In two large randomized trials, researchers examined the effect of annual prostate-specific antigen (PSA) screening on the rate of death from prostate cancer and found that it was small and was offset by false positive diagnoses. Since screening may have benefits in catching cancers early but may also carry risks including that of unnecessary treatment, professional societies have split on the question of whether to recommend regular PSA screening. In a roundtable discussion moderated by Dr. Thomas Lee, oncologist Dr. Philip Kantoff and primary care physician Dr. Mary McNaughton-Collins debate the clinical implications of the new findings and the best way to advise patients about undergoing PSA testing.

Screening for Prostate Cancer

Audio Perspectives from the The New England Journal of Medicine (NEJM), a weekly general medical journal that publishes new medical research findings, review articles, and editorial opinion on a wide variety of topics of importance to biomedical science and clinical practice.
To see the videos and associated commentaries for these Perspectives, visit NEJM.org.

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Fitness & Nutrition

Under the Affordable Care Act, Medicare will launch a Shared Savings Program for groups of health care providers that join forces, with or without hospitals or health plans, to form legal entities that agree to take responsibility for the quality, cost, and overall care of a population of patients. What will these accountable care organizations (ACOs) look like? Who will step forward to form them? What are the best pathways and likely hurdles to achieving ACO status? What are the risks of entering the arena, and what are the expected benefits for clinicians and patients? In a roundtable discussion moderated by Dr. Thomas Lee, experts Lawrence Casalino, Elliott Fisher, and Gail Wilensky explored these and other questions.

Creating Accountable Care Organizations

President Barack Obama has argued that healthcare reform is essential to the future economic health of the United States. But the economics of both healthcare and reform are daunting. Is it possible to pay for healthcare coverage for all Americans without moderating our rapidly rising healthcare costs? And what do we know about the best ways of achieving cost savings? In a roundtable discussion moderated by Dr. Atul Gawande, three experts in health economics — Drs. Elliott Fisher, Jonathan Gruber, and Meredith Rosenthal — explore the most promising ways of slowing the growth of healthcare costs, their potential effects on medical practice, and the likelihood that the current healthcare reform effort will be a step in the right direction.

The Cost of Healthcare: Roundtable Discussion with Dr. Atul Gawande

President Barack Obama has placed US healthcare reform at the top of his domestic agenda, and months of legislative work on the issue have resulted in five bills — three in the House of Representatives and two in the Senate — that proponents believe will move the country in the direction of universal coverage, a fairer insurance system, and slower escalation of health care costs. In part 3 of a symposium co-sponsored by the Journal and the Harvard School of Public Health, health policy expert Mark Pauly explores the promise and limitations of the bills and the outlook for reform. The discussion is moderated by Arnold Epstein of the Journal and the Department of Health Policy and Management at HSPH. To listen to Part 1 of this discussion, click here.

Health Care Reform in Perspective: Part 3

President Barack Obama has placed US healthcare reform at the top of his domestic agenda, and months of legislative work on the issue have resulted in five bills — three in the House of Representatives and two in the Senate — that proponents believe will move the country in the direction of universal coverage, a fairer insurance system, and slower escalation of health care costs. In part 2 of a symposium co-sponsored by the Journal and the Harvard School of Public Health, health policy experts Katherine Baicker and Jacob Hacker explore the promise and limitations of the bills and the outlook for reform. The discussion is moderated by Arnold Epstein of the Journal and the Department of Health Policy and Management at HSPH. To listen to Part 3 of this discussion, click here.

Health Care Reform in Perspective: Part 2

President Barack Obama has placed US healthcare reform at the top of his domestic agenda, and months of legislative work on the issue have resulted in five bills — three in the House of Representatives and two in the Senate — that proponents believe will move the country in the direction of universal coverage, a fairer insurance system, and slower escalation of healthcare costs. In Part 1 of a symposium co-sponsored by the Journal and the Harvard School of Public Health (HSPH), health policy expert Henry Aaron explores the promise and limitations of the bills and the outlook for reform. The discussion is moderated by Arnold Epstein of the Journal and the department of health policy and management at HSPH. To listen to Part 2 of this 3-part discussion, click here.

Screening for Prostate Cancer

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