- Docs and dollars: This one’s a twofer. The first is a hotly-discussed NEJM paper showing that urologists (not radiation oncologists, as we’ve covered earlier) owning a stake in radiation therapy equipment tend to recommend that equipment more often than docs without an ownership stake. The second is a less-publicized government report showing that surgeons with a stake in device distributors also recommend those devices more than other surgeons. This shouldn’t surprise anyone — doctors are human, after all. The Stark laws designed to prevent physician self-referral, for some reason, make an exception for the IMRT conflict-of-interest in the first paper. And I don’t think any legislation foresaw the physician-owned-distributorships in the second article.
- Is Mass. going to shake up health policy again? Massachusetts, a laboratory for experiments that make their way into federal health policy, is now in very early discussions of a single-payer system. Of course, no one’s dethroning private insurance companies just yet, but there is a bill circulating to create a public insurance option that may attract some interest. The sponsors are interested in single-payer for no other (stated) reason than its potential to reduce costs—the state’s next big challenge now that it has widely expanded insurance.
- Consolation prize: The healthcare.gov launch was an abject failure. (Hopefully with a Duke/Advisory Board alum in charge of the cleanup, we’ll see some good news.) Interestingly though, the data services hub—which worried insiders the most, as we’ve covered before—is actually working quite well. It has the important, though unglamorous job of synthesizing information across multiple federal databases and verifying applicants’ information to prevent fraud. And it has done just that for most people who’ve made it through the website’s dysfunctional front end.
- Icing out the family jewels: Because there’s nothing a man’s injured nether regions need less than freezer burn.
Karan is a student at Robert Wood Johnson Medical School and Duke graduate who previously worked in strategic research for hospital executives.