HIV and ID Observations

January 10th, 2016

Medical Marijuana and Painful Neuropathy — An Opportunity to Make Us Believers

Medical marijuana is now officially available in New York, the city with by far the largest number of people living with HIV/AIDS in the country. Reporting on the first dispensary in Manhattan, the aptly named Julie Weed (yes! her real name!) writes: One of the most promising areas for research is the substitution of medical marijuana for […]

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December 19th, 2015

Part 2, Now The Good News: Why ID Will Survive as a Specialty

Part 1 of this post, which highlighted the primary reason for declining applications to ID fellowship programs, could come across as something of a downer. “Moping about it won’t get us anywhere,” someone said to me, and it’s true nobody likes a whiner. But my point was to acknowledge the issue, and find a way forward. It […]

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December 17th, 2015

A Certain Billionaire’s Arrest Prompts Universal Responses — and a Brilliantly Funny One, Too

Several words swiftly come to mind when hearing the news that Turing’s Martin Shkreli was arrested for security fraud. Karma. Just desserts. Kismet. Schadenfreude. Inevitable. But leave it to Andy Borowitz to get it just right: Ha, that’s perfect. Diana Olson from IDSA emailed me “Someone should make a movie …”, which is of course exactly right. […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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