Codeine is a terrible choice for treating children’s pain and cough, and we ought to just stop using it. It’s like an old yogurt container, way at the back of your fridge -- sure, it was once tasty, and then for a while, you held on to it for sentimental reasons. “Remember that yogurt?” you’d say to your spouse. But it’s well past time to throw that stinky stuff away. For ...

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Most everyone has had the experience of sitting across from a doctor, being offered a prescription and walking out the door. Most patients will accept the instructions -- maybe ask a few questions -- and move on. For some of those patients, the medications are more than a one-off; they are intended to be taken indefinitely. One of the most common of these medications is a statin. Imagine you exercise four ...

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In our current health care system, doctors should get to decide what medication is prescribed. Typically, the patient and doctor decide what is the best, then the prescription gets sent off to the pharmacy. When the patient goes to pick up the prescription, often they find a different one instead or are told that their health insurance coverage is not covering that prescription. Instead of receiving the best medication for ...

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Martha arrives for an appointment with her new primary care provider. She hesitantly hands over her pill boxes at the nurse’s request; it seems to take forever to enter them all into the computer. “You are taking a lot of blood pressure pills,” he comments. The doctor comes in and after a brief introduction, notes that she is taking five medications for her blood pressure. “Five?” Martha exclaims in disbelief. She hadn’t ...

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A friend asked me recently about statins. He takes a statin for primary prevention but is concerned that he has muscle pain and weakness as a side effect. So he posed the question: “How important is the statin?” The Washington Post had this recent article: "Who should take statins? A vicious debate over cholesterol drugs."

But while nearly all experts agree that statins are beneficial for people at a substantial ...

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A provocative new study from Denmark supports a link between hormonal contraceptive methods (like birth control pills) and depression. The association seems to be strongest for adolescent girls. Huge studies like this are based on huge datasets. In this case, the study relies on the Danish medical system’s longstanding penchant for meticulous and integrated medical records. You couldn’t do this kind of research in the USA, where medical records ...

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A patient wrote in, asking what she ought to do with unused medications, including some psychiatric drugs and controlled substances. It’s good to get those out of the house, safely -- but how? Parents should make sure to keep their homes free of unused medications. The misuse of prescription medications (usually narcotic painkillers) has surpassed motor vehicle accidents as the leading accidental cause of death in the U.S. A lot ...

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It is the beauty of evidence-based medicine (EBM) that a scientist can at once be a Pope and a Galileo. His transmutation is as effortless as it is discretionary. If you think you’ve met Galileo -- a rebel, a free thinker, a rocker of the establishment -- the following week he is a Pope, castigating detractors, censoring critics, and celebrating uniformity. He changes by a roll of the dice. His ...

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asco-logo Many men experience significant erectile problems after having a radical prostatectomy, and many of the men treated by the urologists I work with eventually land in my office. We talk frankly about the quality of their erections before the surgery, what they are like now, and what they have tried to do to resolve the problems they are having. After this, ...

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A manifesto has been making the rounds on Twitter (and other places) over the past year. It has been attributed to Dr. Mike Ginsberg, a California pediatrician. It reportedly was originally a Facebook post that has since been taken down, perhaps because of the controversy it generated. I can understand why; vaccines are a hot button topic, and anyone who writes about them attracts attention, some of it unpleasant. I know ...

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