Neel Shah, MD
Neel Shah is an obstetrician-gynecologist.
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Physician voices
After eight years of practicing obstetrics and researching childbirth in the United States, I know as well as anyone that the American maternal health system could be better. Our way of childbirth is the costliest in the world. Our health…
After eight years of practicing obstetrics and researching childbirth in the United States, I know as well as anyone that the American maternal health system could be better. Our way of childbirth is the costliest in the world. Our health outcomes, from mortality rates to birth weights, are far, far from the best. 
The reasons we fall short are not …
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Childbirth in the U.S. and India: How it falls short and why
Health policy
Recently, I had the opportunity to sit at the table with some of the nation’s top thought leaders. We convened at the Newseum in Washington, DC, for the Healthcare Leadership Council’s National Dialogue for Healthcare Innovation; it was like a…
Recently, I had the opportunity to sit at the table with some of the nation’s top thought leaders. We convened at the Newseum in Washington, DC, for the Healthcare Leadership Council’s National Dialogue for Healthcare Innovation; it was like a health policy nerd red carpet. Center for Medicare Director Sean Cavanaugh was there. Leapfrog Group CEO Leah Binder was there. America’s favorite bioethicist–oncologist–provocateur Zeke Emanuel was there. The chief executives …
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What exactly is value in health care?
Medical education
Earlier this year, we launched the Teaching Value and Choosing Wisely Competition in conjunction with Costs of Care and the ABIM Foundation. Why a competition? Not surprisingly, traditional “literature review” yielded little by way of promising strategies for educators who…
Earlier this year, we launched the Teaching Value and Choosing Wisely Competition in conjunction with Costs of Care and the ABIM Foundation. Why a competition? Not surprisingly, traditional “literature review” yielded little by way of promising strategies for educators who wished to learn how to teach about value.
However, we had all learned of isolated stories of success, occasionally through attending professional meetings, sometimes via networking with colleagues, or more …
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Finding the most promising innovations to teach value
Physician voices
The pressure on physicians to provide better care at lower costs is coming from all directions – top down from policymakers who want more accountability in how healthcare resources are being used and bottom up from patients who want more…
The pressure on physicians to provide better care at lower costs is coming from all directions – top down from policymakers who want more accountability in how healthcare resources are being used and bottom up from patients who want more transparency in how their money is being spent. Obstetrician and gynecologists have not been spared any scrutiny. As primary care providers for many women we are in thick of the …
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Choosing wisely and delivering value in obstetrics and gynecology
At a time when one in three Americans report difficulty paying medical bills, up to $750 billion is being spent on care that does not help patients become healthier. Although physicians are routinely required to manage expensive resources, traditional medical…
At a time when one in three Americans report difficulty paying medical bills, up to $750 billion is being spent on care that does not help patients become healthier. Although physicians are routinely required to manage expensive resources, traditional medical training offers few opportunities to learn how to deliver the highest quality care at the lowest possible cost. While the gap is glaring the problem is not new.
In 1975, the …
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Medical educators: Take charge and help deflate medical bills
Conditions and diseases
by Neel Shah, MD What are the top reasons doctors over-order tests? 1. How we’re taught. Doctors are taught to consider whether a procedure is safe and whether it’s likely to work. We’re almost never taught to consider cost —…
by Neel Shah, MD
What are the top reasons doctors over-order tests?
1. How we’re taught. Doctors are taught to consider whether a procedure is safe and whether it’s likely to work. We’re almost never taught to consider cost — it’s considered taboo.
2. Trying to do our best for the patient. We’re worried. Often we over-order because of our personal risk aversion.
3. Pre-emptive ordering. For residents, who do much of …
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10 reasons why doctors over-order tests
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