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.
November 8, 2021
Should You Vaccinate Your 5-Year-Old?
If you’re agonizing about whether to have your young child vaccinated against Covid-19, be reassured: The risk is extremely low either way. The Centers for Disease Control and Prevention estimates that 42% of U.S. children 5 to 11 had Covid by June 2021, before the Delta wave—a prevalence that is likely greater than 50% today. Of 28 million children in that age range, 94 have died of Covid since the pandemic began (including deaths before newer treatments), and 562 have been hospitalized with Covid infections....
October 7, 2021
The FDA Can Save Thousands of Lives Today
With the stroke of a pen, the Food and Drug Administration could save thousands of Covid patients’ lives. Data released last week showed that the new antiviral pill molnupiravir, made by Merck and Ridgeback Biotherapeutics, is safe and reduces the risk of the direst outcomes (hospitalization or death) by 50%. It works by directly blocking replication of the virus, is effective against variants, and can be used in combination with other Covid therapies...
August 5, 2021
Why COVID-19 Vaccines Should Not Be Required for All Americans
COVID-19 vaccine mandates have become a hotly contested issue, as coronavirus cases and hospitalizations rebound nationwide, driven by the highly contagious delta variant and unswerving vaccine hesitancy. New York City will soon be the first major U.S. city to require proof of vaccination to enter restaurants, gyms and other indoor public spaces. Dr. Marty Makary, a professor at Johns Hopkins University School of Medicine and editor in chief of MedPage..
September 15, 2021
Natural immunity to covid is powerful. Policymakers seem afraid to say so.
It’s okay to have an incorrect scientific hypothesis. But when new data proves it wrong, you have to adapt. Unfortunately, many elected leaders and public health officials have held on far too long to the hypothesis that natural immunity offers unreliable protection against covid-19 — a contention that is being rapidly debunked by science....
September 13, 2021
Covid Confusion at the CDC
The U.S. spends lavishly on healthcare yet can’t answer basic questions about Covid-19. Some of the best research has come from Israel. American public health agencies should be producing data on breakthrough infections, boosters and natural immunity. But the Centers for Disease Control and Prevention has failed to provide the information needed to inform a sound Covid strategy. Israel began its vaccine rollout with Pfizer in December, only days after the U.S. But Israel kept good data, reported them out frequently...
September 1, 2021
Take Another Look at the Spacing Between COVID Vaccine Doses
When most Americans showed up to get their first dose of an mRNA vaccine, they were sternly warned that they must schedule a second dose within a month. In my case, I politely explained that I would come back for my second dose at 3 months. The scheduler got flustered and treated me like I was a fugitive of the law. But a growing body of evidence over the last several months has shown that a longer interval provides better immunity in the long-term. It may even eliminate the need for a booster shot that's now being recommended...
April 6, 2021
A Salute to China's COVID Heroes
Pinning down the origins of COVID-19 would require a few things that are unlikely to ever happen: 1) Cooperation from the Chinese Communist Party, 2) Lab records and original samples from the Wuhan Virology Institute, or 3) True witness protection and global immunity for lab workers and their extended families. They may have been the first people in the world infected with COVID-19. Will we ever get this information? I'm not holding my breath...
January 20, 2021
The Next Pandemic Is Already Here
The casualties of a global pandemic are now vivid to everyone, and many wished we could have acted earlier to stem the death toll. But another pandemic has already started. It's not one that rips through countries in months. It's a slower growing pandemic, yet it threatens to kill 10 million people a year by 2050. Even so, it has received little attention. We're talking about the global pandemic of antimicrobial resistance -- a pandemic increasingly claiming the lives of patients on our hospital...
September 21, 2020
Sidelining Physicians Contributed to 200,000 U.S. Deaths
share to facebook share to twitter share to linkedin email article 200,000 in a rough font over a computer rendering of the coronavirus When we at MedPage Today saw the contrast between dire warnings from infectious disease experts and broader public complacency on the novel coronavirus, we sounded the alarm. Many of us began urging hospitals, governors, national leaders, and others to begin contingency planning and, in the interim, to stop all non-essential travel. Often falling on deaf ears, our recommendations morphed into advocacy as we begged the mainstream media to stop putting politicos and pundits on TV, and instead to use doctors...
July 21, 2021
We are testing too many vaccinated people who lack covid symptoms
We are testing too many vaccinated people who lack covid symptoms: It’s possible for someone to fight off an infection and still test positive, which skews case numbers Early in the pandemic, the United States had an undertesting problem. Now we are overtesting those who are immune and asymptomatic. A person with immunity to the coronavirus will fight off an infection. But during and after the person’s exposure to the virus, it’s common for a low number of virus particles to be detectable in the nose. In medicine, we call this virus a “colonizer” — a pathogen that does not cause illness or spread the illness...
July 19, 2021
The Flimsy Evidence Behind the CDC’s Push to Vaccinate Children
A tremendous number of government and private policies affecting kids are based on one number: 335. That is how many children under 18 have died with a Covid diagnosis code in their record, according to the Centers for Disease Control and Prevention. Yet the CDC, which has 21,000 employees, hasn’t researched each death to find out whether Covid caused it or if it involved a pre-existing medical condition. Without these data, the CDC Advisory Committee on Immunization Practices decided in May that the benefits of...
July 13, 2021
The U.S. is far too fixated on vaccinating Americans. It must focus on the world.
While the United States is running lotteries and celebrity ad campaigns to convince every American to get vaccinated, other parts of the world are digging mass graves for their victims of covid-19. Therein lies the greatest failure of the current U.S. pandemic response: It has become fixated on the disease at home while giving lip service and responding slowly to the threat abroad. In the United States, the covid-19 threat is currently low. Nearly all at-risk Americans are protected. The virus is now circulating in young people for which...
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...
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 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?
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