The Price We Pay
What Broke American Health Care - And How to Fix it
The Untold Story of One Woman's Mission to Love the Forgotten Children of Egypt's Garbage Slums
What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care
The book details the hazards of transparency done poorly and the reward of transparency done well--when physicians and patients are at the center. How do we take health care to the next level? The barriers and heroes of the American health care system are highlighted vividly in this Library Journal Book of the Year.
June 8, 2021
The Power of Natural Immunity
The news about the U.S. Covid pandemic is even better than you’ve heard. Some 80% to 85% of American adults are immune to the virus: More than 64% have received at least one vaccine dose and, of those who haven’t, roughly half have natural immunity from prior infection. There’s ample scientific evidence that natural immunity is effective and durable, and public-health leaders should pay it heed. Only around 10% of Americans have had confirmed positive Covid tests, but four to six times as many have likely had the infection. A February study in Nature...
May 21, 2021
Risk of COVID is now very low — it’s time to stop living in fear
COVID cases are collapsing in front of our eyes. Daily cases are now one-tenth the number of daily flu cases in the middle of a mild flu season, with a now-identical case fatality rate. That’s because the few Americans testing positive are often young, feel fine, and underwent testing as a screening requirement for playing sports or attending gatherings. The US positive rate is now at a record low, below 3%. Projections for the coming weeks and months are even more favorable. That’s because roughly 80% to 85% of adults are now immune — more than 6 in 10 adults are now vaccinated and more than half...
March 10, 2021
Covid Prescription: Get the Vaccine, Wait a Month, Return to Normal
The Centers for Disease Control and Prevention has lost a lot of credibility during the Covid-19 pandemic by being late or wrong on testing, masks, vaccine allocation and school reopening. Staying consistent with that pattern, this week—three months after the vaccine rollout began—the CDC finally started telling vaccinated people that they can have normal interactions with other vaccinated people—but only in highly limited circumstances. Given the impressive effectiveness of the vaccine, that should have been immediately...
February 18, 2021
We’ll Have Herd Immunity by April
Amid the dire Covid warnings, one crucial fact has been largely ignored: Cases are down 77% over the past six weeks. If a medication slashed cases by 77%, we’d call it a miracle pill. Why is the number of cases plummeting much faster than experts predicted? In large part because natural immunity from prior infection is far more common than can be measured by testing. Testing has been capturing only from 10% to 25% of infections, depending on when during the pandemic someone got the virus. Applying a time-weighted case capture average of 1 in 6.5 to the cumulative 28 million confirmed cases would mean about 55% of Americans...
February 25, 2021
Let’s have ‘immunity nights’ to keep American businesses alive
Restaurants are finally starting to reopen after months of being shuttered due to the pandemic. But many who want to support these restaurants — including vaccinated essential workers and seniors — can’t do so because of capacity restrictions. That makes no sense. Seventeen percent of U.S. adults have received at least one vaccine dose, a number that is growing every day. There is strong evidence that immunity not only makes people far less likely to get sick from covid-19, but also makes it highly unlikely they will spread the disease. Let’s put science into action...
May 14, 2020
How to Reopen America Safely
In late February, as data on the coronavirus pandemic continued to unfold, I started making calls to friends and family to prepare them. I told them to get ready to hunker down for three months. For many then, it was hard to believe that a virus we couldn’t much see evidence of, less understand, would require us to shut down our economy...
October 2, 2019
No Industry Hides Pricing From Its Customers Like Healthcare Does—This Has to Stop
It's hard to think of a worse way to pay for health care than our current system. Imagine if travel websites listed flights with no prices, as airline companies argued that they simply can't know the price before you fly. After all, your flight could be delayed, cancelled, or rerouted. And how could airlines possibly give you a price beforehand if they don't know whether you'll consume a beverage on the flight?...
September 16, 2019
We spend about half of our federal tax dollars on health care. That's ridiculous.
As presidential hopefuls debate how much more money to pour into our broken system, they should consider how much we already spend. In a new report out Monday, my Johns Hopkins colleagues and I found that nearly half of our federal tax dollars are being spent on health care. Bear with me because I know these are a lot of numbers. But let’s add it up...
September 12, 2019
I Shed My White Coat to Find the Healthcare Bloat
share to facebook share to twitter share to linkedin email article Over the last two years, I traveled to 22 cities. I took a deep dive into why healthcare costs so much. With a seasoned journalism professor mentoring me by phone almost every night, I traveled to meet with hospital executives and start-ups companies, doctors and insurance executives, nurses and state legislators, rural hospitals and big pharma, and most importantly, patients...
September 10, 2019
Doctors Sound an Alarm Over Leg-Stent Surgery
Now that unnecessary heart-stent procedures happen significantly less often, doctors are flagging a new area of concern: unnecessary leg stents. Some physicians are stenting leg arteries and removing plaque at alarming rates, these doctors say. The often-avoidable procedures could put patients at risk of complications and worsening disease...
September 9, 2019
Hospitals Go From Serving to Suing the Poor
How did medicine transform from a charitable profession to one that has put one in five Americans into collections for medical debt? How is it that hospitals are scientifically advanced centers of academic genius, but can't even tell you what anything will cost? And how did the noble profession of healing lose control of its billing processes, allowing some hospitals to sue and garnish the wages of thousands of the people in the small town they serve?
April 5, 2019
Let’s Not Make Children Wait 17 Years
Research shows that it takes approximately 17 years for evidence to become broadly adopted into clinical practice. In the case of silver diamine fluoride (SDF) therapy, a simple and painless treatment alternative to drilling dental caries in children, we should move faster.
