Those who forget history are doomed to repeat it. Most of us have not had personal experience with illnesses like measles, mumps, German measles, or polio. Thank goodness for that. It is because a generation ago individuals, families, and doctors choose a different path. They witnessed loved ones stricken with these diseases. When the opportunity arose to protect themselves from these ...
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I was engaged in one of my pleasures, sitting in a coffee shop leafing through medical journals. Usually, I am perusing newspapers. I spend many hours each week combing through various newspapers and routinely forward items of interest to folks of interest. No newspapers today. I have a few gastroenterology journals to look through. My professional reading habits have evolved over my career. I am more interested in reading about ...
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 71-year-old man is evaluated in the emergency department for new dyspnea on exertion. He has a 15-year history of type 2 diabetes mellitus and has had a number of changes in his medications over the past 12 weeks to improve glycemic control. His dosage of metformin has been increased to 1000 mg/d, glyburide ...
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I have a confession to make. I don’t think what I do each day makes any sense.
Perhaps I should explain myself. Six months ago, I started my own private psychiatry practice. I made this decision after working for several years in various community clinics, county mental health systems, and three academic institutions. I figured that an independent practice would permit me ...
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 67-year-old woman is transferred to the cardiothoracic intensive care unit (ICU) after undergoing repair of an abdominal aortic aneurysm. She has a 12-year history of type 2 diabetes mellitus.
Her blood glucose level on arrival at the ICU is 289 mg/dL (16.0 mmol/L). Although no longer on a cardiopulmonary bypass pump, she remains intubated ...
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Doctors at Memorial Sloan-Kettering Cancer Center recently declared they would not use Zaltrap (Sanofi), for advanced colorectal cancer. In a New York Times editorial, they suggested the extraordinary cost for incremental benefit could not justify its use. Sanofi appeared to cave to the pressure and announced a 50% discount - which only made things worse.
This August, Zaltrap received FDA approval for the treatment of advanced colorectal cancer. In ...
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Flu season has begun in the U.S., and in addition to familiarizing themselves with the Advisory Committee on Immunization Practice's vaccination guidelines for the 2012-13 season (offer influenza vaccine to everyone 6 months of age or older), physicians should consider how they plan to diagnose patients with suspected influenza. Despite the availability of multiple antiviral medications for influenza, whom to treat remains a ...
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I learned of a disturbing decision from the Court of Appeals for the Second Circuit. In an insane ruling, two of judges determined that a drug rep promoting “off-label” uses for a drug was exercising his freedom of speech. Let’s stroll to the back of a typical doctor’s office to see how this plays out.
Of all the ways pharmaceutical companies ...
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The long-acting beta agonist (LABA) paradox strikes again. A new article in a Milwaukee newspaper sounds an old theme. Advair, the most widely used asthma medicine, contains a long-acting beta agonist—salmeterol.
“[L]ong-acting beta-agonists have been linked to 1,900 asthma deaths from 2004 through 2011, according to an estimate provided by AdverseEvents Inc., a private firm that analyzes drug side effect data ...
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Today I experienced another example of the growing efficiency of the healthcare world: The Steward of Scripts.
First, a little background information is necessary. After I perform surgery it is necessary to perform a number of immediate post operative duties. The operative note must be dictated, a brief note is written in the chart, post operative orders are written and, for patients that are going home the same day, prescriptions must ...
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"A comprehensive and extremely useful roadmap for doctors."
-Eric Topol, MD, author of The Creative Destruction of Medicine
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Past 6 Months
Dear lawmakers: This is what it’s like to be a doctor today
Matthew Moeller, MD | PhysicianA gun owner responds to Sandy Hook
Edwin Leap, MD | PhysicianIs Chris Christie too obese to run for president?
Jeffrey Parks, MD | PhysicianIf I’m wrong about guns, can you please explain why?
Claire McCarthy, MD | PhysicianPrimary care doctors may no longer be needed
Doug Olson, MD | PhysicianWalgreens moves into primary care, and it’s our own damn fault
Kevin Pho, MD | Kevin's Take