Sağlık Yönetimi

The glomerular filtration rate (GFR) is generally estimated from serum concentrations of endogenous filtration markers such as creatinine or cystatin C. During the past two decades, automated clinical laboratory reporting of GFR estimated with the use of creatinine (eGFRcr) has

The Child Abuse Prevention and Treatment Act (CAPTA), the foundational child-protection legislation in the United States, has been revised more than 20 times since its original passage in 1974. For nearly 30 years, CAPTA didn’t cover infants who had been

The glomerular filtration rate (GFR) is generally estimated from serum concentrations of endogenous filtration markers such as creatinine or cystatin C. During the past two decades, automated clinical laboratory reporting of GFR estimated with the use of creatinine (eGFRcr) has

The Child Abuse Prevention and Treatment Act (CAPTA), the foundational child-protection legislation in the United States, has been revised more than 20 times since its original passage in 1974. For nearly 30 years, CAPTA didn’t cover infants who had been

Before my son left home on the first day of school, I took his photo — attempting, like generations of parents before me, to hit the “pause” button on life for a few seconds, capturing the start of a new

The Association of American Medical Colleges (AAMC) has issued a new assessment of salary disparities among U.S. physicians according to gender, race, and their intersection that reaffirms a persistent gender pay gap. Building on decades of research demonstrating that female

In 2017, Hurricane Maria’s devastating impact in Puerto Rico exposed significant flaws in the U.S. medical and public health response to natural disasters. The majority of the nearly 3000 excess deaths caused by the hurricane were attributable not to its

Nowhere are the effects of climate change manifesting more clearly than in human health. Although many people consider climate change a looming threat, health problems stemming from it already kill millions of people per year. It is well established that

Physicians often find it challenging to apply the lessons of large research studies to their clinical practice, especially when the research participants do not reflect the racial identity, ethnicity, age, or sex and gender of the physicians’ patients. Strict eligibility

What is race? Should medicine stop using racial and ethnic categories as proxies for social determinants of health, genetic ancestry, or both? What are the most promising approaches to dismantling structural racism in medicine? In this video roundtable, moderated by

The United States has learned from the Covid-19 pandemic what is required of the federal government’s executive branch to tackle a national health crisis. In addition to presidential leadership, there must be a team with a single purpose that reports

The United Nations General Assembly in September 2021 will bring countries together at a critical time for marshalling collective action to tackle the global environmental crisis. They will meet again at the biodiversity summit in Kunming, China, and at the

Physicians often find it challenging to apply the lessons of large research studies to their clinical practice, especially when the research participants do not reflect the racial identity, ethnicity, age, or sex and gender of the physicians’ patients. Strict eligibility

The mother clutches her daughter as the nebulized albuterol permeates the young girl’s airways. My eyes dart between the monitor and the child’s small, dark-skinned chest as it heaves up and down at an alarming rate. I smile reassuringly, but

Should access to health services be considered a human right? This is one of the fundamental ethical and political questions facing every society, but both the answers and the ways in which countries have acted on them vary substantially. Until

On June 7, 2021, the Food and Drug Administration (FDA) granted accelerated approval to aducanumab (Aduhelm) for treatment of Alzheimer’s disease. In many respects, this move represents a landmark moment: not only is aducanumab the first drug approved for Alzheimer’s

The United States has learned from the Covid-19 pandemic what is required of the federal government’s executive branch to tackle a national health crisis. In addition to presidential leadership, there must be a team with a single purpose that reports

Throughout the world, including the United States, medical professionals and patients are facing both a pandemic and an infodemic — the first caused by SARS-CoV-2 and the second by misinformation and disinformation. The Annenberg Public Policy Center’s tracking of social

Now that more than half of U.S. adults have been vaccinated against SARS-CoV-2, masking and distancing mandates have been relaxed, and Covid-19 cases and deaths are on the decline, there is a palpable sense that life can return to normal.

If physicians were to amend the U.S. Constitution, the right to health care would almost certainly be guaranteed. Although the Constitution’s preamble offers the assurance of “general welfare,” the omission of an explicit right to health care from both the

Outbreaks of coronavirus disease 2019 (Covid-19) emerged in the United States and in European countries in February 2020. Urgent action was called for, since experts estimated that 30 to 70% of people in these Western countries could become infected —

The emergence of worrisome variants of the SARS-CoV-2 virus has exposed the limited scale of surveillance efforts in the United States. More than 30 other countries conduct more sequencing of viral isolates than the United States does, thereby permitting greater

When I became a physician, I was not expecting to learn so much about ankle monitors. Over the past few years, I have worked in clinics caring for patients with mental disorders, substance use disorders, or both, many of whom

Policymakers are beginning to test new payment models that establish budgets for rural health care providers. By implementing a fixed payment or setting a spending benchmark for health care organizations, budgets are intended to promote efficient care delivery. Rural health

