How Many Doctors Does It Take to Start a Healthcare Revolution?

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(photo: Rohin Francis)

(photo: Rohin Francis)

Season 5, Episode 3

In part one (“How Many Doctors Does It Take to Start a Healthcare Revolution?”), we continue conversations from last week’s episode (“How Do We Know What Really Works in Healthcare?”). Anupam Jena, a physician, economist, and professor at Harvard Medical School, told us about his study that shows mortality rates improve when cardiologists are away at medical conferences. One possible explanation: in certain cases, it may be better for doctors to do nothing than to carry out certain procedures.

We then return to Jeffrey Brenner, a physician and the executive director of the Camden Coalition of Healthcare Providers, whose mission is to lower the cost of quality healthcare. “I’ve always felt that the trick to healing and the trick to wellness and to change, like changing behavior, is relationship-building,” says Brenner. Unfortunately, as he points out, relationship-building is not a big profit center for hospitals.

In part two (“What’s the ‘Best’ Exercise?”), three experts talk about the “best” possible exercise. Gretchen Reynoldso, who writes for the New York Times‘s Well blog, likes the squat. Dr. Peter Attia, co-founder of the Nutrition Science Initiative, suggests flipping tires. And the University of Chicago’s David Meltzer tells us that just about any activity can be a workout, and you can measure its impact with a metabolic equivalent score.

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Ashley Meccariello (student nurse midwife)

I caught this piece on my ride to visit relatives and I can't help but to point out that maternity care in the country is probably the least evidence-based area of medicine and it is one of the biggest costs of care in this country. I am studying to become a nurse-midwife and one of the most important aspects of the care I will provide to women and families is that it is evidence-based. This involves extensive education, relationship building, and shared decision making with clients. Midwives in this country are providing highly effective, low-cost care to women that positively impact entire communities. I believe that if we can change the culture of maternity care in this country from one of low touch/high intervention to one of partnering with women and families to provide individualized evidence-based care, it would be a great start to revamping our entire approach to healthcare in this country. It is inevitable that every single person will be affected by how women are treated during pregnancy and childbirth and how babies are born.

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