Yesterday's Wall Street Journal opinion page (A17) had a column by Dr. Peter Bach entitled "How Many Doctors Does it Take to Treat a Patient?".  Dr. Bach recently published a study of Medicare patients in the New ...

This week's New England Journal of Medicine publishes a health policy report about electronic health records (EHRs).  The article reviews the potential benefits of EHRs to patients and to physicians and laments that as of 2005 only about 23% of physicians used them. The reasons for the slow adoption of EH...

"I think I have bronchitis.  I probably need some antibiotics." All primary care doctors hear that phrase very frequently.  A patient develops a productive cough that lasts for several days, malaise, and slightly elevated temperature.  Then the patient sees her physician with a clear and predetermined expectation of the correct treatment -- antibiotics.  Knowing that antibiotics are not indicated...

Sciatica is the common term for lower back pain that radiates down one leg.  It is a very frequent cause of missed work and disability.  Sciatica is almost always caused by a lumbar disk that has been pushed out of its normal location and is impinging on a nerve. The typical treatment for sciatica is anti-inflammatory pain medication and physical therapy.  Most patients recover entirely with this...

A new study in the New England Journal of Medicine has generated a lot of media attention this week (such as this NY Times article).  The s...

This is another example of a tiny number of irresponsible people imposing a lot of inconvenience on millions of others.  The Associated Press reports in this Forbes article that four East Coast supermarket chains will only sell products containing dextromethorphan (DXM) to customers over 18 years of age.  DXM is...

Recently human papilomavirus (HPV) has been making a lot of news.  The story involves big business, cancer, government policy, and sex.  I'm surprised HBO hasn't made a series about it. HPV is a sexually transmitted virus that causes genital warts, cervical cancer, and has recently been associated with oral cancers.  Merck recently released Garda...

Though heart attacks continue to be the number one cause of death in the United States, the news for treatment and prevention of heart disease keeps getting better.  An article in this issue of The Journal of the American Medical Association exa...

Many patients have been told to take antibiotics before dental procedures.  This recommendation was made to prevent an infection of the lining or valves of the heart called infective endocarditis (IE).  Patients who had leaky heart valves or other heart conditions that were thought to increase the risk of IE were told to take antibiotics before seeing the dentist. Last week the More

I have many patients who swear by alternative therapies that are unproven or, worse, proven not to work.  How should I counsel them?  On the one hand, each individual is unique and it's possible that what applies to thousands of patients in a study shouldn't be generalized to the specific patient sitting in my office right now.  On the other hand, we all (I included) have a staggering capacity for...