Transportation solutions for aging in place, Yelp-ing doctors, and COI in cholesterol drug approval

June 18, 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.



While aging in place seems like the preferred way to live out one’s golden years, doing so may be extremely challenging for suburban seniors who are no longer able to drive. Stuck at home, often in isolation, they become dependent on others to deliver food, provide rides to medical appointments, or simply enjoy human contact–which compromise health outcomes and life expectancy. In Vox this week, writer Joseph Stromberg describes how our car-oriented civic planning harms this vulnerable population. But new transportation solutions are emerging; they include paratransit shuttles, Uber models and perhaps self-driving cars. Keeping seniors as healthy as possible and out of the hospital is important, writes Robert Pearl, MD, in a Forbes piece titled How Hospitals Can Kill Us. He explains that the hospital experience for the elderly, in particular, can weaken bodies and minds, and lead to “post-hospital syndrome,” new illness that occurs as a result of the previous hospitalization. More needs to be done to keep seniors healthy, especially as Baby Boomers continue aging, according to a piece by writer Meghan Hoyer in USA Today, who finds that two-thirds of Medicare beneficiaries over age 65 have multiple chronic conditions, and more than four million of them have at least six long-term ailments.


For both clinicians and patients, identifying what constitutes right care and rating clinicians on their ability to provide it is not a straightforward exercise. Niam Yaraghi, a Brookings Institution Fellow, writes in US News and World Report that Yelp for doctors is not a suitable platform for patients to share reviews and rate their experiences. The reason, Yaraghi contends, is that “patients are neither qualified nor capable of evaluating the quality of the medical services that they receive.” Casey Quinlan, author and patient advocate, directly addresses this and Yaraghi’s other assertions about patients’ ineptitude in appraising their care. On her blog, “The Mighty Mouth” Quinlan argues that patients are more than capable of comprehending and utilizing the necessary information to assess care. Michael L. Millenson of The Health Care Blog discusses how patient engagement could help reduce overtreatment. However, better engaging or empowering patients is not a panacea for the system’s ills. Until healthcare figures out a way to better measure and report outcomes, patients will continue to Yelp.


Continuing the ongoing conversation about how to improve medical science, and the challenges posed by relationships between physicians and the pharmaceutical industry, we have posted a couple of commentaries responding to the IMPROVE-IT trial and the FDA advisory panel’s recommendation to approve two new cholesterol-lowering drugs. David Newman, MD, points out that industry funded trials like IMPROVE-IT sometimes alter research designs to show statistically significant benefits, but those alterations undermine his ability to interpret or trust their findings. In his commentary, Lown Institute President Vikas Saini, MD, adds, “It’s harder to implement evidence-based policy when there is a well-funded stampede to one side of an issue,” and industry involvement in research makes it harder to avoid letting our enthusiasm push policy beyond what medical evidence actually shows.



  • We’re hosting a Twitter Chat in response to the recent Conflict of Interest series in the New England Journal of Medicine. It’s on Monday, June 22, at 2 pm ET. Our previous response generated a great discussion, and we want to keep it going. Joining the Twitter Chat will be Larry Husten (@cardiobrief), Austin Frakt (@afrakt), John Mandrola, MD (@drjohnm), and many others. Please follow us at @LownInstitute, and join in to make your voice heard by using the hashtag #COIchat.


  • The Agency for Healthcare Research and Quality (AHRQ) is an essential funder of health services research and other efforts to improve healthcare delivery. But the budget bill introduced this week in the House Appropriations Committee’s health subcommittee proposes eliminating the agency. AHRQ has been threatened with elimination before, and twenty years ago political interference killed another health policy agency. It’s important that Members of Congress hear from physicians, researchers, and other healthcare professionals about how AHRQ funding makes our healthcare system safer and more effective.

AcademyHealth is coordinating responses to the bill. You can see here for how you can help.


  • The Lown Institute is accepting applications from incoming chief residents for the new RightCare Educator Program. Help shape a more rational medical culture by implementing RightCare Rounds in your institution. Deadline for applications is Tuesday, June 30. A small stipend will be provided. For more information, see here.


  • Have you signed up for RightCare Action Week? It’s our grassroots initiative that engages people across the country to take action to show what our healthcare system should look like. On the, you’ll find an Action Forum, where you can submit, vote on, and discuss Action Ideas with your friends and colleagues. Sign up today.


  • The Arnold P. Gold Foundation is requesting proposals for a new set of rigorous reviews of literature that use established methods of evidence synthesis to produce thoughtful analysis and discussion of evidence relating to the practice or teaching of humanistic healthcare. Learn more.






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