The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy. — Martin Luther King, Jr. 1963 The Covid-19 pandemic has vividly reminded us

Both rapid innovation and equitable access to vaccines are necessary to protect the world from viral pandemics. Today, however, we face gross inequities in global access to Covid-19 vaccines. As high-income countries, such as the United States and European countries,

Both rapid innovation and equitable access to vaccines are necessary to protect the world from viral pandemics. Today, however, we face gross inequities in global access to Covid-19 vaccines. As high-income countries, such as the United States and European countries,

In late July, approximately 11,000 athletes and 4000 athletic-support staff from more than 200 countries will gather for more than 2 weeks of competition at the Tokyo Olympics. One month later, another 5000 athletes and additional staff will attend the

The United States faces a growing maternal health crisis: each year, at least 700 women die from pregnancy-related complications and there are more than 25,000 cases of severe maternal morbidity, such as eclampsia or sepsis. These harms prompted the Department

Despite having been warned for decades, many countries were unprepared for the Covid-19 pandemic. Though some have managed to contain the virus, in most countries, the pandemic response has been poor at best; in some countries, it’s been disastrous. As

Type 2 diabetes affects more than 34 million U.S. adults and significantly increases the risk of cardiovascular events, microvascular disease, and premature death. Tight glycemic, blood-pressure, and lipid control lowers the risk of diabetes-related illness and death, especially when attained…

As the Health Insurance Portability and Accountability Act of 1996 (HIPAA) — which was a step toward greater health information privacy — turns 25, U.S. health disclosure norms are changing, with openness and sharing becoming more commonplace. For many Americans,

The emergence of worrisome variants of the SARS-CoV-2 virus has exposed the limited scale of surveillance efforts in the United States. More than 30 other countries conduct more sequencing of viral isolates than the United States does, thereby permitting greater

As the Health Insurance Portability and Accountability Act of 1996 (HIPAA) — which was a step toward greater health information privacy — turns 25, U.S. health disclosure norms are changing, with openness and sharing becoming more commonplace. For many Americans,

The racially disparate impact of the Covid-19 pandemic has attracted increasing attention and concern. Black Americans have been disproportionately affected throughout the pandemic, and gaps replicating the same well-worn patterns of racial inequity are visible in the early rollout of

Hidden deep within the $2.3 trillion omnibus spending and relief package passed by Congress in December 2020 lies a little-known but powerful provision intended to promote equitable access to clinical trials. Beginning in January 2022, coverage of the “routine costs”

In late July, approximately 11,000 athletes and 4000 athletic-support staff from more than 200 countries will gather for more than 2 weeks of competition at the Tokyo Olympics. One month later, another 5000 athletes and additional staff will attend the

In July 2020, Dr. Lloyd Minor, dean of the Stanford University School of Medicine, cited the Covid-19 pandemic and life expectancy differences by neighborhood in Washington, D.C. as evidence that teaching hospitals and academic health centers must confront the effects

Outbreaks of coronavirus disease 2019 (Covid-19) emerged in the United States and in European countries in February 2020. Urgent action was called for, since experts estimated that 30 to 70% of people in these Western countries could become infected —

In July 2020, Dr. Lloyd Minor, dean of the Stanford University School of Medicine, cited the Covid-19 pandemic and life expectancy differences by neighborhood in Washington, D.C. as evidence that teaching hospitals and academic health centers must confront the effects

Throughout the world, including the United States, medical professionals and patients are facing both a pandemic and an infodemic — the first caused by SARS-CoV-2 and the second by misinformation and disinformation. The Annenberg Public Policy Center’s tracking of social

In 1992, an accelerated approval pathway for pharmaceutical products was added to the Code of Federal Regulations in an attempt to address unmet medical needs of patients with serious or life-threatening diseases. The pathway allows the Food and Drug Administration

Twenty-five years ago, on Sunday, April 28, 1996, a 28-year-old man used a Colt AR-15 semiautomatic rifle to kill 35 people in the quiet tourist town of Port Arthur, tucked away in the southeast corner of Tasmania, a small island

On April 12, 2021, the Food and Drug Administration (FDA) temporarily lifted its decades-long restriction on access to medication abortion, which accounts for two in five abortions in the United States. The agency’s action nullifies a Supreme Court order, 3

As of January 20, 2021, the United States has a national policy aimed at addressing systemic racism. On his first day in office, President Joe Biden signed an executive order on advancing racial equity and supporting underserved communities. Under the

In 1992, an accelerated approval pathway for pharmaceutical products was added to the Code of Federal Regulations in an attempt to address unmet medical needs of patients with serious or life-threatening diseases. The pathway allows the Food and Drug Administration

The Covid-19 pandemic has challenged clinicians to find innovative ways to provide essential services while minimizing risks for themselves and their patients. These approaches increasingly leverage remote patient monitoring (RPM), using technology to support treatment for chronic conditions. As…

On September 8, 2020, AstraZeneca announced that it was pausing its late-phase SARS-CoV-2 vaccine trial because of a serious adverse event in a U.K. participant. The next day, my hairdresser, Ms. J. asked me what I thought about the news.

