Healthy Dialogue

Phil Fontanarosa, MD, MBA, interim editor in chief of JAMA, interviews Harvey V. Fineberg, MD, PhD, from the Gordon and Betty Moore Foundation, and Abraham Verghese, MD, from Stanford University School of Medicine, about diagnostic excellence and a new series on this topic in JAMA.

Related Content:

• Diagnostic Excellence
• Diagnosis and the Illness Experience: Ways of Knowing

Individuals who experience systemic, structural, institutional, and social barriers within society deserve better and more convenient health care access. This idea should be central when advancing efforts to achieve health equity. JAMA Editorial Board member Raina M. Merchant, MD, speaks with Courtney R. Lyles, PhD, and Urmimala Sarkar, MD, about approaches toward improving digital health equity and with Utibe R. Essien, MD, about enhancing targeted efforts toward realizing pharmacoequity.

Related Content:

• A Policy Prescription for Reducing Health Disparities—Achieving Pharmacoequity
• Focusing on Digital Health Equity

Health care expenses that arise from largely nonclinical functions, such as coding and billing and administration, cost the US health care system almost $1 trillion annually. Michael Chernew, PhD, from Harvard Medical School Department of Health Care Policy, and David Cutler, PhD, from Harvard University Department of Economics, join JAMA Associate Editor Karen Joynt Maddox, MD, MPH, from Washington University School of Medicine to discuss some basic fixes and simplifications that could reduce administrative spending by an estimated $265 billion.

Related Content:

• Waste in the US Health Care System: Estimated Costs and Potential for Savings
• Administrative Expenses in the US Health Care System: Why So High?
• Administrative Simplification and the Potential for Saving a Quarter-Trillion Dollars in Health Care
• Economic Incentives for Administrative Simplification
• Waste in the US Health Care System
• Waste in the US Health Care System

Interview with Jason A. Abbott, and Fiona G Li, authors of Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms: A Randomized Clinical Trial

Death rattle, defined as noisy breathing caused by the presence of mucus in the respiratory tract, is common among dying patients. Harriette van Esch, MD, from the Erasmus Medical Center, the Netherlands, and Jared R. Lowe, MD, from the University of North Carolina, join JAMA Associate Editor Ethan Basch, MD, to discuss evidence about use of prophylactic scopolamine butylbromide to reduce the death rattle.

Related Content:

• Effect of Prophylactic Subcutaneous Scopolamine Butylbromide on Death Rattle

• Preventing Death Rattle With Prophylactic Subcutaneous Scopolamine Butylbromide

Canadian law gives the country's individual provinces and territories primary responsibility for coronavirus containment and mitigation. JAMA Associate Editor Preeti Malani, MD, MSJ, from the University of Michigan and Allan S. Detsky, MD, PhD, from the University of Toronto, Ontario, Canada, discuss the national pandemic experience, including public health responses to infection and vaccine allocation, from fall 2020 through summer 2021.

Related Content:

• COVID-19 in Canada: Experience and Response to Waves 2 and 3

Interview with Aaron B. Caughey, MD, USPSTF member and coauthor of Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Related Content:

• Low-Dose Aspirin for the Prevention of Preeclampsia
• USPSTF Recommendation: Aspirin Use to Prevent Preeclampsia
• Patient Information: Use of Aspirin During Pregnancy to Prevent Preeclampsia

Interview with Martha Kubik, PhD, RN, USPSTF member and coauthor of Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement

While health disparities have gained growing attention in recent years, much work is still needed, as inequities continue to have a direct and measurable negative influence on patients in historically disadvantaged communities. David Satcher, MD, PhD, Francisco Cigarroa, MD, and Howard Koh, MD, MPH, join moderator Ebony Boulware, MD, MPH, to discuss the vital importance of the visibility of all races and ethnicities in research, medical schools, and health care. They propose potential solutions, including the recruitment of and support for more physicians who look like their patients, who care enough, know enough, have the courage to make a difference, and who will persevere until changes are made.

Related Content:

• Healing and Health Equity for Asian American, Native Hawaiian, and Pacific Islander Populations
• Uplifting the Latino Population From Obscurity to the Forefront of Health Care
• Does Race Interfere With the Doctor-Patient Relationship? (published 1973)
• Race and the Patient-Physician Relationship in 2021

Noninvasive ventilation (NIV) may help COVID-19 patients in respiratory failure avoid invasive mechanical ventilation but may also lead to delays in intubation with potential for worse clinical outcomes.

Domenico L. Grieco, MD, of Fondazione Policlinico Agostino Gemelli IRCCS in Rome, Jesse B. Hall, MD, of the University of Chicago, and Laveena Munshi, MD, MSc, of Sinai Health System/University Health Network of the University of Toronto join JAMA's live Q&A series to discuss helmet NIV, high-flow nasal oxygen, and other NIV modalities in the management of hypoxic coronavirus patients. Recorded March 25, 2021.

Related Content:

Effect of Helmet Noninvasive Ventilation vs High-Flow Nasal Oxygen on Days Free of Respiratory Support in Patients With COVID-19 and Moderate to Severe Hypoxemic Respiratory Failure

Respiratory Support During the COVID-19 Pandemic: Is It Time to Consider Using a Helmet?

Noninvasive Ventilation of COVID-19 Patients