Cultural competency – should it be required?

We could provide courses for those who find a particular culture difficult to comprehend, but I do not think the New Jersey requirement is a good idea.

Too many medications

The big mistake in the primary care promotion of the late 80s and early 90s was the use of gatekeeper as the metaphor.

Alabama paper writes about medical marijuana

We should make this decision based on data, not belief. But then, we are not allowed to do the right studies to learn the risks and benefits.

Sinusitis – antibiotics not always indicated

And we (most primary care physicians) provide antibiotics to these patients, despite uncertain data on their efficacy.

A problem with guidelines

My friend, Roy Poses, has a great rant on this issue based on a Sounding Board from NEJM – Pitfalls of Single-Disease Solutions

WSJ on pain meds

This article contains the most logical reasonable take on this subject that I have read. As we all know, drugs have side effects.

Celebrex – as I predicted

I would not take a Cox-2 at this time for more than a short course. But then, I would not have taken these drugs chronically prior to the Vioxx announcement

Does anger management work?

I fear they are junk psychology. We need data. But more importantly, Ron Artest and those like him need data, research and real hope.

Grand Rounds 8

Welcome to Grand Rounds 8! I am delighted to host this week. Kudos to Nick who started it all. Grand Rounds was an idea waiting to happen.

An unconvential malpractice solution

If all patients did understand the impact of malpractice premiums increasing, I do believe that they would favor better solutions to this problem.