Most national surveys in the United States, including the decennial census, do not collect demographic data on sexual orientation, gender identity, or intersex status. As a result, despite improvements in the social and legal standing of lesbian, gay, bisexual, transgender,

Concerns regarding access to Covid-19 vaccines in Africa are reminiscent of concerns raised about responding to the HIV pandemic in the mid-1990s and early 2000s, when highly active antiretroviral treatment (ART) was accessible in high-income countries but had limited availability

In September 2008, Katalin Karikó, Drew Weissman, and their colleagues at the University of Pennsylvania modified messenger RNA (mRNA) using nucleoside analogues. These modifications stabilized the molecule and eliminated its capacity for inducing innate immunity, thereby making mRNA a promising…

Dr. H. Jack Geiger, who died on December 28, 2020, was an unforgettable person. But far more important, especially at this moment in the national discourse, is the indelible imprint he left on health equity and social justice as paramount

The passage of the No Surprises Act — which banned “surprise billing” in many scenarios — on December 27, 2020, was an unexpected step forward during an otherwise dysfunctional year of U.S. policymaking. As many as one in five patients

Dr. H. Jack Geiger, who died on December 28, 2020, was an unforgettable person. But far more important, especially at this moment in the national discourse, is the indelible imprint he left on health equity and social justice as paramount

Despite calls for greater awareness of high rates of depression and suicide among physicians, estimates suggest that only about 1% of medical students with major depressive disorder disclose it as a disability. Throughout the medical school admissions process, training, and

On January 12, 2021, the Centers for Medicare and Medicaid Services (CMS) finalized a rule that could substantially alter Medicare-coverage decisions for potentially innovative new medical devices. The rule establishes the Medicare Coverage of Innovative Technology (MCIT) pathway, which would…

The clinical trials of the Pfizer–BioNTech and Moderna vaccines involved two injections given 3 to 4 weeks apart. Both vaccines had approximately 95% efficacy after the second dose — an impressive finding. Under normal circumstances, the vaccines should be deployed

The potential for vaccines to interrupt U.S. transmission of Covid-19 depends not only on technical efficiency in vaccine distribution, but also on the willingness of a large proportion of the public to be vaccinated. Though there has been strong demand

The rapid growth of telemedicine during the Covid-19 pandemic has focused renewed attention on the debate over physician licensure. Before the pandemic, states typically licensed physicians according to policies outlined in each state’s medical practice act, which dictate that physicians

A few weeks ago, I cared for a patient, Mr. C. who had a history of bleeding from antiplatelet therapy but remained at high risk for thrombosis. At the time we met, he had just been extubated and, still a

Imagine a highly contagious virus circulating in the community. Many infected children have fever and some general misery but recover without incident. Rarely, devastating complications occur, leading to hospitalization, severe illness, and occasional deaths. Susceptible adults fare worse, with…

Reforming payment for primary care has been on policymakers’ agendas for well over a decade. The impetus derives from primary care’s foundational role in a high-value health system and from troubling declines in the financial viability of primary care practices.

In January 2020, the Food and Drug Administration (FDA) began considering the U.S. response to Covid-19. On February 4, after the declaration of a public health emergency, we began authorizing tests to diagnose active infections. In such an emergency, the

As U.S. states have developed guidelines for Covid-19 vaccination, some have moved to include “paid or unpaid caregivers (including parents or foster parents) of medically fragile children or adults who live at home” in Phase 1 vaccine allocation. This policy

Vaccination is a powerful method of disease prevention that is relevant to people of all ages and in all countries, as the Covid-19 pandemic illustrates. Vaccination can improve people’s chances of survival, protect communities from new and reemerging health threats,

J. Marion Sims. Henrietta Lacks. The Tuskegee Syphilis Study. With two authorized SARS-CoV-2 vaccines now available, particular concerns have emerged regarding whether Black communities will choose to be vaccinated. In a pandemic that has disproportionately burdened Black Americans, experts have…

Vaccination is a powerful method of disease prevention that is relevant to people of all ages and in all countries, as the Covid-19 pandemic illustrates. Vaccination can improve people’s chances of survival, protect communities from new and reemerging health threats,

On July 18, 2016, the final rule of the Department of Health and Human Services (HHS) implementing Section 1557 of the Affordable Care Act regarding gender nondiscrimination went into effect. Advocates were relieved that the law now included protections against

In the clinical environment, the most important — and most limited — resource is attention. Attention is a key factor in the mastery of complex, skilled practices; it enables both good work and satisfying work. But too often in clinics

