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Community Health
commentary
Should the Definition of Health Include a Measure of Tolerance?
Robert H. Brook
Feb 15, 2017
The Journal of the American Medical Association
Involving the medical community in helping to measure and increase tolerance could help make individuals and communities healthier. Since hate is both deadly and contagious, now is the time to engage the medical profession in eradicating it.
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Physicians
blog
When RAND Applied Weapons Research to Health Care Delivery
Nov 1, 2017
In the 1970s, it was assumed that new physicians wouldn't set up practice in America's small towns. RAND economists used software originally designed to estimate damages from a nuclear bomb to calculate the effects of placing doctors in specific locations.
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Electronic Pharmaceutical Prescriptions
commentary
Responsible e-Prescribing Needs e-Discontinuation
Shira H. Fischer @ShiraFischer, Adam J. Rose
Feb 7, 2017
The Journal of the American Medical Association
Implementation of electronic prescribing has been a big success in health information technology. But most e-prescribing systems don't allow electronic cancellation of orders. Adding this feature could help reduce medication errors.
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Public Health
commentary
What If Being a Leader in Public Health Is About More Than Just Health?
Linnea Warren May, Jennifer Sloan
Nov 17, 2016
The RAND Blog
Public health leaders should be able to articulate the business case for their work and should have the skills to work with others outside the health sector. Schools could help by preparing students to think beyond the traditional boundaries of public health.
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Primary Care
commentary
Can a Nurse Practitioner Replace a Physician?
John N. Mafi, Bruce E. Landon
Jul 22, 2016
Slate
The VA is considering expanding the role of nurse practitioners in order to provide veterans timely access to primary-care services. Research has shown that nurse practitioners working in collaborative settings can provide high-quality care.
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Health Care Delivery Approaches
commentary
Can Hospital Services Work in Primary Care Settings?
Celine Miani, Eleanor Winpenny
Jun 2, 2016
The BMJ
Shifting health care from hospitals to the community will only be justified if patient satisfaction and convenience is valued above costs to the NHS, or if this shift reduces health care costs in the long term.
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Patient Experience
commentary
Debunking Myths About Patient Experience Surveys
Rebecca Anhang Price, Marc N. Elliott
May 27, 2016
Future Hospital Partners Network
Patient experience surveys give patients a voice. They can provide fair and relevant indicators that complement other metrics of health care quality to monitor and improve care.
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Science, Technology, and Innovation Policy
commentary
100 Stories, 10 Years, 1 Transformation: A Recent History of NIHR's Impacts on the Health Research Landscape
Adam Kamenetzky, Jonathan Grant, Molly Morgan Jones
May 19, 2016
PolicyWonkers
The National Institute for Health Research is now ten years old. What benefits has it had on the health research landscape in the UK since its formation?
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Medical Professionals
commentary
What Makes Stakeholders Want to Become Involved in Research?
Thomas W. Concannon @tconcannon, Virginia Kotzias, Dmitry Khodyakov, Jennifer Graff, Gavin Fahey
May 2, 2016
The RAND Blog
Involving stakeholders in comparative-effectiveness research is important. But competing demands for their time can make this a challenge. Why do stakeholders get involved in this research, or not?
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Integrative Medicine
essay
Science and the Healing Arts
Apr 29, 2016
Americans spend billions of dollars out of pocket seeking relief from chronic conditions in alternative schools of health, such as acupuncture or chiropractic. What would it take to more fully integrate such practices into the mainstream?
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Physicians
commentary
Relationships Between Physician Professional Satisfaction and Patient Safety
Mark W. Friedberg @MWFriedberg
Feb 23, 2016
Agency for Healthcare Research and Quality, Perspectives on Safety
Health system leaders should view regular and detailed assessment of physician professional satisfaction as an invaluable early warning system for potential threats to quality and safety. But simply surveying doctors on their overall levels of job satisfaction isn't enough.
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Health Care Quality
commentary
How Can Regulation Improve Quality of Care in the English Health Care System?
Christian Van Stolk
Nov 13, 2015
The RAND Blog
Inspections have become more prominent in England's approach to health service regulation as a way to identify problems before they occur. But the evidence of regulation contributing to better quality of care in different systems is scarce.
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Performance Measurement
commentary
Scoring the Surgeon Scorecard
Mark W. Friedberg @MWFriedberg
Oct 14, 2015
The Health Care Blog
There is no tradeoff between recognizing the serious methodological problems in the ProPublica Surgeon Scorecard, improving the Scorecard, and encouraging providers to release their own data. All three can and should be done simultaneously.
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Nurses and Nursing
commentary
Does Expanding Nurse Practitioner Autonomy Affect the Value of Care Delivered?
