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John D. Stoeckle Center for Primary Care Innovation
Boston Doctors Object to New PSA Screening Recommendations
By Deborah Kotz (Michael Barry, MD; Medical Director, Stoeckle Center, is quoted)
The Boston Globe; October 26, 2011
New recommendations against using the PSA test to screen healthy men for prostate cancer have prompted objections from two Massachusetts General Hospital physicians who wrote a commentary in the New England Journal of Medicine today proposing a different solution -- one in which doctors give men the option of getting screened, but with a full explanation of the benefits and risks.
Link to full article
Men Are Left to Wonder as PSA Test is Disputed
By Deborah Kotz and Carolyn Y. Johnson (Michael Barry, MD; Medical Director, Stoeckle Center, is quoted)
The Boston Globe; October 8, 2011
New recommendations against using the PSA test to screen healthy men for prostate cancer could lead to a dramatic drop in use of the test now routinely given to about 75 percent of men over 50, but only if doctors follow through and change what they say to patients.
An independent panel of specialists concluded in draft recommendations posted online that the harms from screening outweigh the benefits for healthy men, and some Boston primary care physicians interviewed yesterday said they routinely listen to the US Preventive Services Task Force’s advice and will urge patients not to have the blood test to measure prostate-specific antigen, or PSA.
Patient Protection and Affordable Care Act: Promise and Peril for Primary Care
By John D. Goodson, MD (Physician at the Mass General; Secretary of the Stoeckle Center Advisory Board)
Annals of Internal Medicine; April 19, 2010
Abstract: The Patient Protection and Affordable Care Act (PPACA) of 2010 brings both promise and peril for primary care. This Act has the potential to reestablish primary care as the foundation of US health care delivery. The legislation authorizes specific programs to stabilize and expand the primary care physician workforce, provides an immediate 10% increase in primary care physician payment, creates an opportunity to correct the skewed resource-based relative value scale, and supports innovation in primary care practice. Nevertheless, the peril is that the PPACA initiatives may not alter the current trend toward an increasingly specialized physician workforce. To realize the potential for the PPACA to achieve a more equitable balance between generalist and specialist physicians, all primary care advocates must actively engage in the long rebuilding process.
In Medicine, the Power of No
By David Leonhardt (Michael Barry, MD; Medical Director, Stoeckle Center, is quoted)
The New York Times (Economic Scene); April 7, 2010
How can we learn to say no?
The federal government is now starting to build the institutions that will try to reduce the soaring growth of health care costs. There will be a group to compare the effectiveness of different treatments, a so-called Medicare innovation center and a Medicare oversight board that can set payment rates.
But all these groups will face the same basic problem. Deep down, Americans tend to believe that more care is better care. We recoil from efforts to restrict care.
Looking at Final Options
Dr. Angelo Volandes (Physician Researcher at the Stoeckle Center)
The Boston Globe interview; January 10, 2010
Dr. Angelo Volandes has always been fascinated by visual storytelling, dating back to his godfather’s amateur filmmaking and his family’s theater-going when he was a child in New York. While in medical school at Yale, he took a year off to make a documentary about a 40-year relationship between a doctor and a patient who had neurofibromatosis -- better known as elephant man’s disease -- that is still used today to teach medical students and doctors in training. Now at Massachusetts General Hospital, Volandes has researched the use of video to help patients make decisions at the end of life, comparing visual versus verbal-only explanations of care choices among advanced brain cancer patients in one study and people facing advanced dementia in another.
Read full interview
The interview was in response to an article Dr. Volandes published in the Journal of Clinical Oncology: January 10, 2010 (volume 28, number 2).Use of Video to Facilitate End-of-Life Discussions with Patients With Cancer: A Randomized Controlled Trial
Also see our NEWS tab for a list of other newspaper articles on primary care.
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