Dr. Susan Moore was one of us. She immigrated to the United States from Jamaica as a child and earned a medical degree from the University of Michigan. She was a family physician in Indianapolis who found herself hospitalized with

Mr. S. a 28-year-old Black man, arrived at our emergency department (ED) by ambulance after exhibiting altered mental status and agitation in jail. While in solitary confinement for 4 days, he repeatedly and unsuccessfully sought the attention of the medical

The moment a new lethal virus begins spreading in human populations, public health authorities and the communities they serve enter a race against time to prevent a major outbreak. Success depends on tracking viral spread rapidly from its early stages

J. Marion Sims. Henrietta Lacks. The Tuskegee Syphilis Study. With two authorized SARS-CoV-2 vaccines now available, particular concerns have emerged regarding whether Black communities will choose to be vaccinated. In a pandemic that has disproportionately burdened Black Americans, experts have…

One slow afternoon in urgent care, the triage nurse came and found me in the doctors’ room to tell me a patient had arrived. He handed me a vitals sheet, wrote the patient’s initials on the white board with “pneumonia”

In March 2020, when there were 30,000 confirmed Covid-19 cases in the United States, one of us wrote about the pandemic’s effects on undocumented immigrants. By August, there were about 50,000 new U.S. cases per day, and we had spent

The United States has invested more than $10 billion in Operation Warp Speed to fast-track SARS-CoV-2 vaccines from conception to market in 1 year. The result is 11 candidates reaching the final stage of Food and Drug Administration testing —

Coronavirus disease 2019 (Covid-19) has affected tens of millions of people globally since it was declared a pandemic by the World Health Organization on March 11, 2020. Older adults, persons with certain coexisting conditions, and front-line workers are at highest

Medicaid and the Children’s Health Insurance Program (CHIP) insure roughly 35% of all U.S. children (see graph). Apart from the elderly, no other age group depends more on public benefits or has more of a stake in the debate over

Defining what counts as a safety-net hospital has long been a challenging but critical issue in U.S. health policy. The Covid-19 pandemic has brought this subject to the fore, as Congress and the Department of Health and Human Services (HHS)

Medicaid and the Children’s Health Insurance Program (CHIP) insure roughly 35% of all U.S. children (see graph). Apart from the elderly, no other age group depends more on public benefits or has more of a stake in the debate over

Defining what counts as a safety-net hospital has long been a challenging but critical issue in U.S. health policy. The Covid-19 pandemic has brought this subject to the fore, as Congress and the Department of Health and Human Services (HHS)

In 1900, the year the U.S. Census Bureau created the first iteration of the U.S. birth certificate, nearly all births occurred at home, often attended by family members and midwives without specialized training. During the 20th century, as the medical

In the 5 years since one of us published “#BlackLivesMatter — A Challenge to the Medical and Public Health Communities” in the Journal, we have seen a sea change in the recognition of racism as a durable feature of U.S.

Coronavirus disease 2019 (Covid-19) has affected tens of millions of people globally since it was declared a pandemic by the World Health Organization on March 11, 2020. Older adults, persons with certain coexisting conditions, and front-line workers are at highest

The email message’s first words — “Daniel Prude. Say his Name.” — seemed to tell me all I needed to know. Then, my heart racing, I learned that Prude was murdered in my city, where he’d been admitted to my

Drug prices in the United States are high, particularly for innovative drugs used to treat rare and life-threatening conditions. In some cases, a reasonable defense of high prices for brand-name drugs is that they are temporary — historically, the prices

A stink filled the room as my patient eased coal-black toes out of his shoes. After spending winter nights in a tattered sleeping bag behind a local grocery store, he had developed frostbite and then gangrene. In the hospital, we

On January 31, 2020, the U.S. secretary of health and human services declared a public health emergency in response to Covid-19. This disease, caused by the SARS-CoV-2 virus, can have severe manifestations, including pneumonia, respiratory failure, multiorgan failure, and death.

It’s time to change how we think about the sensitivity of testing for Covid-19. The Food and Drug Administration (FDA) and the scientific community are currently almost exclusively focused on test sensitivity, a measure of how well an individual assay

To the Editor: More than 2 million persons are incarcerated in the United States, and many of them are vulnerable to infection because of chronic medical conditions. Correctional settings are considered to be high-risk environments for transmission of the severe

In the spring of 2020, the Idaho legislature passed a bill that effectively precludes transgender girls and women (from kindergarten through college) from joining female athletic teams. Idaho Governor Bradley Little signed the Fairness in Women’s Sports Act into law

To rapidly communicate short reports of innovative responses to Covid-19 around the world along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. After a 2-month period

Operation Warp Speed (OWS), an effort of the U.S. Department of Health and Human Services and the Department of Defense in partnership with the private sector, is providing financial investment, scientific support, regulatory expertise, and logistic assistance to deliver vaccines,

