- N Engl J Med 2022; 387:844-849
Since wealth is a fundamental driver of health, health equity strategies that fail to close the racial wealth gap may be ineffective. What can health systems do to help address this major social determinant of health?
- N Engl J Med 2022; 386:2429-2432
The patient-safety movement has turned clinical medicine into a team sport, but administrators have been left off the team. The effects on patients of administrative decisions and changes therefore remain obscure, unexamined, and unimprovable.
- N Engl J Med 2022; 386:2239-2242
In the face of a rapidly changing technology landscape, the National Academy of Medicine has formed the Committee on Emerging Science, Technology, and Innovation in health and medicine to convene diverse stakeholders to reenvision governance in health and medicine and drive collective action.
- N Engl J Med 2022; 386:2054-2058
Physicians’ dual loyalties to their academic institutions and to patients may not only constrain their ability to act in patients’ best interests, they may also reflect and perpetuate structural racism — a reality of which academic residency clinics provide a case study.
- N 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?
- N 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?
- N 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.
- N 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.
- N Engl J Med 2022; 386:1284-1287
“Physicianhood” has long been conceived as masculine, an implicit characterization that affects the quality and nature of health care. A deeper understanding of gender issues in medicine may help us improve both the experiences of nonmale physicians and patient care.
- N Engl J Med 2022; 386:290-293
Photographer Graciela Iturbide captures death and suffering, using her camera to protect herself emotionally from the painful events she witnesses. What can a young surgeon learn from her about aesthetic distance and empathy in medicine?
- N Engl J Med 2021; 385:2478-2484
The emerging specialty of consultative medicine is rooted in generalism and aims to integrate the best of the Oslerian diagnostic tradition with the multidisciplinary collaboration and modern technologies needed to tackle uncertain, difficult, or complex diagnoses.
- N Engl J Med 2021; 385:1810-1814
Over time, myriad developments in health care have multiplied the places and people available to provide care to patients. Viewed through the lens of classic economics, this fragmentation can be seen as a division of labor — which has both benefits and drawbacks.
- N Engl J Med 2021; 385:1526-1530
Building integrated translational pipelines that use data rapidly and effectively to address health effects of natural disasters will require substantial investment, which must rely on evidence of which approaches improve outcomes. But promising solutions are available.
Remembering Past Lessons about Structural Racism — Recentering Black Theorists of Health and SocietyN Engl J Med 2021; 385:850-855
Though the mounting resolve to address structural racism in U.S. medicine and public health is welcome, the theory and empirical grounding for this work was laid out more than a century ago by W.E.B. Du Bois and his colleagues in the Atlanta school of sociology.
- N Engl J Med 2021; 384:1861-1865
An important step in addressing racism as a U.S. public health crisis is accurate measurement of progress necessary to hold ourselves collectively accountable. Public Health Critical Race Praxis provides guiding principles for analyzing myriad health equity challenges.
- N Engl J Med 2021; 384:1769-1773
Obtaining care in a mental health crisis should be as routine and assistive as calling an ambulance for other health crises. Yet for too long, calling 911 for psychiatric aid has been fraught with the possibility of lethal consequences.
- N 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.
- N 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.
- N Engl J Med 2021; 384:1163-1167
Ideally, race will be replaced with genetic ancestry as a variable in medical research and practice. But until more ancestry data are available, ignoring race and extrapolating research findings from European-ancestry populations to others is neither equitable nor safe.
- N Engl J Med 2021; 384:1070-1074
Questions about excluding transgender people from antidiscrimination protections reflect the polarizing nature of definitions of sex. Yet historians of medicine know that the relevant moral and scientific questions touch on age-old themes in medical understanding.