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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I have already opined on my disapproval of a medical marijuana law recently passed in Ohio.  Once of my points in that piece is that I did not want legislators making medical decisions for us.  They can’t even do their own jobs. I am not against medical marijuana; I am for science.  The currency of determining the safety and efficacy of a medicine should be medical evidence, not faith, ...

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In March, 2016, the CDC released guidelines for prescribing opioids.  The guidelines were a response to a serious and growing problem: millions of pain patients became addicted to prescribed opioids, and hundreds of thousands died as a result. Since the guidelines were released, reports of pain patients being abruptly cut off of their medication or having their medication abruptly reduced have become rampant. These patients report they were using opioids long ...

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One of the most difficult things I deal with as a physician is patients’ demands for pain medications. I treat patients with cystic fibrosis, a genetic disease present at birth with no cure, and its issues are indeed complex. There are legitimate causes for misery from the chronic coughing, abdominal pain, and joint pain recognized as common symptoms of the disease. But the associated issues of depression, stress with family, and ...

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I'm seeing a fifty-something with knee pain when I feel the curtain behind me erupt open. It's Roland, my last patient, and his breath is at my neck: "Why are you being so difficult?" he says. "Why can't you just give me the prescription?" I turn, and wave my hand over Roland's head. "Call security." He's swearing again, and I can hear security's racing footsteps as a code white is called. "I have nothing more to ...

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Over the past year I’ve lost track of how many times the opioid epidemic has, in one incarnation or another (Prince, naloxone, fentanyl, newborns in agonizing withdrawal and so on) found its way onto the front page news. What distinguishes this epidemic is not only its catastrophic toll -- hundreds of thousands dead, uncountable millions harmed -- but also the fact that, unlike SARS, Ebola or influenza, this epidemic has ...

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EpiPens have gotten crazy expensive, yes: $600 for a two-pack. Here are some alternatives that might help you save a few bucks. 1. Wait a few weeks, and see what Mylan does. Mylan, the company that makes the “EpiPen” brand of epinephrine auto-injector, has been under a lot of pressure lately to back off their unseemly price gouging. They’ve introduced a savings card that claims to lower your ...

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Last week I had an appointment with one of my well-controlled diabetics.  She has been in my care for the last six years.   Our usual cheery interaction turned sour when she stated in an accusing tone, “My husband is diabetic, and I talked to his doctor about the medication you have me on.  He says it is junk, and he only writes it for poor people, and he doesn’t understand ...

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