HIV and ID Observations

November 6th, 2016

Do ID Clinicians Perpetuate Our Own Stigma?

Infectious Diseases doctors will find this exchange familiar: New person you’re meeting:  What to do you do? ID Doc:  I’m a doctor. New person:  Oh — what kind? ID Doc:  A specialist in Infectious Diseases. New person (making a face, or moving a few feet back, either to be humorous or truly frightened, or both):  Yuck! […]

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July 14th, 2016

Must-Read Item: This Year’s JAMA HIV/AIDS Issue

The folks over at the Journal of the American Medical Association have been doing a periodic HIV/AIDS themed issue for years, generally around the time of the International AIDS Conference. The latest issue is out this week, and it’s terrific. Here are some highlights: In serodiscordant couples practicing “condomless sex”, there were zero transmissions if the infected partner […]

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July 3rd, 2016

Velpatasvir/Sofosbuvir Makes HCV Treatment Simpler, Especially For Genotypes 2 and 3

One of the ways ID and hepatology hepatitis C experts like to show off is by discoursing on the nuances of cleverly named clinical trials, and how these impact treatment guidelines. It usually goes something like this: “In the EP-CILEON [I made that up] study of [insert HCV regimen here], treatment-experienced patients with genotype [insert non-genotype 1 patients here, […]

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June 12th, 2016

Progress in Lyme Disease Badly Needed — Could a “Hackathon” Help?

Someone recently asked what keeps me, a specialist in Infectious Diseases, up at night. With the admission that I do all my clinical work here in the USA — a person working in the tropics would undoubtedly have a different list — several challenging patient care and public health issues came to mind. Multidrug-resistant bacteria. Endovascular infections in […]

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May 30th, 2016

The Sanford Guide — 46 Editions Later, Still Going Strong

I recently had a chance to visit Portland, Oregon, which for many will conjure up images of bicycles, hipsters, Mount Hood, roses, organic everything, and craft beers. It’s also the lifelong home of Dr. David Gilbert, the lead editor of The Sanford Guide to Antimicrobial Therapy, an invaluable resource well-known to almost every clinician. Dave was kind […]

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May 22nd, 2016

Drug Prior Authorizations Are a Very Blunt Tool for Cost Containment — And They’re Annoying

Insurance prior authorizations, or prior approvals (PAs) — those dreaded forms clinicians have to fill out, usually triggered by prescribing a non-formulary drug — are much on my mind these days. And most of it has to do with three letters, specifically “TAF.” As readers of this site probably know, there are now three tenofovir alafenamide (TAF)-based coformulations […]

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May 16th, 2016

Lots of College Graduations ID Link-O-Rama

For those of us living and working in Boston, we are most definitely smack dab in the middle of college graduation season — which means traffic is crazy, restaurants are booked, and energetic young adults are everywhere wearing gowns and funny hats. In other words, a good excuse for an ID Link-o-Rama: FDA advises against use of fluoroquinolones for uncomplicated […]

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April 30th, 2016

A Ridiculously Long Post: How EHRs Expose Unspoken Hierarchies Within Medicine — Or Maybe Are Just Bad

I am consulted by a surgeon about a patient with something that might be infectious, might not. A very appropriate referral. After seeing the patient and reviewing the history and scans, I decide a CT-guided biopsy is the next step. The nice radiology fellow tells me “Just place the order in [enter name of EHR here]”. Since this is the first time […]

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April 24th, 2016

Why Getting Old Isn’t Always So Terrible — and Why People with HIV Can Now Get Life Insurance

Two patient-related anecdotes, then a news item. Anecdote #1: A little email exchange I had with one of my patients recently: Hi Paul, Wondering if you got the refill request for my meds from my mail-order pharmacy — their customer service is lousy, and I can’t tell if it’s been approved. I’d like to get this settled before […]

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April 15th, 2016

Mystifying Abbreviations on Daily Medical Rounds

I am currently attending on the inpatient medical service — always a treat, and a great learning experience for me each year. Aside from the refresher on inpatient general medicine — hey, no amount of repetition is too much when it comes to working up hyponatremia — I’m also fascinated by the steady proliferation of abbreviations and acronyms, bits […]

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