Author Archives: Michael J. Barry, MD

Michael J. Barry, MD

Doctors Keeping Up: A Patient and Doctor Perspective

By: Michael J. Barry, MD and Patty Skolnik Editor’s note: The following exchange is a conversation between Patty Skolnik and Michael Barry regarding the current controversy about physicians’ maintenance of their licensure and certification. Patty Skolnik is the founder and … Continue reading

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Michael J. Barry, MD

The President’s Corner: July/August 2015

In a 2012 report for The King’s Fund, Foundation cofounder Al Mulley and colleagues described the problem of misdiagnosis of patients’ preferences. “Preference misdiagnosis” may be the most common form of medical error in health care. It can occur when a person has more than one medically reasonable course of action open to him or her. A clinician, sometimes supported by recommendations from clinical practice guidelines, may prescribe or withhold a treatment based on what the evidence best supports and what he or she thinks the patient would want. However, research shows that among fully informed patients who understand a certain treatment’s possible benefits and risks, some would want that prescribed treatment, and some would not want that treatment prescribed. While there is evidence that preference misdiagnosis occurs, its epidemiology and solutions have not been well described. Continue reading

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Michael J. Barry, MD

The President’s Corner: May/June 2015

Together, Jack and Al wrestled with how to find the “right rate” of medical care, preserving wanted variation attributable to patients’ clinical conditions and preferences while reducing unwanted variation due to clinicians’ preferences. They concluded that the answer would be found in ensuring that patients are fully informed about and involved in their medical decisions. This melding of minds produced the Informed Medical Decisions Foundation in 1989. And for 26 years we’ve had truly big shoes to fill in carrying forward their ideals! Continue reading

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Michael J. Barry, MD

Decision aid reduced men’s interest in PSA screening and helped shape patient-clinician conversations

Recent clinical practice guidelines from the United States Preventive Services Task Force (USPSTF) recommend against PSA screening for men of all ages, while other guideline groups, including the American Urological Association (AUA) and the American College of Physicians (ACP), recommend a shared decision making (SDM) approach to the prostate-specific antigen (PSA) test. “Dueling guidelines” can create confusion for people who are facing a health decision, as well as for their clinicians. Continue reading

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The President’s Corner: March/April 2015

As Shared Decision Making Month drew to a close at the end of March, I found myself reflecting on forces that get in the way of all patients sharing in their fateful health decisions. One potential collision is between clinical practice guidelines, with their related performance measures, and the preferences of informed patients. Continue reading

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