By July 1, 2020, the first wave of Covid-19 in Europe had ebbed, with death rates down to less than 5% of their April peaks. After locking down too late, the United Kingdom experienced one of the worst first waves

Confidence in any Covid-19 vaccine that is made available under an emergency use authorization (EUA) will depend on the rigor of the clinical criteria, including the duration of follow-up, used to evaluate it. Recently published guidance from the Food and

On October 5, 2020, the Center for Drug Evaluation and Research (CDER) of the Food and Drug Administration (FDA) proposed withdrawal of approval of Makena (hydroxyprogesterone caproate injection), the only drug approved for the prevention of recurrent preterm birth. Here

As SARS-CoV-2 continues its global spread, it’s possible that one of the pillars of Covid-19 pandemic control — universal facial masking — might help reduce the severity of disease and ensure that a greater proportion of new infections are asymptomatic.

As of August 24, 2020, nearly 5.7 million cases of Covid-19 had been reported in the United States, with more than 176,000 deaths. Although there is debate about the accuracy of these specific numbers — many people with mild symptoms

In late April 2020, Ethan Weiss, a San Francisco cardiologist, joined colleagues in New York to care for critically ill patients with Covid-19. On Weiss’s last day there, a relatively young man was dying of Covid, as his wife lay

As of August 24, 2020, nearly 5.7 million cases of Covid-19 had been reported in the United States, with more than 176,000 deaths. Although there is debate about the accuracy of these specific numbers — many people with mild symptoms

The most severe Covid-19 outbreaks in the United States are no longer occurring in nursing homes or meat-packing plants, but in correctional facilities. Incarcerated populations are especially vulnerable to acquiring infectious diseases like Covid-19 because of factors including overcrowding,…

The only way out of today’s misery is for people to become worthy of each other’s trust.— Albert Schweitzer As the race to develop a vaccine for Covid-19 has reached phase 3 clinical trials, concerns are increasing about the low

As the U.S. health care system defines the new normal for ambulatory care in the Covid-19 era, it needs a new approach to providing routine preventive care for adults. Concerns about contagion, competing demands, and shortages of personal protective equipment

The world has already observed many devastating effects of human-induced climate change. A vivid manifestation is the several large wildfires that have occurred recently — in some cases, fires of unprecedented scale and duration — including wildfires in Australia in

The novel coronavirus pandemic has spawned four intertwined health care crises that reveal and compound deep underlying problems in the health care system of the United States. In so doing, however, the pandemic points the way toward reforms that could

As Covid-19 continues to exact a heavy toll, development of a vaccine appears the most promising means of restoring normalcy to civil life. Perhaps no scientific breakthrough is more eagerly anticipated. But bringing a vaccine to market is only half

It’s time to change how we think about the sensitivity of testing for Covid-19. The Food and Drug Administration (FDA) and the scientific community are currently almost exclusively focused on test sensitivity, a measure of how well an individual assay

Patients with type 2 diabetes mellitus in the United States are a large and growing population. These patients are at risk for serious complications of their disease and often have multiple coexisting medical conditions. Many need lifelong treatment with medications,

In late April 2020, Ethan Weiss, a San Francisco cardiologist, joined colleagues in New York to care for critically ill patients with Covid-19. On Weiss’s last day there, a relatively young man was dying of Covid, as his wife lay

It is not till it is discovered that high individual incomes will not purchase the mass of mankind immunity from cholera, typhus, and ignorance, still less secure them the positive advantages of educational opportunity and economic security, that slowly and

Responses to the Covid-19 pandemic by stakeholders throughout the health care ecosystem are contributing to rapid innovation. To support health care delivery today, capital equipment (such as ventilators) and personal protective equipment (such as masks and gowns) are being redesigned

Black, Latinx, and Native Americans are experiencing disproportionate burdens of infections, hospitalizations, and deaths from SARS-CoV-2 (Covid-19). Similar disparities are observed in other countries where minority groups face hurdles in accessing health, education, and social services as well as…

The first reports of an unusual cluster of pneumonia cases in the city of Wuhan, China, emerged in December 2019, heralding a global pandemic. As of July 13, 2020, more than 3.3 million U.S. residents have received a diagnosis of

On February 4, 2020, the U.S. secretary of health and human services declared that emergency use of diagnostics for SARS-CoV-2 was justified, triggering emergency authority for the Food and Drug Administration (FDA) to grant an emergency use authorization (EUA) for

In recent months, epidemiologists in the United States and throughout the world have been asked the same question by clinicians, journalists, and members of the public, “When will we have a vaccine?” The obvious answer to this question would be,

Obesity is a disease with a high prevalence that has a major effect on public health in the United States. Approximately 40% of American adults have obesity, which confers a predisposition to type 2 diabetes, cardiovascular disease, cancer, and premature

