I never wake up late. This wasn’t always the case. All the way through residency, I was completely dependent on alarm clocks to keep from oversleeping. So much so that when my alarm clock broke halfway through my internship, I replaced it the next day. I remember driving in the middle of the night to…
“It’s like winning Powerball.” For months, there has been a steady trickle of questions from my patients, asking for my opinion about the new vaccines being developed to prevent COVID-19. More to the point, they want to know if they should be vaccinated. After some fits and starts, I finally struck upon a pat answer…
In case you missed it, on Nov. 20, the Centers for Medicare & Medicaid Services (CMS), a department within the U.S. Department of Health and Human Services, announced that it will overhaul the payment system for Medicare Part B (i.e., infusion) drugs on Jan. 1, 2021. The plan is called the Most Favored Nation (MFN)…
The search for knowledge has shaped Western culture and is based on Greek philosophy, especially Aristotelian metaphysics. During the Middle Ages, this knowledge was matured by dialectical scholasticism, culminating, in its later stages, in the amalgam between Islamic science and the neo-Aristotelianism of St. Thomas Aquinas.1 In this way, the foundations of the future scientific…
Our hospitals have had their finest hour in the care of acutely ill inpatients during the COVID-19 pandemic, including dealing with allocation decisions fairly and transparently, maximizing good outcomes and remaining cognizant of the enduring ethics of healthcare. The honorable traditions of self-effacing conduct and acceptance of some level of personal risk by healthcare professionals…
On April 5, 1950, a small group of scientists met in Silver Spring, Md., to talk about geophysics. I know this is not the most riveting way to start, but if you stick with me, I promise the story will get much more interesting. This group of scientists met to discuss all that was still…
In a December 2019 editorial in the Journal of the American Medical Association, the implications of diagnostic error were explored through the story of two parents, both medical professionals, who sought a diagnosis for their sick child.1 Their son saw specialist after specialist and underwent repeated procedures, but for years was left without an explanation…
It came down to the toss of a coin. David Yancey represented the Newport News district in the Virginia House of Delegates beginning in 2011. In 2017, he had a challenger. Shelly Simonds, a member of the local school board, decided to run for the privilege of representing the 94th District. The final tally: 11,608…
The ACR position statement on access to care proposes the goal that “… all patients have timely access to expert rheumatology care … .”1 The reality is that new and established rheumatology patient wait times are often prolonged, causing delays in necessary diagnosis and treatment. The 2005 and 2015 ACR Workforce studies document intractable and…
I should have paid more attention in medical school. If I had, I might have remembered enough about basic pathophysiology to know why everyone was suddenly pulling their patients off of lisinopril. For those of you who need a quick primer: When the pressure in the renal artery drops, the kidney secretes renin. Working together,…