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Nine great TED talks on improving health care

I've just listened to nine great TED talks and read a few companion articles on improving health care and health care outcomes. Check out these speakers: Atul Gawande, Ben Goldacre, Rebecca Onie, Brian Goldman, Ernest Madu, Peter Saul, Eric Dishman, Thomas Goetz. They are talking about improving health care--in particular about ways in which poor people have access to good health--not about changing our approach to health insurance. Click on the titles to get to the TED talks.

Atul Gawande: How do we heal medicine? Medicine requires pit crews, not cowboys. Complexity requires group success. Hence the importance of checklists. (19:19 min.) You can also read Gawande's story Cowboys and Pit Crews (New Yorker, 5-26-11 -- Atul Gawande's commencement address at Harvard Medical School)

Ben Goldacre: What doctors don't know about the drugs they prescribe (13:29 min.) Freak (positive) research results get published; negative results do not. Numerous drubs tested for controlling arrhythmia got negative results, which were not published--but those results might have been a warning of trouble ahead. Over 100,000 people died from the prescription of anti-arrhythmic drugs. Negative results go missing in action. We blindly tolerate publication bias, which is a cancer at the core of evidence-based medicine. We need to force people to publish all trials conducted on humans, including older trials with negative results. You can also read: The drugs don't work (Goldacre, Viewpoint, 10-25-13) "Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques that are flawed by design, in such a way that they exaggerate the benefits of treatments. ... [And then:] the results of these trials are given in secret to the regulator, which then sits and quietly makes a decision....Missing data poisons the well for everybody. If proper trials are never done, if trials with negative results are withheld, then we simply cannot know the true effects of the treatments we use."

Rebecca Onie: What if our healthcare system kept us healthy? Doctors were asked, If you had unlimited resources, what would you give your (poor, clinic) patients? What is we had a health care system instead of a sick care system? What if we measured success by diseases prevented, not diseases treated or cured. What if doctors could prescribe such basics as nutritious food, an exercise program, and a safe and warm place to live, especially in bad weather. What if "health leads" got your heat turned back on? Rebecca Onie chases a vision of organizing an army of young people to mobilize what poor people need for good health. Health takes time and an army of workers. (16:34 min.) Follow-up TED talk: At last, healthcare considering patients’ social needs

Brian Goldman: Doctors make mistakes. Can we talk about that? Every doctor makes mistakes. But, says physician Brian Goldman, medicine's culture of denial (and shame) keeps doctors from ever talking about those mistakes, or using them to learn and improve. Telling stories from his own long practice, he calls on doctors to start talking about being wrong. (19.28 minutes) You can also read his article for Huffington PIost What If Talking About Medical Mistakes Went Viral?

Abraham Verghese: A doctor's touch (18:32 min.) Modern medicine is in danger of losing a powerful, old-fashioned tool: human touch. Physician and writer Abraham Verghese describes our strange new world where patients are merely data points, and calls for a return to the traditional one-on-one physical exam.

Ernest Madu: World-class health care Dr. Ernest Madu runs the Heart Institute of the Caribbean in Kingston, Jamaica, where he proves that -- with careful design, smart technical choices, and a true desire to serve -- it's possible to offer world-class healthcare in the developing world. (filmed 2007; 16:43 min.)

Peter Saul: Let's talk about dying We can’t control if we’ll die, but we can “occupy death,” in the words of Dr. Peter Saul. “Increasing longevity means more old age, not more youth.”He quotes Gloria Steinem: "The truth will set you free, but first it will piss you off." People who are dying are often attached to intensive care machinery to prolong life, when there is no cure for their medical conditions -- though the stress level on everyone when a person dies in intensive care is seven times greater than when a person dies just about anywhere else. Saul calls on us to make clear our preferences for end of life care -- and suggests two questions for starting the conversation. (13:19 min.)

Eric Dishman: Health care should be a team sport When Eric Dishman was in college, doctors told him he had 2 to 3 years to live. That was a long time ago. Now, Dishman puts his experience and his expertise as a medical tech specialist together to suggest a bold idea for reinventing health care -- by putting the patient at the center of a treatment team. (15:59 min.) Listen also to his TED talk Take health care off the mainframe . As our aging population booms, it's imperative, he says, to create personal, networked, home-based health care for all.

Thomas Goetz: It's time to redesign medical data Have you ever tried to read your medical chart, only to give up after being unable to decipher the medical jargon? Thomas Goetz shows how redesigned medical charts can provide us with a wealth of important information about our health.
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