I have to admit, I’m not the biggest follower of popular culture. I couldn’t pick a Kardashian out of a crowd if my life depended on it. I don’t know who Brad Pitt is currently married to, if he’s married. And I have no idea how many kids Natalie Portman has, if she has any […]
Why do we underestimate risk? This phenomenon isn’t unique to politics or natural disasters, and it contradicts our need to prepare for future events. It explains why it is hard to get healthy “millennial invincibles” to sign up for health insurance, why earthquake insurance policies skyrocket after an earthquake, and why people tend to underinvest […]
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old man is evaluated for dark-colored urine for 2 days, swelling of the face and hands for 1 day, and severe headaches this morning. He reports having an upper respiratory tract infection 1 week ago with fever, sore throat, and […]
How do we balance freedom and safety for those with dementia, particularly in the risky domains of sex, driving and money? In 2014, Henry Rayhons, a 78-year-old Iowan, was arrested because he allegedly had sex with his wife. Wait. What? The Rayhonses, both previously widowed, met while singing in a church choir. Over time, Mrs. Rayhons […]
In a prior post, I shared my heretofore reluctance to prescribe medications for my hepatitis C (HCV) patients. In summary, after consideration of the risks and benefits of the available options, I could not persuade myself — or my patients — to pull the trigger. These patients were made aware of my conservative philosophy of medical practice. […]
We’ve all been through difficult times. It may be the death of someone we love or suffering abuse with no one to help. In life, many events fly at us that are hard to manage. Many of us just suffer silently through the pain, not allowing anyone in. And even while we do that, we […]
The bedrock requirement to obtain informed consent before patients may be enrolled in research has been eroding. I’ve documented the different ways and different reasons for this several times over the years (“Informed Consent for Babies: When Experts Disagree,” “Informed Consent in Infant Research: Ethical Problems Remain,” “Informed Consent in Comparative Effectiveness Research,” and “The […]
Sometimes I wonder if I am wired differently from other doctors, in terms of what I remember on my own and what I need some help with. The other day I got a “medical call” that simply said, “Mr. Brown called to report his blood pressure is 120/80.” With more than fifty calls in my […]
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated in follow-up after being recently diagnosed with HIV infection. She is asymptomatic. Medical history is unremarkable, and she takes no medications; she has not yet started antiretroviral therapy. She received all scheduled childhood immunizations. On physical […]
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 77-year-old woman is evaluated for frequently fluctuating INRs (<1.8 to >3.5) while taking warfarin therapy. She has undergone INR testing every 1 to 2 weeks and frequent warfarin dose adjustments. She reports a consistent dietary intake. Medical history is notable […]
