Should Evidence-Based Medicine Be Replaced By Interpersonal Medicine?

An opinion piece in the New England Journal of Medicine complains about the limitations of evidence-based medicine (EBM) and recommends a new approach they call “interpersonal medicine.” In my opinion, good clinical medicine is already interpersonal medicine; there is no need for something new. The 22 November 2018 issue of The New England Journal of Medicine carried an opinion

New Blood Pressure Guidelines: Why Are Previously Normal BPs Now Classified as High Blood Pressure?

Under the new blood pressure guidelines, more people are classified as having high blood pressure; but the treatment emphasis is on lifestyle changes, not medications. The American Heart Association and the American College of Cardiology recently released new guidelines for the diagnosis and treatment of high blood pressure. The highlights are reported here. Previously, high blood pressure (HBP)

Vaginal Birth After C-Section: How Safe Is It?

Doctors used to insist “once a C-section, always a C-section.” Today it is standard practice to allow vaginal births after C-section (VBAC) for appropriately selected patients. The American Congress of Obstetricians and Gynecologists (ACOG) has issued a Practice Bulletin to guide obstetricians in determining which patients are appropriate candidates for VBAC. We frequently hear criticisms of practice

Who’s Crazy Now? DSM-5 and the Classification of Mental Disorders

What does it mean to be crazy? We use the word loosely. In casual conversation we might say “He’s crazy” or “That’s insane!” but that doesn’t mean we really think the person is certifiable. Sometimes all it means is “He doesn’t agree with me.” What does it take to be formally diagnosed with a mental