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A Very Tepid Defense of the Physical Exam

Sensible Medicine

The differential diagnosis includes a rotator cuff strain (probably infraspinatus), osteoarthritis (maybe flared up with the gardening), the beginning of adhesive capsulitis (frozen shoulder), or even Lyme arthritis (again, given the gardening). He discharges the patient with instructions to follow up if necessary.

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A review of the newly approved novel non-opioid pain reliever suzetrigine (Journavx)

Sensible Medicine

A Google search brings up news releases from Vertex , and news coverage—which are essentially the same and lacking links to the evidence. The differences (from baseline) at each time are summed and weighted to come up the score. Last week the FDA approved a novel non-opioid pain medication. This was much more difficult to find.

Follow-Up 308
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Diseases Just Learned: Part 2

Sensible Medicine

Following up with another 35 “diseases just learned.” ” Please look back to last week’s intro if you are just coming to this series. Like Part I, this is a gift to our paid subscribers. This Substack is reader-supported. If you appreciate our work, consider becoming a free or paid subscriber. Read more

Follow-Up 141
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Will New Medicaid Policies Put Hospital Margins at Risk?

EvidenceCare

These improvements reflect stabilization following pandemic-related disruptions and cost pressures. Cost-Sharing: Medicaid recipients earning above the poverty line could face copays up to $35 per visit, capped at 5% of income. Effective care transitions and follow-up can improve outcomes and reduce unnecessary costs.

Hospital 130
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Friday Reflection 41: Sometimes I Just Need to Complain

Sensible Medicine

What there was -- courtesy of colleagues from across the country – were cases illustrating needless excess, careless follow-up, poor commitment to clinical care, and the devaluation of primary care that undermines our entire system. In the days following, there are questions, or test results, or complications.

Follow-Up 278
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Universal Depression Screening Leads to Unnecessary Harm

Sensible Medicine

The USPSTF claims "screening interventions" decrease the prevalence of depression at six-month follow-up by an odds ratio of 0.60. This number is surprising when we consider the following: A meta-analysis of six RCTs found the benefit of SSRIs, compared to placebo, to be small and statistically insignificant at six months.

Follow-Up 361
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In Honor of the Three Greatest Words in the English Language

Sensible Medicine

RM is a 72-year-old man who comes to the office for routine follow-up of spinal stenosis, hypertension, and peripheral vascular disease. I was obsessed with the sport long before I began telling people, “I want to be a doctor when I grow up.” Sensible Medicine is a reader-supported publication. It is March.