For the past 6 months, policymakers and the U.S. public have weighed economic against public health considerations in debating what limits to set on individual and collective behaviors in attempting to control the Covid-19 pandemic. As fall approaches, attention has

Physicians still lack consensus on the meaning of race. When the Journal took up the topic in 2003 with a debate about the role of race in medicine, one side argued that racial and ethnic categories reflected underlying population genetics

As economic and political pressure has built to relax “shelter in place” public health orders for control of coronavirus disease 2019 (Covid-19), industry, professional service firms, retail and service establishments, and educational institutions seek to establish norms that protect workers,…

To address the unprecedented challenge posed by the Covid-19 pandemic, much of the world — including an estimated 90% of Americans — was locked down and socially distanced. Large gatherings were prohibited, most schools and nonessential businesses were closed, and

As the U.S. health care system defines the new normal for ambulatory care in the Covid-19 era, it needs a new approach to providing routine preventive care for adults. Concerns about contagion, competing demands, and shortages of personal protective equipment

“What brings your loved one here?” the hospice nurse asked. She was seeking an abbreviated history of my mémère’s terminal diagnosis, but I couldn’t muster the words without losing my composure. Somehow, the nurse understood. She said, “Tell me about

There is broad consensus that widespread SARS-CoV-2 testing is essential to safely reopening the United States. A big concern has been test availability, but test accuracy may prove a larger long-term problem. While debate has focused on the accuracy of

On June 15, 2020, the U.S. Supreme Court advanced the rights of lesbian, gay, bisexual, transgender, and queer (LGBTQ) Americans by issuing a decision in Bostock v. Clayton County confirming that the prohibition on sex discrimination in employment in Title

For the past 6 months, policymakers and the U.S. public have weighed economic against public health considerations in debating what limits to set on individual and collective behaviors in attempting to control the Covid-19 pandemic. As fall approaches, attention has

Amid enormous uncertainty about the future of the Covid-19 pandemic, epidemiologic models are critical planning tools for policymakers, clinicians, and public health practitioners. Some models with apparently conflicting conclusions have received substantial press coverage, giving the impression…

It is not till it is discovered that high individual incomes will not purchase the mass of mankind immunity from cholera, typhus, and ignorance, still less secure them the positive advantages of educational opportunity and economic security, that slowly and

In Minnesota, where black Americans account for 6% of the population but 14% of Covid-19 cases and 33% of Covid-19 deaths, George Floyd died at the hands of police. “Please — I can’t breathe.” He was a black man detained

How long will this pandemic last? When will we find a treatment or vaccine? Which drug should we give our patients? Will we run out of personal protective equipment (PPE)? When will everyone return to work? We find ourselves in

In Minnesota, where black Americans account for 6% of the population but 14% of Covid-19 cases and 33% of Covid-19 deaths, George Floyd died at the hands of police. “Please — I can’t breathe.” He was a black man detained

To the Editor: We understand that some people are citing our Perspective article (published on April 1 at NEJM.org) as support for discrediting widespread masking. In truth, the intent of our article was to push for more masking, not less.

“Try Googling ‘record-setting lake trout New Hampshire,’” I found myself saying recently to an anxious patient while we explored ways to cope with the Covid-19 pandemic. He loves fishing, and I remembered a story in the paper recently — just

To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. Covid-19 has arrived at

The third coronavirus outbreak in the past 20 years, the SARS-CoV-2 pandemic has caused unprecedented morbidity, mortality, and economic disruption. Safe, effective, and deployable SARS-CoV-2 vaccines are urgently needed to mitigate the consequences of the pandemic and protect from future…

“So, when can I actually see you again, doc?” Silence fills the space of our televisit, save for the occasional crackle of static. Do we tell our patients the truth — that we don’t know whether we’ll ever see them

Surveillance of the clinical characteristics and outcomes of hospitalized patients with coronavirus disease 2019 (Covid-19) is imperative for elucidating the epidemiology of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United States. As of May 13, 2020, the

On January 20, 2020, the first U.S. case of Covid-19 was reported in Washington State. Substantial challenges lay ahead. Covid-19 is highly contagious, it can cause severe illness, and no proven, effective treatments or vaccines are available. As leaders at

To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. Covid-19 has arrived at

To the Editor: Information on the natural history of asymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains scarce. The outbreak of coronavirus disease 2019 (Covid-19) on the cruise ship Diamond Princess led to 712 persons being infected

The search for a treatment for Covid-19 is testing our country’s ability to quickly develop, test, and deploy medications, presenting both opportunities and challenges to our drug-assessment apparatus. Several aspects of the U.S. response raise serious concerns, highlighting how the

For physicians, the words “I can’t breathe” are a primal cry for help. As many physicians have left their comfort zones to care for patients with Covid-19–associated respiratory failure, the role of the medical profession in addressing this life-defining need

