Documentary on ‘Being Mortal,’ transparency of health care costs, & why it’s so hard to weed out unneeded care

February 19, 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 health care system toward the right care for all patients.


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  • Last week PBS’s Frontline premiered the documentary Being Mortal, hosted by Atul Gawande, MD, who wrote the book that inspired it. The show is a powerful exploration of the many challenges patients face at the end of their lives, as well as the difficulties faced by family members and caregivers. The documentary underscores that dealing with death, even for clinicians, is hard. Yet the clinicians featured are skilled at having the conversations necessary to help patients make their final decisions. Some of the physicians Gawande interviews talk about what they wish they did differently in communicating with patients. However, the picture presented isn’t entirely bleak. One scene, with a dying patient speaking to his young grandson is particularly beautiful, and gives a sense of how death can be a meaningful, loving experience – if we’re willing to reimagine how to approach it. That rethinking is starting to happen, with The Conversation Project helping families share end-of-life wishes, and books like Angelo Volandes’s The Conversation and Katy Butler’s Knocking on Heaven’s Door.


  • “There is no sector in society where the issue of cost and what one (patient) is responsible for is so opaque,” says Steven Weinberger, MD, executive vice president and CEO of the American College of Physicians. Weinberger, who will lead a plenary session at the Lown Institute’s third annual meeting next month in San Diego, is concerned about the lack of transparency regarding health care costs. “Even when patients ask for a price up front, many doctors don’t know the answer…what bills will come in, say, from the physician or surgical group.” He suggests an effort involving regulatory agencies at the federal and state levels, insurance companies and provider communities could lead to solutions to the what-does-it-cost medical issue that often causes personal bankruptcies. Weinberger’s session will engage a patient who received an outrageous bill from an assistant surgeon, one the patient had not even met. Read the interview with Weinberger. If you have not yet registered for the conference, you can do so now.


  • In an op-ed on, Lown Institute Senior Vice President Shannon Brownlee asks the perennial question: Why is it so hard to make a dent in the huge volume of unnecessary health care? Brownlee describes the frustrations of many clinicians who are pushed in the direction of doing more to patients, instead of more for patients. “Overtreatment is so hard to weed out,” Brownlee says, “because American health care is organized not as a common good rooted in social need, but rather as a commodity.” She adds that the “estimated $1 trillion wasted in our current system diverts resources that could be spent on preventing chronic disease, building healthy communities, and addressing the deep injustice of health disparities.”



  • Congratulations to the award recipients of the first national Do No Harm Project competition, jointly sponsored by the Lown Institute and the Do No harm Project and supported by the Robert Wood Johnson foundation. They are Spyridoula Maraka, MD and secondary authors Derek O’KeeffeMD and Victor Montori, MD, all from the Mayo Clinic; and Stephanie Chen, MD, from Johns Hopkins, Bayview Medical Center. Read more here.


  • Full descriptions are available for the workshops at the 2015 Lown Conference, March 8 – 11 in San Diego. Check out the schedule and descriptions, including our all-star faculty. The workshops will be a highlight of this year’s conference, and we hope you’re excited about them. If you still haven’t registered for the conference, we’ve extended the deadline, so sign up today!



Medical evidence


Patient safety


Patient demand for unnecessary treatment




Patient communication


End-of-life care


Conflict of interest


Choosing Wisely




Antibiotic overuse


Medical education


Mental health


Payment system


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