HIV and ID Observations

October 30th, 2024

The Riveting Conclusion of How PCP Became PJP

Before I get back to the saga of Brave New Name — How PCP Became PJP and Why It Matters, allow me to share that I had some trepidation about publishing this thing. A deep dive down a hole with very high-risk for tularemia exposure (see what I did there?), it veered off topic more than half-baked […]

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October 8th, 2024

Why We Have Antibiotic Shortages and Price Hikes — And What One Very Enterprising Doctor Did in Response

At the start of our weekly case conference, we get announcements from one of our ID pharmacists. New drug approvals, hospital policies, updated guidelines — that kind of thing. But over the last decade or so, the most common topic they’ll comment on is the latest important antibiotic shortage. For those not in medicine, you […]

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September 19th, 2024

How Electronic Health Records Tyrannize Doctors — ID Doctors in Particular

A paper just appeared in the Journal of General Internal Medicine entitled “National Comparison of Ambulatory Physician Electronic Health Record Use Across Specialties.” The goal of the study was to track clinician workload by specialty, divided into various functions — documentation, chart review, orders, inbox. Importantly, there was no gaming the system. By using Epic’s built-in […]

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July 14th, 2024

Should We Continue to Use Contact Precautions for Patients with MRSA?

Back in the early 2000s, I heard about a local hospital that eliminated contact precautions while caring for patients with methicillin-resistant Staphylococcus aureus (MRSA). No more required gowns and gloves, or warning signs on the doors, or private rooms for patients known to have MRSA. They planned to track MRSA cases carefully over the next […]

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May 28th, 2024

More on ID Doctors and Primary Care for People with HIV

A recently published study suggested that “non-ID doctors do better” when it comes to providing primary care to people with HIV. At least that was the attention-grabbing subject line of an email summary distributed by a local primary care doctor, Dr. Geoffrey Modest. He periodically sends around detailed descriptions of studies he finds interesting, then […]

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April 26th, 2024

Hey, Insurance Companies and Pharmacies — Stop Messing Around with the Price of Cheap Generic Drugs

If you’re practicing medicine these days, you’ve likely experienced some version of this painfully annoying scenario. You prescribe a generic medication, one that’s inexpensive. Your patient goes to the pharmacy, and the pharmacist says that it requires a prior approval. They leave without getting their meds. Here’s a recent example from one of my patients (details […]

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December 8th, 2023

Clinician-to-Clinician Advice Is Great for Everyone but Still Horribly Undervalued

One of the best things about being an ID doctor is that you get to interact with all the medical and surgical specialties. This is one of the most common answers to the question, “Why did you choose to specialize in ID?” and it certainly resonates with me. As a result, we’re frequently in the position […]

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October 8th, 2023

An October ID (and Non-ID) Link-o-Rama

For those venturing next week to IDWeek here in Boston, fall gives us our very best weather. Comfortable sunny days with brilliant blue skies, cool evenings, low humidity — great weather for exercising and sleeping. Usually you just need a light jacket. And now, after one of the rainiest Septembers on record (boo!), October has […]

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September 8th, 2023

Endless Recertification in Medicine — Some Thoughts About the Tests We Take

The tests issued by the American Board of Internal Medicine (ABIM) for credentialing physicians are much in the news again. There’s even a petition circulating to eliminate the Maintenance of Certification (MOC) process entirely, signed by nearly 20,000 physicians. I have a bunch of memories, thoughts, and feelings about ABIM and the tests they issue. They’re […]

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May 8th, 2023

As the Public Health Emergency Comes to an End, How Are We Feeling About This?

As you no doubt heard, on Friday, May 5, 2023, the WHO declared the end of the global health emergency from COVID-19. Here in the U.S., the federal public health emergency will expire on May 11. That’s Thursday, just a few days from now. These events reflect two realities that, while seemingly contradictory, make these decisions reasonable […]

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