In the 117th Shattuck Lecture, Dr. Steven Schroeder asks why American system fails to deliver a standard of health similar that observed in many other countries. his arguments, he focuses on public risks smoking and obesity how they have been managed.

In this article, the authors argue that although racial and ethnic disparities in health have attracted appropriate attention, association between class (i.e., income, education, occupation) is not widely appreciated. Pointing to strong correlations higher income educational levels better health, they suggest nation's would be greatly enhanced by investment social economic policies address differences.

Despite the reality that smoking remains most important preventable cause of death and disability, clinicians underperform in helping smokers quit. Of 46 million current United States, 70% say they would like to quit, but only a small fraction are able do so on their own because nicotine is highly addictive. One third one half all die prematurely. Reasons avoid quit include time constraints, lack expertise, financial incentives, respect for smoker's privacy, fear negative message might lose...

Tobacco dependence treatment efforts have focused on primary care physicians (PCPs), but evidence suggests that they are insufficient to help most smokers quit. Other health professionals also frequently encounter smokers, their smoking prevalence, cessation practices, and beliefs less well known.The study included 2,804 subjects from seven professional groups: PCPs, emergency medicine physicians, psychiatrists, registered nurses, dentists, dental hygienists, pharmacists. Outcomes...

Variation in costs of laboratory and drug use was audited among 33 faculty internists caring for a homogeneous population at university clinic. more extreme (17-fold) than (fourfold). Laboratory per physician were significantly correlated ( P

Internal medicine residencies risk becoming obsolete if they are not adjusted to changing patterns of medical practice. Declining length hospital stay, increased intensity care, movement critical management decisions outpatient settings, proportions admissions for specific diagnostic procedures, and needs perioperative consultations all erode the foundation traditional internal training. Furthermore, demographic shifts, move prepaid a projected oversupply subspecialists warrant more exposure...

Few factors influence health care standards in the United States today more than actions of Joint Commission (formerly on Accreditation Healthcare Organizations). And few opportunities hold promise for increasing rate tobacco-use cessation patient contact with system. Health visits represent teachable moments when a patient's very real fears and concerns about tobacco use can provide particularly powerful motivation to quit. The Commission's new Tobacco Cessation Performance Measure-Set took...

This Special Report discusses the implications of 1998 Master Settlement Agreement between states and tobacco industry. In context current state budget crises, a decreasing proportion settlement dollars is being spent on programs to reduce smoking. report presents an overview local, state, federal tobacco-control policies reviews recent developments focused taxation, smoking cessation, bans in public areas, international trade policies.

Previous studies from this institution have shown extreme variation in laboratory and x-ray use among comparably trained physicians caring for similar patients. In addition, essentially no correlation (r = --.13) existed between a physician's lab profile subjective estimates of clinical competence. This study compares variations with both productivity outcome care. Costs tests 149 long-term ambulatory hypertensive patients cared by 13 faculty internists during one year were computed....

Aserkoff, B., S. A. Schroeder and P. Brachman (Bacterial Diseases Branch, NCDC, Atlanta, Ga. 30333). Salmonellosis in the United States—a five-yearreview. Amer. J. Epid., 1970, 92: 13–24.—In 1963, a national program of salmonella surveillance based on laboratory identification salmonellao was instituted. The results first 5 years (1963–1967) document epidemiologic characteristics salmonellosis indicate where control measures can be effective. reported average annual incidence States 10.4...

Four hundred Salmonella strains isolated during 1967 from clinical sources throughout the United States were examined for resistance to 11 antibiotics, and suitable tested transfer factor (RTF). Only 89 (22%) of resistant one or more antibiotics. Resistance was most common streptomycin (14.2%), tetracycline (12.5%), sulfathiazole (11.5%). None chloramphenicol, nalidixic acid, colistin sulfate. significantly in of<i>Salmonella typhimurium</i>than other<i>Salmonella</i>serotypes. Of 52...

The current landscape of tobacco use presents new challenges and opportunities. Since the net harms combustible products dwarf those other forms use, should be focus concerted clinical public health efforts.

Academic medicine is entrusted by society with the responsibility to undertake several important social missions toward improving health of public, including education, patient care, and research. This trust given implicit authority generous public funding considerable autonomy. Medical academia can take pride in its successes, manifested a premier scientific establishment, development use sophisticated medical technologies drugs, recent dramatic declines death rates from heart disease...

Context: Counseling smokers to quit smoking and providing them with pharmaceutical cessation aides are among the most beneficial cost‐effective interventions that clinicians can offer patients. Yet assistance quitting is not universally covered by health plans or offered all clinicians. Analysis of stakeholders' perspectives interests identify barriers more widespread provision services suggest strategies for public policy agenda advance cessation. Methods: Review literature discussions...

A previous study at this institution demonstrated extreme variation in use laboratory tests among similarly trained internists caring for similar groups of ambulatory patients. This report examines whether these variations can be related to differences the quality physician performance. The group studied consisted 21 medical interns George Washington University Hospital. In order insure that physicians were not attributable clinical their patient populations, measurement was restricted a...

Prochaska JJ, Reyes RS, Schroeder SA, Daniels AS, Doederlein A, Bergeson B. An online survey of tobacco use, intentions to quit, and cessation strategies among people living with bipolar disorder. Bipolar Disord 2011: 13: 466–473. © 2011 The Authors. Journal compilation John Wiley &amp; Sons A/S. Objectives: Tobacco use is prevalent We examined attempts tobacco‐related attitudes 685 individuals disorder who smoked ≥ 100 cigarettes in their lifetime. Methods: Data were collected through the...

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Our website uses cookies to enhance your experience. By continuing use our site, or clicking "Continue," you are agreeing Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications Network Open Cardiology Dermatology Health Forum Internal Medicine Neurology Oncology Ophthalmology Otolaryngology–Head & Neck Surgery Pediatrics Psychiatry Archives of (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning /...