Dear clients and friends: Given your interest in health and medicine, we would like to share with you our collection of the most interesting perspectives on our industry's trends and developments. We are happy to share them with you — and hope you share your thoughts with us.

1. Doctor, Do Little

 Healthcare systems across the world are pinched by labor shortages. One chief struggle is between doctors and nurses, and how much oversight the former needs over the latter. A new academic study reviews malpractice suits as a way to measure negative patient outcomes when nurses are in charge. It finds that MDs need to let NPs do their own thing:

The results of this paper indicate no evidence of harm severe enough to result in medical malpractice payouts and adverse actions against licenses. These results add to the growing literature showing that removing physician oversight requirements from the NP SOP results in health outcomes that are either no different or slightly better under NP care, with lower costs and more patient access, and with no evidence of harm or other downsides to patients.

2. Economist, Do More

 “This is the golden age of biomedicine.” So begins Tyler Cowen’s column in Bloomberg, where he worries that we are failing to appreciate “this special time in the history of science.” His solution? For economists to create new methods of assessing the economic impact of medical innovation:

What’s needed are new metrics…There is a risk of underestimating the revolutionary impact of current technological developments…An index of biomedical advances, and their degree of reach through the population, would be a welcome addition to the standard discourse about economic growth. If the health-care sector reaches 29% of GDP by 2040, as economics Nobel Laureate Robert W. Fogel once predicted, such an index will become all the more important

3. So, About that Golden Age…

 If Tyler Cowen’s language about the “golden age of biomedicine” feels hyperbolic, consider this testimony from Victoria Gray. She battled sickle cell disease for 37 years. Then, she entered an experimental gene therapy trial:

“During [a] hospital stay, with a ketamine infusion in one arm and a Dilaudid infusion in the next — but still no pain relief — I called all the doctors into the room and told them I could no longer live like this,” Gray said.

Gray explained how she finally received the CRISPR gene-edited cells — “supercells,” she calls them — as part of a study. “The life that I once felt like I was only existing in, I am now thriving in,” she told the assembled scientists, doctors, bioethicists and others. “I stand here before you today as proof that miracles still happen — and that God and science can coexist.”

Another example: The Guardian trumpets “cancer and heart disease vaccines ‘ready by the end of the decade.’”

4. Down with the IRB!

The always-insightful, sometimes-cranky blogger behind Astral Codex Ten offers a deflating, head-smacking anecdote about trying to get IRB approval. It’s a test-case for bad policy. And an unhappy warning for any researcher needing IRB approval:

When I worked in a psych ward, we used to use a short questionnaire to screen for bipolar disorder. I suspected the questionnaire didn’t work, and wanted to record how often the questionnaire’s opinion matched that of expert doctors. This didn’t require doing anything different - it just required keeping records of what we were already doing. But because we were recording data, it qualified as a study; because it qualified as a study, we needed to go through the IRB.

After about fifty hours of training, paperwork, and back and forth arguments - including one where the IRB demanded patients sign consent forms in pen (not pencil) but the psychiatric ward would only allow patients to have pencils (not pen) - what had originally been intended as a quick record-keeping had expanded into an additional part-time job for a team of ~4 doctors. Our team of four doctors considered the hundreds of hours it would take to document compliance and agreed to give up. As far as I know that hospital is still using the same bipolar questionnaire. They still don’t know if it works.

5. Mental Health on Capitol Hill

After Senator John Fetterman sought treatment for depression, Congressional leaders from both parties spoke out. They shared their own experiences with mental ill health, as well as what’s changing and what needs to be done:

 
“When I started going to therapists I [would] try to find as many ways as possible to hide that I was going to a therapist. Like I would make sure that I was driving in a way that people couldn't figure out that I was pulling up to the therapist's office,” [Rep. Ruben] Gallego said. “And it's been … a sea change that I don't have to do that anymore,” he said.

Other lawmakers may be privately struggling still, [Rep. Ritchie] Torres said: "There are 535 members in Congress. I suspect we're not the only four. I think the fact that the four of us are here is a sign of progress. But the fact that only four of us are here is a sign that we have a distance to travel.”