Intermittent fasting has salutary effects. Listen how Dr. Mark P. Mattson, co-author of a recent NEJM review on the topic, assesses the practice — and how he’s managed to skip breakfast for the past 30 years or so. Dr. Ali Raja joins Joe as co-host again this time. Links: de Cabo and Mattson’s review in the New […]

It turns out that the disrespect starts even earlier — when women are questioned about their choice of a surgical specialty. Nor is the bad behavior the exclusive province of the “old guard.” We talk with Dr. Pringl Miller, a Chicago surgeon who’s compiled a collection of instructive stories from women surgeons who’ve had to dodge […]

Why aren’t you able to navigate your electronic health record (EHR) as easily as you can find a recipe on, say, Google? And, what about those requirements for documenting everything? Listen to a chat with Julia Adler-Milstein, the author of an editorial that comments on a recent Annals of Internal Medicine study detailing the amount of time […]

The process of identifying super-users of healthcare and reducing the frequency of their hospitalizations — so-called “hotspotting” — was subjected to a randomized, controlled trial in Camden, NJ, the birthplace of the idea. It failed there. Those in the intervention group had a readmission rate within 6 months that was statistically identical to those getting usual care. […]

A “network meta-analysis” (we’ll explain that) finds that “test and treat” is the best way forward in managing this common condition. Patients, paradoxically, prefer immediate endoscopy to test-and-treat, but unless the patient has “alarm symptoms” (such as dysphagia, weight loss, and anemia), endoscopy is likely to add complications and costs without adding further benefit. Our guest is […]

For the first time in almost a century, Americans are dying at home more often than dying in hospitals. This seems to mark a cultural change that will affect both how and where clinical medicine is practiced. Dr. Haider Warraich’s letter to the editor of the NEJM presents the numbers, and he’s agreed to talk about their implications. […]

In November 2018 we interviewed two authors of an Annals of Internal Medicine study comparing the quality of diabetes care afforded by three provider types: nurse-practitioners, PAs, and MDs. They reported that there were no clinically significant differences in the intermediate outcomes — glycated hemoglobin, systolic pressure, or low-density lipoprotein cholesterol — among the groups. We’re […]

The anti-inflammatory colchicine is powerful and cheap. It’s thought that, because cardiovascular problems often stem from inflammation, colchicine could help prevent secondary events after MI. That’s what Jean-Claude Tardif and an international group of colleagues set out to investigate. The group reports in the NEJM that daily low-dose colchicine was associated with a lower rate of […]

Controlling hypertension lowers the relative risk for dementia and Alzheimer’s disease by roughly 15%. Given that many people have poorly-controlled hypertension, the finding that all antihypertensives are effective in bringing about this result might get your patients to be more adherent. We talk with Dr. Lenore Launer of the NIH’s Institute on Aging about her recent meta-analysis […]

Tranexamic acid, which frustrates clot dissolution, has been shown to reduce death from intracranial bleeding in a large international placebo-controlled trial — “CRASH-3.” Ali Raja and Joe Elia host a lively chat with Ian Roberts, the co-chair of the trial’s writing committee, who, in addition to chastising the hosts’ seeming fascination with P-values, recounts a story […]