Peter Ubel, MD

Peter Ubel is a physician and behavioral scientist who blogs at his self-titled site, Peter Ubel and can be reached on Twitter @PeterUbel. He is the author of Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together.

Should physicians discuss spirituality with their patients?

Peter Ubel, MD

Physician

April 18, 2013

“I can fix this.”

The neurosurgeon was nothing if not confident.

“The cyst is pushing on your spinal cord. If it continues to expand, it will damage your nerves and you may lose the ability to walk. But I can remove the cyst, and cure you.”

The patient was a business school professor, a man comfortable with risk-benefit ratios and complex decisions. He probed for more information. The surgeon was happy to provide …

I let my hope and optimism interfere with accurate communication

Peter Ubel, MD

Conditions

April 4, 2013

Andrews was easily the most anxious patient I took care of that month, a gray Michigan February (is there any other kind?) which I spent in the hospital caring for patients admitted to the general medical ward at the Ann Arbor Veterans Affairs Medical Center. (Andrews is a pseudonym, as are all the patients I blog about, unless otherwise indicated.) He had plenty to be anxious about, too. His leukemia …

Just sign here: That isn’t real informed consent

Peter Ubel, MD

Physician

March 26, 2013

Before patients can become savvy consumers of healthcare, they need information about their healthcare choices. Too often, such information is nearly impossible to get, especially when it requires doctors to give patients useful statistics about things like treatment side effects.

Since publishing Critical Decisions this fall, I have received a number of emails from readers who have recognized their own medical histories in the pages of my book. I received …

Why the primary care physician shortage is overblown

Peter Ubel, MD

Physician

March 14, 2013

Are there really too few primary care physicians? And if so, what can we do to solve the PCP shortage? The standard answer to the first question is “yes, we have too few PCPs.” And the standard solution is to train more such docs, or allow more foreign-trained primary care docs into the country or, better yet, simply pay PCPs more money, so that graduating medical students will be more …

The ethical breach surrounding the first test tube baby

Peter Ubel, MD

Physician

February 22, 2013

The first test tube baby was born July 25th, 1978 in the north of England. Louise Brown was called the “baby of the century” by some and a “moral abomination” by others. It wasn’t Brown who critics accused of being immoral, of course. She was just a blameless infant. Instead, it was her doctors who came under fire for their new fertility treatment—in vitro fertilization (or IVF). Roman Catholic theologians …

Do doctors take advantage of desperate couples with infertility loans?

Peter Ubel, MD

Physician

January 30, 2013

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Somewhere near where you live, a couple will discover this week that they are infertile and that if they want biological children of their own, they are going to need in vitro fertilization (or IVF). According to treatment protocol, the woman will need to take powerful medicines to ramp up her production of fertilizable eggs. One monthly cycle of this treatment will run …

Why the medical professions should be color blind

Peter Ubel, MD

Physician

January 12, 2013

The role of race in college and graduate school admissions remains controversial in the U.S. In fact, the Supreme Court is currently taking up a challenge to a University of Texas program that considers race in its admission decisions. Critics of race-based admissions question whether educational institutions would serve the goals of affirmative action better by relying exclusively on non-race based criteria, such as socioeconomic status and family …

Screening for ovarian cancer: Where’s the outrage?

Peter Ubel, MD

Conditions

January 7, 2013

In September the United States Preventive Services Task Force, a panel of medical experts, concluded that tests to screen for ovarian cancer do more harm than good. As a result, insurers will not be required by federal law to pay for such tests.

And the announcement was met with near silence.

Why was this recommendation greeted with such malaise when the same panel’s earlier and similar conclusions about Read more…

Screening for ovarian cancer: Where’s the outrage?

Jumping to quick conclusions after Newtown would be a tragic mistake

Peter Ubel, MD

Physician

December 20, 2012

Gun rights advocates are correct: a well armed principal might have reduced the death toll from the tragic elementary school shootings in Connecticut last week. Gun carrying citizens might also have been able to take down the shooters in Aurora and Virginia Tech. To most people, after all, guns are about self-defense, not about committing crimes. As the old saying goes: “There has never been a mass shooting at a …

Don’t overwhelm patients with unnecessary detail

Peter Ubel, MD

Physician

December 10, 2012

It is not an easy time to be a physician in the United States. Attempt to order an expensive test for a patient and an insurance company is likely to second guess your decision. Try upholding the bottom line for your medical practice and the government will probably start questioning whether you are overcharging for your services. To make matters worse, …

Finding the balance in calorie count regulations

Peter Ubel, MD

Physician

November 30, 2012

As a fan of free markets, I recognize that sometimes intelligent government regulations (not always an oxymoron!) can improve markets by requiring companies to provide consumers with information that will help them make better choices. Informed consumers, after all, are a central ingredient of a successful free market. That’s why even most libertarians support regulations that ban fraudulent advertising.

