May 10th, 2021

Goodbye, Physician’s First Watch — We’re Really Going to Miss You

WPA travel poster (1939) has nothing to do with this post, but I like it since everyone hates mosquitos, especially ID docs.

One of the great joys of life is working with great people, and for me, this includes frequent interactions with several skillful medical editors. They scan these posts for typos and awkward sentences, and warn me when I inadvertently include a copyrighted image or an inappropriate video.

They also worked, until recently, for Physician’s First Watch, which sent out daily emails highlighting the top stories in medicine — published papers, conference highlights, policy changes, new guidelines.

For practicing clinicians too busy to keep up with the voluminous medical literature and breaking news, this service was absolute gold — how else would an Infectious Diseases doctor learn about (yet another) negative vitamin D study? The latest on how to manage back pain in outpatients? Or understand that the USPSTF has come out with (yet another) recommendation against screening for a certain disease?

(Those USPSTF guys sure are tough. Wonder if you have to take a standardized skepticism test before joining this group, with only those scoring in the 99th percentile allowed in.)

That the First Watch newsletter came from a trusted source, with the appropriate references readily linked, only added to the value. You never felt like it was a thinly veiled marketing platform, or clickbait. Here’s What the Grouchy USPSTF Panel Does in Its Free Time — and You’ll Never Believe It.

Physician’s First Watch also kept me updated in my own field, Infectious Diseases — in particular advances outside of my primary areas of focus. Recent examples included a systematic assessment of delayed antibiotic prescribing in the outpatient setting and an observational study comparing amoxicillin-clavulanate and metronidazole plus a fluoroquinolone.

Alas, Physician’s First Watch ceased publication on April 29th — and the medical world mourns. Email from a Dr. Frank Domino, a primary care physician:

Hey Paul —
Why did NEJM stop First Watch? It was awesome! Kept me up to date better than anything, and I used it as a teaching tool with students all of the time.

We agree, Frank. It was regular breakfast table conversation fodder for both my wife (a practicing pediatrician) and me.

As I understand it, the decision was purely a business one, as the quality was always superb. But publishing in general, and medical publishing in particular, is going through a very unstable time. It’s no secret that many online and other “free” electronic endeavors have not been able to generate revenue from their content, a problem exacerbated during the COVID-19 pandemic. Here is a superb review of why some of these sites have either shifted to a subscription model or shut down entirely.

But one thing is clear, at least for now (looks over his shoulder) — I’m going to continue writing on this site. Am enormously grateful to NEJM Journal Watch for the opportunity to write this blog or column or newsletter, or whatever you want to call it. I also greatly appreciate all the regular readers, and comments, and suggestions, and feel like we’ve built a wonderful ID-oriented community that welcomes anyone interested, ID-trained or not.

For those who relied on Physician’s First Watch for notification about new posts, that’s not going to work anymore. But you can subscribe by entering your name and email address in the Subscribe box at the end of this post or in the column to the right, and confirming that you want a subscription — then shazam, just like magic, you’ll get an email when a new post appears. Don’t worry, we won’t share your name or email with anyone.

I’ll continue to cover the latest on ID, HIV, and while it’s still with us, (deep breath) COVID-19 — along with other general ID and non-ID topics, and the occasional silly digressions. Here’s a summary of the various things covered over the years.

Who knows? One of these days I might come up with a more interesting title — suggestions still welcome!

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29 Responses to “Goodbye, Physician’s First Watch — We’re Really Going to Miss You”

  1. Gisela Herrera says:

    I will miss you so much

  2. Katy Godfrey says:

    I am IN

  3. Loretta S says:

    “this service was absolute gold”. I could not have said it better. And that’s why I wrote a response to the email that told of the demise of PFW a few weeks ago. I said,

    “I have depended on PFW for over 8 years. What I love(d) about it is(was):

    — Short, succinct, to-the-point summaries of important studies, guideline changes and other medical news that has direct clinical relevance.
    — Opinions of the editors regarding the significance (or not) of studies. I relied on those opinions frequently.
    — Certain studies were flagged “Practice changing”, and they were. Those nuggets have always been one of my favorite and most useful features of PFW.
    — It kept me up-to-date! I can’t tell you how many times I told a colleague about something important I read in PFW and they said, “Where did you hear that? I haven’t heard anything about that!”.