To address the unprecedented challenge posed by the Covid-19 pandemic, much of the world — including an estimated 90% of Americans — was locked down and socially distanced. Large gatherings were prohibited, most schools and nonessential businesses were closed, and

To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. On March 15, 2020,

Covid-19 has exposed major weaknesses in the United States’ federalist system of public health governance, which divides powers among the federal, state, and local governments. SARS-CoV-2 is exactly the type of infectious disease for which federal public health powers and

To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. Massachusetts quickly followed New

To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. On March 15, 2020,

The need to rapidly develop a vaccine against SARS-CoV-2 comes at a time of explosion in basic scientific understanding, including in areas such as genomics and structural biology, that is supporting a new era in vaccine development. Over the past

On March 28, 2020, the Office of Civil Rights at the Department of Health and Human Services (HHS) opened investigations into recently released critical care crisis triage protocols. Disability rights advocates are urging Congress to prohibit crisis triage based on

As the United States navigates one of the most serious pandemics in history, much of the country has been shut down to prevent devastating local outbreaks that threaten lives and can overwhelm hospitals. A breakdown in the federal disaster response

To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. Massachusetts quickly followed New

A few weeks ago, Dr. D. a middle-aged chief of cardiology at one of the biggest hospitals in northern Italy, developed a fever. Fearing he might have Covid-19, he sought confirmatory testing but was told there weren’t enough tests available

In Racism without Racists, Eduardo Bonilla-Silva articulates why “color blindness,” an ethos based on the belief that race is no longer relevant, is contradictory and harmful. Color-blind policies, such as race-neutral mortgage practices and Medicare and Medicaid rules, have resulted

To the Editor: The effect of the Covid-19 pandemic on medical care for conditions other than Covid-19 has been difficult to quantify. Any decrease in care for patients with acute conditions such as ischemic stroke may be consequential because timely

To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. “It is as if

To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. The Covid-19 pandemic has

Before the onset of the Covid-19 pandemic, each day seemed to bring another headline about the crisis of physician burnout. The issue had been simmering for years and was brought to a boil by mounting changes in the health care

This August marks the 75th anniversary of the conclusion of World War II. In history’s largest, most destructive war, an estimated 80 million people, or roughly 3% of the world population, died. Nearly 420,000 Americans were killed, and 670,000 were

To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. The Covid-19 pandemic has

I stand in the parking lot of our emergency department and watch three men on horseback trot up the shoulder of the highway. They wear bandanas over their faces, a traditional accessory here in northwest New Mexico, where spring is

The President says we are at war with the coronavirus. It’s a war we should fight to win. The economy is in the tank, and anywhere from thousands to more than a million American lives are in jeopardy. Most analyses

In late March, Zoran Lasic, an interventional cardiologist at Jamaica Hospital Medical Center and Lenox Hill Hospital in New York, was finishing afternoon clinic when he was approached by a nurse colleague seeking his advice. Her husband — a 56-year-old

To rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series. As a chief physician

To the Editor: Anfinrud et al. now illustrate in the Journal how liquid droplets exhaled during speech can linger in the air. The large particles to which they refer remain airborne only briefly before settling because of gravity; these particles

Dr. Wakam: I’m 5 hours into my ICU shift at a community hospital in Detroit when the results of another arterial blood gas return. My patient has been hospitalized for 3 days and is Covid-19–positive. Over the past 12 hours,

As Covid-19 spreads around the globe, governments have imposed quarantines and travel bans on an unprecedented scale. China locked down whole cities, and Italy has imposed draconian restrictions throughout the country. In the United States, thousands of people have been

The 1918 influenza pandemic was the deadliest event in human history (50 million or more deaths, equivalent in proportion to 200 million in today’s global population). For more than a century, it has stood as a benchmark against which all

The President says we are at war with the coronavirus. It’s a war we should fight to win. The economy is in the tank, and anywhere from thousands to more than a million American lives are in jeopardy. Most analyses

In 2019, as the “public charge” rule made its way through the U.S. court system, many low-income immigrant parents of American children in the Johns Hopkins pediatric practice asked our case managers to disenroll their children from the Supplemental Nutrition

The epidemic of 2019 novel coronavirus (now called SARS-CoV-2, causing the disease Covid-19) has expanded from Wuhan throughout China and is being exported to a growing number of countries, some of which have seen onward transmission. Early efforts have focused

Smoking rates peaked in the United States in the mid 1960s and have since declined to historically low levels. In contrast, use of e-cigarettes has recently soared, particularly among young people. In 2019, more than 27% of high school students

Covid-19 is officially a pandemic. It is a novel infection with serious clinical manifestations, including death, and it has reached at least 124 countries and territories. Although the ultimate course and impact of Covid-19 are uncertain, it is not merely

For many weeks, the British instinct to “Keep Calm and Carry On” was the public face of the U.K. government’s response to Covid-19. Policies were to be “based on the science,” with an initial focus on containment, involving identification of