That’s also why, at first glance, the federal government seemed to be …

Good decision making often depends on good communication

Peter Ubel, MD

Physician

November 19, 2012

We live in an age of patient empowerment. Medical students are now routinely taught that the “right choice” often depends on patient preferences—on how an individual patient weighs the pros and cons of her treatment alternatives. That means medical decisions depend, more than ever, on good communication. Physicians need to help patients understand their choices so that they can partner with their patients in discovering the best alternatives, ones personalized …

What kind of basic healthcare coverage should we offer to prisoners?

Peter Ubel, MD

Physician

November 13, 2012

I expect most of us agree that an incarcerated felon experiencing a heart attack should receive medical treatment, even if that treatment comes at taxpayers’ expense. The same probably goes for more preventive measures—blood pressure pills, cancer screening tests and the like. While serving out the sentence for their crimes, prisoners should not be forced to suffer from treatable and preventable illnesses without receiving appropriate medical care. They can pay …

Help your doctor understand where you’re coming from

Peter Ubel, MD

Physician

October 29, 2012

Charlotte Scott had an eye for madness—for just the right amount of madness. As a booker for The Springer Show, her job was to find—and forgive me if I’m getting too technical here—minor nut jobs, the kind of people who were just unbalanced enough to make for entertaining T.V. but not so wacky that they would pull an Uzi out on the audience.

I learned about Scott while reading Jon Ronson’s …

Why hospital pricing practices concern me

Peter Ubel, MD

Policy

October 12, 2012

The gynecologist made several incisions and inserted the laparoscope. With the help of her surgical team of nurses, students and anesthesiologists, she removed the patient’s uterus, which had been bleeding uncontrollably for the past six months despite aggressive medical therapy. The price tag of the procedure? Around $6,000.

Meanwhile in a nearby hospital, another gynecologist removes another woman’s uterus, in a procedure no more complicated or time consuming than the first …

To fix health care, we need to be screwed

Peter Ubel, MD

Policy

October 3, 2012

“We need to be screwed!”

Not altogether surprising words to spill out of a college student’s mouth. But this particular student was not talking about sex. She was discussing the U.S. healthcare system—more specifically what she thought it would take for our two political parties to come together to find a reasonable way to control our nation’s healthcare costs.

It was the last day of the semester, the last class discussion in …

The ethics of conducting a pelvic exam on an anesthetized woman

Peter Ubel, MD

Physician

September 12, 2012

I felt a woman’s uterus without her permission. How this happened, and why I thought I had done the right thing at the time, tells us something important about medical education and shows us why doctor/patient interactions often play out like conversations between earthlings and aliens.

To understand my inappropriate actions, you need to know something about the physical exams that we physicians conduct on our patients. More specifically, about the …

Don’t accept advice from physicians until they understand your values

Peter Ubel, MD

Physician

August 20, 2012

Facing advanced cancer, who among us wouldn’t look to our oncologist for expert advice on whether another round of chemotherapy makes sense? But do you know what your oncologist cares about, and can you be sure her recommendations map onto your own treatment preferences?

A recent study lead by Michael Kozminski (I was senior author) shows that American oncologists downplay the value of treatments that improve quality of life, …

Many doctors fail to understand the math of cancer prevention

Peter Ubel, MD

Physician

August 2, 2012

All too often the most powerful illusions seduce us through truthful whisperings. Let’s start with an obvious truth: Living a long and happy life after a cancer diagnosis is better than living a short miserable one.

Given a choice between receiving a diagnosis of metastatic cancer—an incurable life-ending-it’s-already-spread-to-your-brain neoplasm—versus the diagnosis of a localized, snip-it-out-and-it’s-done tumor: Who wouldn’t choose the latter?

And yet this simple truth causes doctors to embrace unproven screening …

Why does fear of litigation turn into preference for action?

Peter Ubel, MD

Physician

July 18, 2012

LeBron James exploded past his defender and raced towards the lane. Serge Ibaka, the Thunder’s mountainous center, planted his feet and raised his hands straight up into the air. LeBron ducked his left shoulder and plowed right into Ibaka, who went crashing backwards into a nearby cameraman.

Offensive foul?

Maybe if it had been the first quarter. But given that this was the last minutes of a tightly fought game, the referees …