    The emails were great. Never too long and always factual and important.”

    Yep, that about says it. And oh, yes, I recommended PFW to numerous students over the years.

    Heck, I would be willing to pay for PFW. That’s how much I am going to miss it and how much I have depended on it. Sigh.

    Well, at least we still have this blog, which I (a non-ID-trained provider) have read for about as long as I have subscribed to PFW — and find endlessly fascinating and useful. (If only I could decipher all those acronyms in Paul’s conference summaries!) I even quoted Paul in a lecture on infective endocarditis. 🙂

    Goodbye to Physician’s First Watch. Thanks for all the great clinical information over the years.

    • Heather M says:

      I agree with this wholeheartedly. How am I to look smart now without my guide? 😉 I subscribe to Journal Watch, but PFW was always so much more immediately relevant. Sigh.

  4. Philip Saccoccia Jr MD FCAP says:

    First Watch is and was far more valuable than parent NEJM.
    It’s just another example of out to lunch business managers.
    Thanks for a great run!

  5. Ryan says:

    Does anyone have recommendations for another service to take the place of PFW?

  6. Shishir Gokhale says:

    Oh, I am so sad.

    I always looked forward to this column for the contents as well as the valuable comments. I am sure going to miss this column.

    But all good things come to an end someday, or they metamorphose, evolve and come out better.

    I am sure we are in for better and will get to more information and knowledge.

    P.S. I have subscribed.

  7. Rekha goswami says:

    May be the parent Journal can add section with the nuggets of gold (lPFW) that will increase its value.

  8. James Leo says:

    Dr. Sax,

    I agree completely with your sentiments about PFW. It has been the first thing I look at every morning throughout the COVID-19 pandemic, my go-to for keeping up to date in specialties outside my own, and my morning coffee companion. I would happily have paid an additional subscription fee to keep this service,

    That being said, I’m glad to know your posts will continue; they are always thought-provoking and a pleasure to read. I’m signing up now.

  9. Karen Williams says:

    Thank you Paul, for continuing your wonderful blog. What really floors me is they never asked us to pay a subscription fee! I would gladly have paid for this service. Where do they find their focus groups?

  10. Pansori Bird says:

    Thank you for your sikky digressions!

  11. Ganz Richard says:

    Can’t find “email box in column to right”. Please subscribe me to PFW. Thanks

  12. Michael LeFevre says:

    As a practicing family physician, a vitamin D skeptic, and the former chair of the USPSTF I have to say I Ioved your comments. And I really appreciate your insightful commentary. I will try to keep it coming. And oh, yes, I am at least at the 99th percentile on skepticism. Time, science and experience has led me there.

    • Paul Sax says:

      USPSTF does great work! Thanks for your comment — and your skepticism.

  13. Doug Osmon says:

    Thank you for all you do

  14. liz rantz says:

    I don’t understand PFW. I subscribed for years and totally relied on it. Fortunately I’m retiring.

  15. Victor Amorim says:

    I strongly agree with Doctor Sax.

    Today, browsing the internet feels like navigating a sea of politically motivated fake news. Having frequent access to a succint, clear and above all trustworthy source of updates about the impossibly vast ocean of medical literature was priceless.

    I agree with the colleague above – I would gladly have paid a monthly subscription for Physician’s First Watch.

  16. JoAnn Kieller says:

    Sorry to see PFW retire. I agree it has been like gold. I’m an Infection Preventionist and have read the site for years and have learned reams. I appreciate that the blog/column/newsletter will continue. Thank you.

  17. Amy A says:

    Uh— Paul, Regarding Journal Watch sticking around. I guess you are not aware that there were specialty Journal Watches that were of fabulous quality and beloved that got the heave ho. Journal Watch Dermatology, for example. Hensin Tsao and others had a quality product that was a go to for many of us. I got this in the old days as a paper newsletter. But budgets needed to be cut apparently. So, sadly, you shouldn’t forget to keep looking over your shoulder.