Grant Martsolf
Jan 28, 2015
The RAND Blog
Given the high cost of health care in America, policymakers should be very concerned about the effect of expanded nurse practitioner autonomy on the value of care. However, to have a sensible policy debate, we need to admit that we hardly know anything about it.
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Health Care Quality Measurement
commentary
The Great Patient Experience Survey Myth
Rebecca Anhang Price, Marc N. Elliott
Dec 10, 2014
The Health Care Blog
Patient experience with care is an essential element in any assessment of health care quality. Surveys give patients a voice and provide fair and relevant indicators that complement other metrics of health care quality to inform patients' choices and providers' decisions about how to improve care.
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Health Care Workforce
commentary
How to Avert a Doctor Shortage
Michael D. Rich @michaeldrich
Apr 2, 2014
RAND Review and The Health Care Blog
Within the next decade, the United States may face a shortage of 130,000 physicians due to a growing, aging population and the anticipated demands of those newly insured under the ACA. This shortage can be alleviated by early creative interventions.
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Health Information Technology
commentary
Physicians' Concerns About Electronic Health Records: Implications and Steps Towards Solutions
Mark W. Friedberg @MWFriedberg, F. Jay Crosson, Michael Tutty
Mar 12, 2014
Health Affairs Blog
If practicing physicians are correct, the current state of EHR technology has introduced several impediments to providing patient care, undermining physician professional satisfaction. Many of these problems also should be of great concern to patients.
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Health Care Costs
blog
Small Ideas for Saving Big Health Care Dollars (No. 1-3)
Jan 8, 2014
Focusing on smaller, more focused approaches can identify less controversial opportunities for modest health care savings.
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Health Care Workforce
commentary
Is There Really a Physician Shortage?
David I. Auerbach
Dec 6, 2013
The Health Care Blog
Large coverage expansions under the ACA have reignited concerns about physician shortages. These estimates result from models that forecast future supply and demand for physicians based on past trends and current practice. While useful exercises, they do not necessarily imply that intervening to boost physician supply would be worth the investment.
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Influenza
commentary
Are County Masking Requirements the Future of Influenza Prevention?
Dmitry Khodyakov, Lori Uscher-Pines, Victoria Shier
Nov 20, 2013
The RAND Blog
If it doesn't seem that state laws as currently written can help increase the number of health care workers vaccinated against influenza, then what can? There is evidence that imposing consequences for vaccination refusal, including the requirement to wear a surgical mask, can help.
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Medicare Part D
commentary
An Inexpensive Prescription for Medicare
Walid F. Gellad
Nov 18, 2013
The RAND Blog
If Congress wants to save Medicare, it can start by driving waste and excess out of the system. This can be done without impoverishing patients or driving doctors out of business, if physicians are willing to practice smarter, more efficient medicine. Spending on prescription drugs is a case in point.
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Health Care Workforce
blog
The Future of the Health Care Workforce: RAND Researchers Well Represented in Health Affairs Special Issue
Nov 7, 2013
In 'Redesigning the Health Care Workforce,' a new special issue of the journal Health Affairs, RAND researchers contribute to several timely examinations of challenges, opportunities, and potential solutions relating to the future of health care staffing in the U.S. and abroad.
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Pediatric Medicine
blog
Mark Schuster Elected to the Institute of Medicine
Oct 25, 2013
Dr. Mark Schuster has been elected to the Institute of Medicine. He is an adjunct researcher at RAND and the William Berenberg Professor of Pediatrics at Harvard Medical School and Chief of General Pediatrics and Vice Chair for Health Policy in the Department of Medicine at Boston Children's Hospital.
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Evidence Based Health Practice
commentary
How to Improve the Way Medical Research Is Applied in Frontline Care
Bryony Soper, Ellen Nolte
Oct 7, 2013
Guardian Healthcare Professionals Network
Many people assume that it is enough to present clinicians and managers with the results of medical research for them to adopt those techniques that work best. This is quite untrue. The scale and pace of medical advance poses a continual challenge, and there is often a gap between recommended care and actual care received.
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Affordable Care Act
commentary
Will ACA Implementation Lead to a Spike in Demand for Care?
David I. Auerbach
Sep 27, 2013
The Health Care Blog
The growing number of Americans newly-insured under the ACA will undoubtedly lead to a surge in demand for care, whether through Medicaid or insurance exchanges. But, if predictions hold, the increase won't be as dramatic as some may fear, writes David I. Auerbach.
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Emergency Medical Services
commentary
What to Do About 'Futile' Critical Care
Neil S. Wenger
Sep 13, 2013
The Health Care Blog
There are times when no amount of care, however cutting-edge it is, will save a patient. In these instances, further critical care is said to be “futile.” This type of treatment is not uncommon in intensive care units, and that raises some uncomfortable questions.
