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elder woman sick in bed with husband looking on

Advance Directives in Hospice Healthcare Providers: A Clinical Challenge

On a daily basis, healthcare providers, especially those dealing with terminally ill patients, such as hospice workers, witness how advance directives help ensure the wishes of patients. They also witness the deleterious consequences when patients fail to document the care they desire at their end of life. To the best of our knowledge there are […]

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Denying International Medical Graduates Entry to the United States: A Loss at Both Ends

A resident colleague of ours at the Cleveland Clinic was recently deported soon after entering the United States. This was in conjunction with the executive orders at that time that barred individuals from selected countries to enter the United States, whereas suggesting “extreme vetting” for the others. She had traveled to spend vacation time with […]

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Why California’s Proposition 61 Was a Bad Idea

New approaches to control state pharmaceutical costs are needed.1 This issue is particularly critical in California, the state with the largest pharmaceutical expenditures in the country.1 A controversial California ballot initiative aimed at reining in prescription drug expenditures was defeated on November 8, 2016 by a 54% to 46% margin.2The California Drug Price Relief Act, also known […]

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Joseph S. Alpert

Digital Medicine: “O Brave New World”

Recently, I participated in an international meeting in Nanjing, China on digital medicine. The meeting was sponsored by the Chinese Society of Digital Medicine and the newly formed International Society of Digital Medicine, both under the leadership of the remarkably energetic and effective professor, Shaoxiang Zhang from Chongqing, China. For my part of the meeting, […]

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stethoscope on a graphic of the U.S.A.

Healthcare Disparities Affecting Americans in the US Territories: A Century-Old Dilemma

In 1917, the Jones Act granted US citizenship to natives of Puerto Rico, the first among the 5 territories acquired by the United States since 1898.1 A dilemma in that early period—“Does the Constitution follow the flag?”—was addressed in several cases considered by the Supreme Court between 1901 and 1932, known as the “Insular Cases.”2 These decisions ultimately […]

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