HIV and ID Observations

December 12th, 2015

The 2015 ID Fellowship Match “Historic Bad”: Part 1, Debating the Cause

This year’s ID fellowship match has just taken place, and the results were, ahem, not pretty. Part 1 will cover why we’re in this situation; in Part 2, I’ll offer some reasons for optimism, and even some solutions. According to data provided by NRMP, 117 of the 335 ID fellowship positions were unfilled. Dan Diekema from U of Iowa, […]

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December 6th, 2015

Do Electronic Health Records Make You a Better (or Worse) Clinician?

Earlier this week, JAMA Internal Medicine published a study entitled, “Level of Computer Use in Clinical Encounters Associated with Patient Satisfaction”. A more descriptive title would have been “More Computer Use in Clinical Encounters Associated with Reduced Patient Satisfaction”, as here’s the take home point: High computer use by clinicians in safety-net clinics was associated with lower patient satisfaction […]

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November 29th, 2015

Flu Vaccine Keeps Taking Hits, Still the Best We’ve Got — Don’t Stop “Belivin'” [sic]

For reasons understood only by the geniuses in Mountain View, CA, for some reason my Google news feed picked up this bit of “scientific” reporting: Let me allow the author, an unfortunately named “Clapway” (gonorrhea researcher?), to speak for him/herself: However, is the flu vaccine really worth it? The author of this article never takes it and […]

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November 1st, 2015

Should Doctors Still Be Allowed to Wear White Coats? You Decide

If you’re not immersed in the ID or the Infection Control world, you might not be aware that there’s currently quite the controversy about whether doctors should wear white coats. I almost wrote “raging controversy” — but the adjective “raging” doesn’t really fit the sort of people who specialize in Infection Control, who are some of the most measured, […]

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September 24th, 2015

Decision to Lower Price of Pyrimethamine a Good One, Especially Given the Weak Defense of the Price Hike

The big ID story the past couple of weeks is that the price of pyrimethamine — a drug that’s been available generically for decades — went from $13.50 to $750 for one pill after the exclusive rights to the drug were purchased by Turing Pharmaceuticals. Now, after a barrage of criticism — all the way from this […]

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September 7th, 2015

Two Drugs with High Prices — One is (Surprise!) Good Value, The Other is Truly a Rip-off

By now, the fact that HCV treatment carries a high price is a fact as well known to the medical and non-medical public as 1) a million dollars doesn’t get you much in Manhattan or Bay-area real estate; 2) a Rolex is an expensive way to know what time it is; and 3) even though […]

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August 23rd, 2015

Post-Exposure Prophylaxis for HCV Can’t Be Cost-Effective — But We Might End Up Recommending It Anyway

An email query from a colleague: Hi Paul, Just got a call from one of our surgeons who got a needlestick from a suture needle, small amount of blood. Patient is HCV +. Any post-exposure prophylaxis recommended? Thanks, Dan The quick answer is no, it’s not recommended. From the guidelines: But it’s a natural question to ask for several reasons — […]

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July 7th, 2015

For HIV in the USA, Not in Care Exceeds the Undiagnosed — Solutions Welcome

In last week’s post, I asked about two of the key components of the HIV care cascade — the “undiagnosed” vs the “diagnosed but not in care,” and which group was larger in the USA. Here are your answers as of now: The people who read this site are a pretty knowledgeable group when it comes to […]

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April 22nd, 2015

Seriously — How Much Would You Pay for a Curbside Consult?

Yes, seriously. Let me start with an email exchange I had with a PCP recently: Hi, Paul, quick question 😉 This lady, 49 YO woman from Haiti, asymptomatic, totally healthy. Got TSpot done for immigration purposes, it’s positive with negative chest Xray. Treated with INH 6 months in 2001. She travels to Haiti annually so could had been reexposed, though […]

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April 15th, 2015

Does Scientific Language Come Across as Wishy-Washy?

I had the opportunity to interview author Seth Mnookin recently for a podcast on Open Forum Infectious Diseases, and it was a real treat. He’s Associate Director of the graduate program in Scientific Writing at MIT, and the author of the The Panic Virus: The True Story Behind the Vaccine-Autism Controversy. Not surprisingly given his title, […]

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