My favorite line--"...and then just sit quietly". One of the hardest things for a physician to do.

This is the exact same reasoning people use when interventions like ivermectin and cod oil fail to show benefit.

Considering how siloed we all are this is very silly. but you better believe you got my vote! Aaron Goodman - “Papa Heme”

A compelling argument to not renew Medicare coverage for virtual care.

Where is the CICU metric for the flu vaccine? open.substack.com/pub/sensibleme…

Disagreements are good! Means we need more randomization. jamanetwork.com/journals/jamas…

Race concordance between physician and patient, does it matter? I sit in an armchair and read an economics paper. open.substack.com/pub/unrelentin…

Hope the remaining 2% of valid claims aren’t important.

My take on API-CAT study. Does this mean we should trial no anticoagulation next? open.substack.com/pub/unrelentin…

1) What

Funny enough care that increases mortality is a great way to reduce carbon impact of patients.

“I order fructosamine, but I’m not sure how to interpret it” 😬

How many patients were on bisphosphonates and why isn't there a supplement provided? (Freedom Trial-Denosumab in Osteoporosis) nejm.org/doi/full/10.10…

Is Denusomab worth a prior auth? open.substack.com/pub/unrelentin…

Ironically this mandate is exactly what big pharma would want (easier to prove efficacy)

Irrational patients (we are all patients btw) is not something "AI" can handle right now. If patient doesn't want to do intervention ("irrationally") and/or it does not align with their values trust breaks. Less of AI problem, more reflective of current system problem

Non-inferiority study of preventive care (screenings, BP control etc) of genAI vs standard care. Outcome - patient satisfaction, quality metrics) I assume already being run?

If guidelines adopt more uncertainty then where does that leave payors? I worry an unintended consequence could be physicians with more burden to get approval from payors

Odd that COVID did not disrupt the trial. (at least not mentioned in the publication, trial ran from 2009 to 2024). Would also add this was not just "exercise". It was extensive behavioral reframing with success measured by exercise metrics)