February 26, 2018
We have too much medical care. That's where Bezos, Buffett and Dimon should start.
Jeff Bezos, Warren Buffett and Jamie Dimon want to fix health care and have indicated they will use technology to do so. But in health care, unlike their own industries of retail, investing and banking, technology is not the answer. Just ask any doctor who switched over to using electronic health records, a technology that increased costs despite their promise to lower them. Sure, health care is messy and technology can help alleviate inefficiencies and access issues that frustrate us all, but fixing the health care cost...
August 4, 2017
How doctors can stop the opioid crisis at its source: Quit overprescribing
For most of my surgical career, I gave out opioids like candy. My colleagues and I were unaware that about one in 16 patients become chronic users, according to new research by doctors at the University of Michigan. Even more alarming, research shows that relapse rates after opioid addiction treatment could be as high as 91%. In addition to expanding treatment, it’s time we address the root of the problem — overprescribing.
July 6, 2017
Hopkins surgeons develop minimally invasive surgery for chronic pancreatitis
Johns Hopkins surgeons have developed a minimally invasive surgery to address chronic pancreatitis, a painful condition that can be remedied by removing the pancreas. While some cases of chronic pancreatitis are caused by alcoholism, most come from a genetic mutation. But sufferers are often written off as alcoholics or drug addicts because they use opioids to manage the pain, said Martin Makary, a professor of surgery at the Johns Hopkins University School of Medicine...
June 8, 2017
A Path to Lowering Health Care Costs
When I heard Golden State Warriors head coach Steve Kerr will not join his team on opening night of the NBA finals for health reasons, I thought “Oh my, he must have something serious.” Well he did, but it was not a virus or heart plaque—it was the endemic problem of too much medical care...
September 30, 2016
The NFL’s Pink Publicity Stunt Isn’t About Fighting Cancer
As it does every October, the NFL is set to “go pink” this Sunday to show support for the American Cancer Society’s efforts to find a cure for breast cancer. But make no mistake: The NFL will not contribute one dime to breast-cancer research in this campaign. Instead, the NFL “billionaires’ club”—the team owners—will require all of their players and coaches to be political showpieces.
December 28, 2015
Why our health care system is broken
A new report found that hospitals have been gaming the system to make their re-admission numbers look good by putting patients who return in a special observation area instead of counting them as readmission. Independently, another report from the Agency for Healthcare Research and Quality shows that nationwide reductions in patient complications have plateaued. Furthermore, part of the reductions was due to creative ways that hospitals code or report complications...
December 20, 2015
One Pharma Fix: Limit the ‘Orphan Drug’ Incentives
The cost of drug prescriptions has become an issue in the presidential-primary season, most notably with Hillary Clinton and Bernie Sanders competing to see who can do the most to protect the wallets of potential voters. Mrs. Clinton this fall proposed capping out-of-pocket drug expenses at $250 a month, while Mr. Sanders vowed to make the federal government drop its unwillingness to negotiate prices with pharmaceutical companies...
July 20, 2015
Greece's Costly Health Care Craze
Greece’s bloated pension program is often cited as a primary cause of its crushing national debt, but its government-run health care system has been a significant and under-recognized contributor to the country’s crisis. The sad and appalling tale of how this came about has important lessons for other countries, especially the United States...
The Orphan Drug Act: Restoring the Mission to Rare Diseases
Daniel MG, Pawlik TM, Fader AN, Esnaola NF, Makary MA
Association of Safety Culture with Surgical Site Infection Outcomes
Fan CJ, Pawlik TM, Daniels T, Vernon N, Banks K, Westby P, Wick EC, Sexton JB, Makary MA
Laparoscopic Total Pancreatectomy With Islet Autotransplantation and Intraoperative Islet Separation as a Treatment for Patients With Chronic Pancreatitis
Fan CJ, Hirose K, Walsh CM, Quartuccio M, Desai NM, Singh VK, Kalyani RR, Warren DS, Sun Z, Hanna MN, Makary MA.
Outlier Practice Patterns in Mohs Micrographic Surgery: Defining the Problem and a Proposed Solution
Krishnan A, Xu T, Hutfless S, Park A, Stasko T, Vidimos AT, Leshin B, Coldiron BM, Bennett RG, Marks VJ, Brandt R, Makary MA, Albertini JG
Overtreatment in the United States
Lyu H, Xu T, Brotman D, Mayer-Blackwell B, Cooper M, Daniel M, Wick EC, Saini V, Brownlee S, Makary MA
The Potential Hazards of Hospital Consolidation: Implications for Quality, Access, and Price
Xu T, Wu AW, Makary MA
Group Purchasing Organizations, Health Care Costs, and Drug Shortages
Bruhn WE, Fracica EA, Makary MA
Sleep deprivation and starvation in hospitalised patients: how medical care can harm patients
Xu T, Wick EC, Makary MA
Obstetrics & Gynecology
Utilization of Minimally Invasive Surgery in Endometrial Cancer Care: A Quality and Cost Disparity
Fader AN, Weise RM, Sinno AK, Tanner EJ 3rd, Borah BJ, Moriarty JP, Bristow RE, Makary MA, Pronovost PJ, Hutfless S, Dowdy SC
Patient, surgeon, and hospital disparities associated with benign hysterectomy approach and perioperative complications
Mehta A, Xu T, Hutfless S, Makary MA, Sinno AK, Tanner EJ 3rd, Stone RL, Wang K, Fader AN
JAMA Internal Medicine
Variation in Emergency Department vs Internal Medicine Excess Charges in the United States