Tuesday, February 28, 2023

Hsieh Forbes Column: The Unsettled Science Of Covid-19

My latest Forbes column is now out: "The Unsettled Science Of Covid-19".

I discuss some recent controversies over Covid-19, including natural immunity, the efficacy of mask mandates, and the "lab leak" hypothesis -- and what that means for the concepts of "consensus" and "misinformation".

Wednesday, February 15, 2023

Burdensome Guidelines

The New York Times reports, "According to Medical Guidelines, Your Doctor Needs a 27-Hour Workday"\

Some excerpts:

The intent is admirable: Give doctors guidelines so they can be sure to cover what needs to be discussed with patients and help select options. Let’s talk about your diet and any problems you might have sleeping. Are you getting enough exercise? If not, here is some advice. You are due for colon cancer screening. Do you prefer a colonoscopy or a fecal test? Here are the pros and cons of each.

But there is a problem. There are just not enough hours in a workday to discuss and act on all the guidelines...

[I]magine a doctor shrugged off the chronic and acute care, as well as administrative work, and merely followed the preventive care checklist recommended by the U.S. Preventive Services Task Force, an independent panel of health experts. That would be 8.6 of the doctor’s hours each day, according to a study in the American Journal of Public Health.

As anyone who has been sped through a 15-minute annual wellness visit knows, doctors cannot be so exacting. That the guidelines are so thorough yet so often glossed over prompts questions about their usefulness. At the same time, doctors’ pay often depends on checking off guideline boxes.

This is not just a problem in the US: 

[I]mplementing all the British guidelines for improving patients’ lifestyles could require more doctors and nurses than are practicing in the entirety of Britain. 

Good intentions from central planners does not always translate to actual good medical practice by physicians on the ground.