- Medicine and SocietyVOL. 386 No. 19, May 12, 2022
Peers, Professionalism, and Improvement — Reframing the Quality QuestionN Engl J Med 2022; 386:1850-1854
Drawing on peer review and professionalism, some quality-improvement efforts tap into physicians’ intrinsic motivations for giving their patients the best possible care. How can we scale up such promising approaches and create and sustain a spirit of inquiry?
- Medicine and SocietyVOL. 386 No. 18, May 05, 2022
Metric Myopia — Trading Away Our Clinical JudgmentN Engl J Med 2022; 386:1759-1763
Proliferating measures of health care quality may distract clinicians from what matters to individual patients and from larger public health problems. Has the quality-improvement movement gone astray by ignoring the complexity of both high-quality care and physicians’ motivations?
- Medicine and SocietyVOL. 386 No. 17, Apr 28, 2022
Reassessing Quality Assessment — The Flawed System for Fixing a Flawed SystemN Engl J Med 2022; 386:1663-1667
Decades into the quality improvement movement in U.S. health care, the fix for the system has become a massive, cumbersome, time-consuming, demoralizing system in its own right — and we don’t even know whether it is improving care.
- Medicine and SocietyVOL. 386 No. 15, Apr 14, 2022
Unclouded Judgment — Global Health and the Moral Clarity of Paul FarmerN Engl J Med 2022; 386:1470-1474
When Paul Farmer died in February, it became clear to the world that he had saved millions of lives. He did so by valuing every life equally and refusing to accept constraints. Many of us enter medicine hoping to change the world; Farmer actually did it.
- Medicine and SocietyVOL. 384 No. 15, Apr 15, 2021
No Cure without Care — Soothing Science SkepticismN Engl J Med 2021; 384:1462-1465
To the extent that Covid vaccine hesitancy reflects deeper, longer-standing fractures in medicine’s relationship with the public, its exploration provides an opportunity to improve patient care in ways that go far beyond the pandemic.
- Medicine and SocietyVOL. 384 No. 14, Apr 08, 2021
Escaping Catch-22 — Overcoming Covid Vaccine HesitancyN Engl J Med 2021; 384:1367-1371
About 27% of Americans say they definitely or probably won’t get a Covid vaccine, even if it’s free and deemed safe by scientists. The behavioral obstacles to widespread vaccination are thus as important to understand as the scientific and logistic hurdles.
- Medicine and SocietyVOL. 383 No. 17, Oct 22, 2020
Tribal Truce — How Can We Bridge the Partisan Divide and Conquer Covid?N Engl J Med 2020; 383:1682-1685
Since human behavior — including wearing or shunning masks — will determine the ultimate toll of the Covid-19 pandemic, communication strategies that bridge our partisan divide over science may prove as important as any novel therapeutic.
- EditorialVOL. 383 No. 3, Jul 16, 2020
Diagnosing and Treating Systemic RacismN Engl J Med 2020; 383:274-276
Our country’s long and troubled history of racism has permeated the physician–patient relationship with mistrust. Now, amid an acute public health crisis that is transforming medicine, perhaps we have an opportunity to reset our priorities to face this deeper, more chronic crisis as well.
- PerspectiveVOL. 383 No. 2, Jul 09, 2020
Once Upon a Time…the Hero Sheltered in PlaceN Engl J Med 2020; 383:e5
For some clinicians, the pandemic offers an opportunity to take on the hero’s role as never before. But those who can’t must confront not only shame and guilt, but also the loss of their primordial story. Who are you, if you can’t be the hero you imagined yourself to be?
- Medicine and SocietyVOL. 382 No. 24, Jun 11, 2020
The Untold Toll — The Pandemic’s Effects on Patients without Covid-19N Engl J Med 2020; 382:2368-2371
As the pandemic focuses medical attention on treating affected patients and protecting others from infection, how do we best care for people with non-Covid disease? Some physicians predict that “the toll on non-Covid patients will be much greater than Covid deaths.”
