The opioid overdose epidemic was the centerpiece of U.S. Secretary of Health and Human Services Tom Price, MD’s West Virginia listening tour recently. While the tour was billed as an opportunity to gain knowledge on the epidemic, his response to his observations illustrates just how difficult it is to change attitudes and beliefs with information alone. In response to Herculean state-based and volunteer efforts to keep people alive -- not to ...

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Long before the Internet and direct-to-consumer advertising, the medical profession tried to reassure people about their health concerns. Remember “take two aspirins and call me in the morning?" Flash forward to today’s online “symptom checkers.” They are quizzes to see if someone has a certain disease and exhortations to see their doctor even if they feel fine. Once drug makers discovered that health fears and even hypochondria sell drugs, there seems ...

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I had an interesting conversation with a patient in the office some time ago. He was sent to me to evaluate abnormal liver blood tests, a common issue for gastroenterologists to unravel. I did not think that these laboratory abnormalities portended an unfavorable medical outcome. Beyond the medical issue, he confided to me a harrowing personal tribulation. Often, I find that a person’s personal story is more interesting and significant than ...

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A small study published this month showed that most Epipens retain their potency for at least 4 years after their expiration date. That’s no guarantee, of course. I’d still recommend as a “best practice” that families replace them as they expire. But it’s reassuring to know that they’ll usually be effective even when expired. And using an expired EpiPen is almost certainly better than using nothing ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. One thing about me that even my closest friends are unaware of is that I am a zombie fighter. Unlike the ones in video games, TV series, or movies, the zombies that I fight in my practice are prescriptions that won’t die. They ...

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“Pigs get fat, but hogs get slaughtered,” the saying goes. And so may it prove to be true for the pharmaceutical industry. Three articles, all published May 3, illustrate the greed and egregious pricing by certain drug companies that are gaining public recognition and scrutiny. As an example, Marathon invested $370,000 to obtain the license for the data on “deflazacort,” a steroid available for about $1,200 a year in the United Kingdom. ...

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Opioids have become so closely associated with chronic pain that it is nearly impossible to talk about one without the other. When we look back just five years ago, when we were still in residency, news stories about chronic pain and opioid overdoses were not commonplace. Now, we find ourselves almost desensitized to each new opioid headline. We are general internists, primary care providers and junior faculty. We practice at ...

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I recently took a three hour online course on something I learned to do when I was a medical student. And I thought it was something I had been doing fairly well for the past 20 years.

New regulations have come down requiring all practitioners to take a CME-certified course on safe and effective management of opiates for acute and chronic pain. This has clearly ...

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There is enthusiasm in politics about reducing regulation to stimulate creativity and economic growth. Maybe. But reduction in oversight of medication and medical devices by the Food and Drug Administration (FDA) will probably lead to a proliferation of expensive potions and gadgets that don't actually help. The New England Journal of Medicine published an article detailing the near miss associated with an injectable monoclonal antibody for Alzheimer's disease. ...

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One of the most challenging and difficult parts of my professional day is trying to determine if my patients are actually taking their as prescribed. I ask my patients to bring their medications to each visit in the original pill bottles, and we count pills. I ask them to bring their medication lists as well, and we go through the time-consuming practice of reviewing each medication against the prescribing date and ...

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