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Health Care Services Capacity
commentary
NHS 24/7: An Effective Way to Improve Quality of Care?
Christian Van Stolk
May 24, 2013
The RAND Blog
There are proposals to have England's National Health Service offer non-emergency service on weekends. Since there is a strong association between the health and well-being of staff and the quality of patient care, 24/7 working could have unintended consequences for patients.
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Medical Professionals
blog
In Current Flu Epidemic, Health Care Personnel Could Be a Key Element in Prevention—Not Just Treatment
Jan 17, 2013
Blog post addressing the role of health care providers in vaccination rates and public health preparedness
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Crime and Violence Prevention
commentary
Accounting for Risk of Violent Death
Arthur L. Kellermann
Jan 7, 2013
The Washington Post
As a Southerner who learned to shoot at an early age, I've never had a problem with guns. But emergency-room doctors like me also know how much damage they can cause if misused or allowed to fall into the wrong hands, writes Arthur Kellermann.
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Influenza
blog
Health Care Providers May Be the Key to Improving Flu Vaccination Rates
Dec 4, 2012
For vaccination to become a public health priority in the U.S., stakeholders must strengthen guidance for providers, which would make it easier for physicians to both assess vaccination needs and aid communication with patients about the efficacy and safety of vaccines.
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Emergency Medical Services
blog
Caring for the Uninsured: What Role Do Emergency Rooms Play?
Oct 9, 2012
Absent from the discussion about health care during the first debate between President Barack Obama and Governor Mitt Romney was any mention of one of the main providers of care for America's uninsured: emergency rooms. What does research tell us about the use of ERs and the relevant implications on health care access and cost?
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Nurses and Nursing
blog
Giving “Voice” to Nursing Home Residents: A Revolution in Quality Assessment
Debra Saliba
Oct 9, 2012
It seems obvious to ask nursing home residents about their own health. But until a quiet revolution that took place in 2010, it didn't work that way.
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Health Care Workforce
blog
Addressing the Geriatrician Shortage May Help Reduce Costs Without Compromising Quality
Melony E. Sorbero
Aug 30, 2012
Greater use of geriatricians in the hospital setting could reduce health care costs while maintaining quality of care, but there are fewer than four certified geriatricians in the United States per 10,000 individuals 75 years of age or older.
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Prescription Drug Benefits
blog
When Patients Don't Take Their Medicine: What Role Do Doctors Play in Promoting Prescription Adherence?
Douglas S. Bell, David M. Adamson
Aug 29, 2012
A new paradigm that clarifies joint provider–patient responsibility may be needed to better guide communication about medication adherence, write Douglas S. Bell and David M. Adamson.
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Health Care Costs
commentary
We Need to Know What Physicians Are Thinking
Robert H. Brook
Jun 17, 2012
ABIM Foundation's Medical Professionalism Blog
Before we allow others to implement policies attempting to optimize the use of physician time or reduce the amount of equivocal or inappropriate care, we need to understand what physicians think about these issues and what they are prepared to do about them, writes Robert H. Brook.
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commentary
The Role of Physicians in Controlling Medical Care Costs and Reducing Waste
Robert H. Brook
Aug 10, 2011
The Journal of the American Medical Association
Because the budget crisis is really a crisis, it behooves physicians to answer the waste question as rapidly as possible. Without an answer, there is no hope that an appropriate policy process for reining in health care costs will be identified, writes Robert H. Brook.
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commentary
Physician Compensation, Cost, and Quality
Robert H. Brook
Aug 18, 2010
The Journal of the American Medical Association
Pay for performance, transparency, and other innovative ways of compensating physicians will work only if, at the same time, the system for providing care is changed to one that has clear objectives and provides specific tools to help physicians achieve those objectives, writes Robert H. Brook.
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commentary
Medical Leadership in an Increasingly Complex World
Robert H. Brook
Jul 28, 2010
The Journal of the American Medical Association
It is time for physicians to think beyond making their institution, practice, or professional society better. The population needs, and deserves, such leadership, writes Robert H. Brook.
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commentary
Continuing Medical Education: Let the Guessing Begin
Robert H. Brook
Jan 27, 2010
The Journal of the American Medical Association
It is time for a change before innovative medical researchers develop a new array of tests and measurements, making it even less likely that physicians will have the right answer, writes Robert Brook.
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commentary
Quality, Transparency, and the US Government
Robert H. Brook
Apr 1, 2009
The Journal of the American Medical Association
If the government is demanding transparency of physicians and hospitals, the very least the physicians and hospitals should do is demand transparency of the government, writes Robert Brook.
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commentary
Afghanistan Without Doctors
Cheryl Benard
Aug 12, 2004
Wall Street Journal
Published commentary by RAND staff.
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