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A physician’s response to observational studies of opioid prescribing
Not long ago, we were told we needed to do better at relieving pain.
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Small fibers, large impact
The wide interest in small fiber neuropathy may reflect our current apparent epidemic of chronic pain.
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We can learn a lot from drug adverse effects
No one likes adverse effects, but they can teach us important things about human biology.
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The bias of word choice and the interpretation of laboratory tests
Words matter. Calling ALT and AST “liver function tests” can lead to premature diagnosis of liver disease.
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How well do we understand calcium and vitamin D?
I do not believe we truly understand the ideal amount of dietary and supplemental calcium or vitamin D for a given patient.
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Training physician leaders to save the health system…and us
The success of the health system and the emotional well-being and clinical skills of its physicians are clearly interrelated.
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The algorithm less traveled
At Bellevue, the RPR was a routine test; at the University of Pennsylvania, not so much—it all depends on context.
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Understanding the tests we order: Comments and an invitation
Some new laboratory tests go through a life cycle, first being used by subspecialists and then by physicians everywhere.
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Deprescribing: When trying for less is more
We should periodically revisit the goals and rationale for all prescribed medications
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Can a shared decision be wrong if made for the ‘right’ reasons?
Providing information alone is not enough; we need to understand the patient’s biases, fears, and priorities.
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A New Year’s transition and looking forward
Time to take stock of advances in—and obstacles to—the delivery of quality healthcare.
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To have not and then to have: A challenging immune paradox
The immune reactivation syndrome can occur when the immune system in an immunosuppressed patient with a partially controlled indolent infection is...
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Toward understanding chronic kidney disease in African Americans
African Americans respond differently to some treatments than the white male patients who participated in the clinical trials.
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When cold-induced vasospasm is the tip of the iceberg
For a minority of patients, Raynaud phenomenon may be the presenting sign of a systemic disorder.
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Watson, the game is a foot…or a palm
Sherlock Holmes I am not, but some useful clues are readily apparent if one is prepared to recognize them.