An Inside Look at Health Care for the Elderly and Medicare

This week the major media outlets published results of a JAMA Internal Medicine study linking proton pump inhibitor (PPI, medicines like Prilosec) use to chronic kidney disease (CKD). Not long ago a flawed study linked PPI use to heart attacks, utilizing exaggerated relative risk numbers and failing to establish a causal relationship between the drug and the outcome. Now a new study shows that people who use PPIs have a 20-50% higher risk of chronic kidney disease. Therefo

Periodically in this blog we discuss physician burnout. A recent medscape survey showed a fairly significant increase in burnout among all physicians, but especially those in primary care. The burnout rate in primary care now exceeds 50%; more than half of primary care doctors are burned out. This leads to worse patient care and satisfaction, as well as more general unhappiness among physicians. A lot of patients now are contending with grouchy, overworked, and frustrated

PSA has always been a poster child of cancer screening. On the one hand, it does prevent the spread of prostate cancer in some people screened. In fact, a recent study showed that since doctors have been ordering PSA tests, the incidence of metastatic prostate cancer has declined. (Welch, NEJM, 10/15) However, there has never been evidence that PSA screening has reduced survival at all, and there are a tremendous number of false positive PSA’s leading to over-testing and o