Writing in the heady days of new antibiotics and immunizations, esteemed microbiologists Macfarlane Burnet and David White predicted in 1972 that “the most likely forecast about the future of infectious diseases is that it will be very dull.” They acknowledged

Under the U.S. Health Information Technology for Economic and Clinical Health (HITECH) Act, $48 billion in federal funds were invested to promote adoption of electronic health records (EHRs). Now, in an effort to realize returns on this outlay — and

The Affordable Care Act (ACA), known colloquially as Obamacare, is almost certainly one of the most consequential — and controversial — pieces of enacted health care legislation in U.S. history. To the delight of some observers and the consternation of

On April 1, 2020, the Trump administration plans to implement the first in a series of three proposed changes to the Supplemental Nutrition Assistance Program (SNAP), the federal safety-net program formerly known as “food stamps.” More than 36 million Americans,

This past year has demonstrated how dangerous U.S. detention centers have become for migrant children. Before September 2018, no child had died in the care of the U.S. Department of Homeland Security’s Customs and Border Protection (CBP) in a decade.

On August 1, 2019, the first cases of electronic cigarette (e-cigarette), or vaping, product use–associated lung injury (EVALI) were reported to the Centers for Disease Control and Prevention (CDC). The cluster was an initial signal of an outbreak that by

Since entering the U.S. marketplace in 2007, e-cigarette, or vaping, products have evolved into a diverse class of inhaled aerosol devices. Earlier generations of these products were disposable, resembled conventional cigarettes in shape, and were designed to deliver nicotine to

The year 2019 looked to be the one in which the U.S. Congress would solve the problem of surprise medical bills, the unexpected and unavoidable bills that result when a patient sees an out-of-network provider in an emergency or at

To the Editor: On September 30, 2019, the Centers for Medicare and Medicaid Services (CMS) removed CMS regulation 482.22(d), thereby eliminating the requirement that hospitals have an autopsy program to qualify for Medicare reimbursement. This action was strongly opposed by

Ongoing payment reforms are pressing health systems to reorganize delivery of care to achieve greater value, improve access, integrate patient care among settings, advance population health, and address social determinants of health. Many organizations are experimenting with new ways of

To the Editor: On September 30, 2019, the Centers for Medicare and Medicaid Services (CMS) removed CMS regulation 482.22(d), thereby eliminating the requirement that hospitals have an autopsy program to qualify for Medicare reimbursement. This action was strongly opposed by

Only about 20% of the more than 2 million Americans with an opioid use disorder (OUD) receive treatment in a given year, much of which is not evidence-based. Buprenorphine, one of several medications used to treat OUD, substantially reduces the

I walked into the hospital room in the early morning and observed the patient from across the room. As a physician, you start observing, gathering clues, from the moment you enter the door. The patient was disheveled, sprawled in bed

Only about 20% of the more than 2 million Americans with an opioid use disorder (OUD) receive treatment in a given year, much of which is not evidence-based. Buprenorphine, one of several medications used to treat OUD, substantially reduces the

Although HIV remains an important contributor to the global disease burden, during the past decade great strides have been made in addressing this epidemic. The global health agenda has now begun to include improving delivery of surgical and noncommunicable-disease services

On December 18, 2019, just 3 days after the close of open enrollment on the exchanges and on the same day the House of Representatives impeached President Donald Trump, a conservative appeals court handed the President a major victory in

This past year has demonstrated how dangerous U.S. detention centers have become for migrant children. Before September 2018, no child had died in the care of the U.S. Department of Homeland Security’s Customs and Border Protection (CBP) in a decade.

For most surgical procedures, Medicare and many other insurers give physicians a single bundled payment that covers both the procedure itself and related postoperative care during “global periods” encompassing the 10 or 90 days after the procedure. Postoperative visits account

“The subject of climatic and environmental changes that result from human activity has been much in the news recently,” Alexander Leaf wrote in the Journal 30 years ago. Threatened by acid rain, greenhouse gases, ozone depletion, and global warming, the

Health care spending in the United States is heavily concentrated, with 5% of the population accounting for 50% of annual spending and 1% accounting for almost a quarter of annual spending. There is therefore substantial interest in interventions that can

In 2017, a committee convened by the mayor of Philadelphia as part of a task force on the opioid-overdose crisis recommended opening safe consumption sites in the city. The core function of the more than 165 such facilities operating globally

During the past two decades, the hospital industry has consolidated substantially in the United States, including a surge in mergers and acquisitions beginning in 2010. Multiple studies have shown that consolidation of the hospital market has led to higher negotiated

In 2017, a committee convened by the mayor of Philadelphia as part of a task force on the opioid-overdose crisis recommended opening safe consumption sites in the city. The core function of the more than 165 such facilities operating globally