President’s Corner

Michael J. Barry, MD

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Michael J. Barry, MD

The President’s Corner: January/February 2016

In 2010, Dr. David Ring, a hand surgeon at Massachusetts General Hospital (MGH), courageously published an article about performing the wrong operation at the wrong site on a patient. The patient was scheduled for a trigger finger release procedure, and … Continue reading

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The President’s Corner: November/December 2015

Last month, the Association of Health Care Journalists (AHCJ), with funding from the Patient-Centered Outcomes Research Institute (PCORI), offered the AHCJ Fellowship on Comparative Effectiveness Research. A group of 12 health care journalists from around the country spent four days in Washington DC at the PCORI offices getting a “crash course” in comparative effectiveness research (CER) and how it can be used to improve health and health care. Continue reading

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Michael J. Barry, MD

The President’s Corner: September/October 2015

I attended the 6th annual Wennberg International Collaborative (WIC) Fall Research Meeting in London September 2-4, 2015. This invitation-only meeting is a collaboration between The Dartmouth Institute (TDI) and the London School of Economics and Political Science (LSE). The WIC is a research network committed to improving health care by examining organizational and regional variation in health care resources, utilization, and outcomes. The goal of the collaboration is to better understand the causes and consequences of unwarranted variation—that is, variation in health care not explained by differences in population needs or preferences—around the world, leading to clinical improvement and policy change. 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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