  18. Sheryl M Long MD says:

    As the reality of the business decision markers finally successfully invaded this wonderful body of work, produced daily by some of the most trusted professionals in the world of medicine, I grieved. Then along comes Dr. Paul Sax, in his way of challenging each of us to think. with a lighthearted, cheerfulness that comes from being confidently the best at what one does and, I feel like the body might survive. Saved again, by the ID called to the case. Okay maybe I just feel very validated in my grief, Plus, I got to formally sign up for your Blog! Need I say, I & we are grateful for you, Paul.
    As a very busy Family Medicine small private practice doc, how else could I have had the information I needed quickly, in the middle of holiday surge,to know that I needed to chase down Bamlanivimab! To then get it delivered to several of my very high risk patients as outpatients, who trust my knowledge enough to let me do so. I kept them out of the ER, out of the hospital, (read decompressed ERs & hospitals & all their tents and hallway beds, and their staff) and maybe saved some lives, Folks remember things change, that was Dec. Yes, I know now it’s BAM + Etesevimab, or did it change today? I don’t know yet, I don’t have PFW any more.
    YES! Why didn’t they ask if we would subscribe. Shame on you, business gurus, Come back, I’ll sign up! and, No, I can’t find anything better, and it was already highly evolved into pure gold,and in a nugget,best of all!
    Does anyone think if I wrote to Biden and ask his Admin, to help, that it could be revived and funded, at least until we are long past this pandemic? I get a ton of patient portal messages to me daily, yes mine is a labor of Love! Last week, it was all about the J & J. I relied on PFW to give me the facts. Now that Vaccines are moving even more to the one on one with patients and their Docs, You need me to have the latest facts, pure, simple truths, with data to help me, help you win this war against COVID, and the bigger war against stupidity, (not mine, best said by ER doc in TX). This takes humility, the time to listen to someone’s valid concerns, to then have the knowledge to be their trusted expert yet again, the one that PFW (had) helped me remain.
    At least for the Pandemic, We’ve got you Paul!

  19. Peter says:

    Yes, why don’t they offer a pay option at least?

  20. Rachel Wagner says:

    I first heard about PFW when I graduated from residency in 2004 from my residency director. I always thought it was one of the best pieces of advice he gave me for staying up to date with medicine. What do directors recommend now? Please advise.

  21. Nathan Brooks says:

    I would also pay to subscribe to PFW, which I found extremely valuable as a busy PCP and instructor of FM residents. Just in case any of the business people are listening…

  22. Sanford R. Kimmel says:

    I agree with the many positive comments about Physicians First Watch. In particular I found it very useful in keeping up with the real medical developments during the Covid-19 pandemic. This is in contrast to the conspiracy theorists, anti-vaxxers and promotors hawking “quack” remedies who seem to have no problem finding a platform to shout their falsehoods.
    I also enjoyed Dr. Sax’s humor and will sign up for his blog.

  23. Naksanguan. T says:

    So sad to hear that. Hope that we will have re-unite party nearly in the future

  24. Jay Buechner says:

    I join those who are willing to pay for PFW. In fact, I’ve been paying an annual fee to get fuller access to the underlying articles and opinions, and I would be willing to increase that if it would help resuscitate PFW.
    The New York Times charges $1.25 a week for its cooking website. Consider the relative value…

  25. SETH M MANOACH says:

    I am a critical care doctor. I already wrote the Massachusetts Medical Society to say what a horrible loss journal watch is. I finished med school 1995 I got board certified in emergency medicine internal medicine critical Care medicine and neuro critical Care medicine. I make sure I’m up on primary Care stuff too at least enough to answer relatives questions. I just think this was a horrible decision. It’s a public service. In any case I can’t figure out how to sign up for your column ie hiv and ID observations. I’m a regular reader. We see lots of infections in the ICU. Can you sign me up because I can’t again find the place. Thx

  26. Claire Zilber says:

    I, too, was an avid daily reader of First Watch and mourn its absence. As a psychiatrist, I often have more time to educate my patients about their medical problems than do their PCPs. Staying up to date with FW helped me field questions from my patients and my family members. I agree with others that I would pay for that service. I am also a columnist for Psychiatry News, and I have referred to you, Dr. Sax, as my favorite medical blogger and linked to your column on several occasions. I’m glad you’re still in it. Please don’t stop!

  27. David Koffman says:

    As a PCP that has migrated to the dark side of administrative medicine, I found PFW invaluable and also would be willing to pay for it. I’ve also been a huge fan of Dr. Sax’s blog to the point where I send my college age kids and surgeon wife a group text 90+ % of the time a new blog is posted! Keep them coming, please.

HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

Biography | Disclosures | Summaries

Learn more about HIV and ID Observations.