- PerspectiveVOL. 382 No. 22, May 28, 2020
Harnessing Our Humanity — How Washington’s Health Care Workers Have Risen to the Pandemic ChallengeN Engl J Med 2020; 382:2069-2071
As the Covid-19 pandemic spreads, we’ll continue to be plagued by resource constraints that will compromise our ability to protect ourselves, our patients, and our communities. But as Washington’s response reminds us, the professional spirit marches on, unconstrained.
- PerspectiveVOL. 382 No. 20, May 14, 2020
Facing Covid-19 in Italy — Ethics, Logistics, and Therapeutics on the Epidemic’s Front LineN Engl J Med 2020; 382:1873-1875
Physicians in northern Italy have learned some painful lessons about rationing care during an epidemic. As health care systems work out ethical allocation principles, it seems clear that only with transparency and inclusivity can public trust and cooperation be achieved.
- PerspectiveVOL. 382 No. 6, Feb 06, 2020
Altruism in Extremis — The Evolving Ethics of Organ DonationN Engl J Med 2020; 382:493-496
With a clear understanding of his terminal prognosis, W.B. wanted to donate his organs before he died — but the legal and ethical hurdles proved insurmountable. In Canada, where medical assistance in dying is now legal, some patients are able to fulfill this last wish.
- PerspectiveVOL. 382 No. 2, Jan 09, 2020
Costs, Benefits, and Sacred Values — Why Health Care Reform Is So FraughtN Engl J Med 2020; 382:101-104
As debate about U.S health care begins anew, with particular focus on a “Medicare for All” type insurance design, it’s worth considering why weighing the complex but real trade-offs involved in health policy remains so politically challenging.
- PerspectiveVOL. 381 No. 13, Sep 26, 2019
Losing Hahnemann — Real-Life Lessons in “Value-Based” MedicineN Engl J Med 2019; 381:1193-1195
The announcement that Hahnemann Hospital would soon close came as a shock to many people. Is the hospital a casualty of the push to optimize the distribution of limited resources — or a cautionary tale about the greed and corruption underlying our health care ills?
- PerspectiveVOL. 381 No. 12, Sep 19, 2019
All InN Engl J Med 2019; 381:1099-1101
Before Joe, a psychiatry resident, was killed, distinguishing between work born of love and that born of duty was his life’s theme. His struggle to practice medicine in a way that was meaningful to him may offer one antidote to the spiritual crisis of physician burnout.
- PerspectiveVOL. 381 No. 10, Sep 05, 2019
Perilous Politics — Morbidity and Mortality in the Pre-Roe EraN Engl J Med 2019; 381:893-895
If Roe v. Wade were overturned, morbidity and mortality due to unsafe abortion, including self-induced abortion, would increase, especially among disadvantaged women. We don’t know how many women died from abortion attempts before Roe, but we should recall what we do know about what killed them.
- EditorialVOL. 380 No. 10, Mar 07, 2019
Eyes Wide Open — Examining the Data on Duty-Hour ReformN Engl J Med 2019; 380:969-970
In a world moved by story, medicine — we like to believe — is still moved by measurement. That is why, when resident work-hour limits were implemented in 2003, catalyzed by the tragic death of Libby Zion, many in the medical community pointed out the paucity of evidence to support...
- Medicine and SocietyVOL. 380 No. 10, Mar 07, 2019
The Future of Gene Editing — Toward Scientific and Social ConsensusN Engl J Med 2019; 380:971-975
The news that Chinese scientist He Jiankui had attempted to edit the CCR5 gene in the germline of two embryos led to a swift backlash in the scientific community. But the rogue experiment may inspire broader discussion about the fraught ethical issues involved.
- Medicine and SocietyVOL. 380 No. 9, Feb 28, 2019
Teamwork — Part 3: The Not-My-Problem ProblemN Engl J Med 2019; 380:881-885
In cases in which the “bystander effect” seems to be at play in medicine, inaction by a group of clinicians usually takes the form of tacit acceptance of the status quo when the status quo isn’t working. What can social psychology teach us about such group failures?