Brody, New York Times Well blog


Conflict of interest

  1. Do Patients Care About Your Sunshine Act Payments? – Leslie Kane, MA, Medscape



  1. Overuse of antibiotics tied to increase in painful gut infection – Kelly R. Reveles, The Conversation
  2. Most doctors concerned about overuse of antibiotics in animals – Maggie Oliver, Laurel Mark, and David Wallinga, Milwaukee Journal-Sentinel


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