For content related to the science and practice of medicine

Why I speak up

I was asked by a colleague at work (someone who frequently but privately agreed with me but never spoke up publicly), “Why do you tilt at windmills?” Many have answered this better than I.

Doing nothing - but doing it right

It’s always easier to do something than to do nothing. Doctors often offer treatments for things they know are what we call ‘self-limited’ meaning that they will clear up all by themselves.  I think this form of unnecessary treatment reflects an awareness that although many things resolve without intervention, both doctors and patients are driven to DO SOMETHING. Though it is usually tempered by the wish to do something as benign as possible, sometimes doing nothing is the best choice. The trick is knowing how to do nothing properly.

Humility and medical guidelines

We have LOTS of guidelines and recommendations. We we need is more humility.

The Advisory Committee for Immunization Practices (ACIP) issued a recommendation in September of 2014 that pneumococcal vaccine naive individuals 65 and over get a Prevnar13 followed by a Pneumovax 6-12 months later, and that those who have had a Pneumovax get a Prevnar13 a minimum of 12 months after their Pneumovax.