Case Studies
This is a library of case studies written by students with faculty mentors. This site contains information about writing cases, as well as using them to promote discussion. In addition, the site includes a series of shorter clinical vignettes, which can also be used to stimulate discussion.
The most recent cases are listed below; the library also contains cases written prior to 2005.
Complementary and Alternative Medicines
David Nemer
Complementary and alternative medicines (CAM) are widely used. A National Health Interview Survey in 2007 revealed that 38% of American adults and 12% of children used some type of CAM in the prior 12 months. This case discusses common perspectives of CAM within the medical community and decisions made by the insurance companies when deciding whether or not to provide reimbursement for a particular medical service. Read more....
Conflicts of Interest and Patient-Physician Trust
Zirui Song
A conflict of interest exists under circumstances in which the professional judgment concerning a primary interest is influenced by a secondary interest. The primary interest may be the patient’s health or the validity of research, while the secondary interest could take such forms as financial gain through industry relationships or equity holdings, the desirability of positive research findings, and offers of gifts or vacations. This case examines conflicts of interest as they relate to medical research and patient care. Read more....
Consumerism in Health Care
Lindsay Cole
Involving the patient as a consumer of health care represents one strategy to control rising health care costs. This case follows a patient diagnosed with breast cancer as she navigates her way through the health care system as a "consumer" of health. Read more....
Drug Development and Regulation
Akash Chandawakar
The FDA is charged with ensuring the efficacy and safety of a drug before allowing its distribution to the American public. This case investigates the development of Provenge, immunotherapy for prostate cancer, and the challenges it faced in passing FDA approval, choosing an appropriate price and meeting demand. Download Drug Development and Regulation Read more....
End of Life Care
Jay Reidler and Deep Shah
In recent years, assisting patients with advanced care planning has become an important aspect of caring for seriously ill patients. This case provides a brief overview of prominent legislation related to the end-of-life and its introduction into the clinical setting. It also describes several topics relating to the care of patients with serious illnesses. Read more....
Health-Information Technology and the Use of Computerized Records in Medicine
Katrina Abuabara and Julia Adler-Milstein
A patient's use of the "patient portal" feature of her hospital's electronic medical system saves her physician time. The patient can view lab results, learn about her medical problems, schedule appointments, refill prescriptions, follow postprocedure protocols, communicate with her physician, and track her blood-sugar fluctuations. Nevertheless, the electronic system is not without hitches. Read more....
High deductible health plans
Reid Merryman
A deductible is an amount of money that an individual must pay out-of-pocket before a health plan begins to cover expenses. High deductible health plans (HDHPs) are fee-for-service insurance plans with higher than normal deductibles, defined by the federal government as greater than $1200 per year for a single person or more than $2400 for
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HPV vaccine
Amanda K. Johnson
The HPV vaccine, which showed greater than 90% efficacy in preventing the development of certain kinds of cervical cancer, was approved by the FDA in 2006. Both Australia and the UK made vaccination compulsory and administered the vaccinations through schools. This case explores the variation in US guidelines on vaccination and screening for cervical cancer.
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Massachusetts Health Care Reform
David Mou and Aartik Sarma
As national health reform took center stage in the Obama administration in 2008, policymakers turned the spotlight onto Massachusetts, where a model that virtually achieved universal coverage had been pioneered two years earlier. The path that Massachusetts took resulted in near-universal coverage of its citizens. This case outlines the strengths and weaknesses of the MA
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Medical Malpractice: The Case of Julie Freeman
When a patient presents to the local emergency room with acute lower abdominal pain, lack of clear communication among providers, poor trainee supervision, and conflict between a specialist team and ED physicians lead to major delay in her diagnosis, which ultimately leads to loss of her left ovary. Frustrated and angry over the quality of care she received, the patient considers filing a malpractice claim. Read more....
Mental Health Parity
Rifaquat Rahman
Approximately one in four adults in the United States experience a mental health disorder in a given year, and mental illness costs society over 100 billion dollars in lost productivity per year, yet mental services have historically struggled to achieve insurance coverage on par with general medical and surgical care. This case explores access to
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Patient Protection and Affordable Care Act of 2010
Michael Honigberg
The Patient Protection and Affordable Care Act (PPACA) of March 2010 represents the most significant government overhaul of the U.S. healthcare system since the passage of Medicare in 1965. It includes a wide range of provisions, including expanded insurance coverage, regulation of the private insurance market, and longer-term changes to care delivery aimed at improving
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Pay for Performance and Red Blood Cell Transfusion Appropriateness
Daniel W. Kim
P4P is a concept that was originally developed in the business world to help improve efficiency and productivity. In health care, P4P refers to a payment model that offers financial incentives to physicians and hospitals for meeting pre-established clinical performance measures. The goal is to link financial incentives, in part, to the quality and efficiency
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Paying Physicians
The challenge of establishing systems of physician compensation has been recognized since the earliest days of formalized medical practice. While a basic fee-for-service approach can still be found in American health care, it is supplemented by several alternative models. Of the many models in place today, four common approaches that together cover the majority of compensation practices for base compensation are fee for service, episode of illness/diagnosis-related group, capitation, and salary. Read more....
Post-Approval Medication Surveillance: The Case of Antidepressants in Children
This case follows a 15-year-old girl whose parents notice several behavioral changes in their daughter, including sulking, secretiveness, lower grades, and loss of interest in her sport. Her pediatrician diagnoses depression and prescribes an antidepressant, Paxil. Who should decide that medication is warranted? Are antidepressants appropriate and safe for children and adolescents? This case discussions a number of questions related to this question and provides background information on antidepressant medications. Read more....
Rural Health Care
Emily Hinchcliff
Rural communities represent nearly 20 percent of the population and are incredibly heterogeneous in their culture, population density, economic and geographic characteristics. This case aims to illustrate the challenges faced by rural populations with respect to their health care and the problems involved in the provision of such care. This case is centered on the
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The Transformation of the Veterans Health Administration: The Case of Dr. Sarah Biel
This case focuses on the efforts undertaken by the Veterans Health Administration (VHA) to transform itself from a ridiculed health care network of last resort to a model health care system praised for the quality of care provided to its patients. The case tells the story of Dr. Sarah Biel, a fictional VA psychiatrist and administrator, who is charged with the turnaround of a poorly performing VA institution. In her quest to improve the performance of Islesford VA Hospital, Biel and her team of providers embrace many of the key initiatives that helped transform the VHA and enabled it to shake off its reputation for poor-quality care and earn the respect of veterans, providers, politicians, and academics. Specifically, the case examines the VHA strategies of information technology, internal reporting and root cause analysis, and accountability. Read more....
Value Based Insurance Design
Sariah Khormaee and Rena Xu
Value Based Insurance Design (VBID) represents a strategy of using attractive pricing to steer patients towards better health and, in the long term, lower overall health care costs. It focuses on pricing as a mechanism to encourage patients to use medicines beneficial to their health instead of solely attempting to dissuade them from using expensive
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