Should the patient really get the drug?

I recently gave a lecture to 70 primary care physicians here in Stockholm, titled “should the patient really get the drug?”. The lecture seemed to generate quite a bit of cognitive dissonance among some in the audience, based on the somewhat aggressive discussion that followed the lecture, which suggests to me that much of what I was saying was stuff they had literally never been … Read more

Bisphosphonates: pros and cons

Bisphosphonates are one of the most commonly prescribed drug classes. Their intended purpose is to strengthen bones, and thereby prevent fractures. They are primarily prescribed to postmenopausal women with evidence of bone thinning, either because a bone scan has shown that they have a weak skeleton, or because they’ve experienced a fracture from relatively low energy trauma. Examples of drugs in this class are alendronate, … Read more

What defines a good drug?

Most people will naturally assume that when a doctor prescribes them a drug, it’s because the doctor thinks they will receive a meaningful benefit from it. Most people have never heard the term NNT, which stands for Number Needed to Treat, or to put it another way, the number of people who need to take a drug for one person to see a noticeable benefit. … Read more

Why sleeping pills are a bad idea

I hate sleeping pills. I really hate them. The negative emotional response I get when I see them in a patient’s chart is much stronger than what I feel when I see pretty much any other drug. In particular, there is one class of sleeping pill that I really hate, and that is the weirdly named “nonbenzodiazepine”, which is basically a benzodiazepine (a highly addictive … Read more

Is insulin life-saving for type 2 diabetics?

There are two diseases that share the name “diabetes mellitus”. This is unfortunate, because the diseases have very little in common, except for the fact that both are associated with high levels of glucose in the blood stream. Type 1 diabetes is an auto-immune disease, in which the immune system destroys the insulin producing cells that reside in the pancreas. Type 1 diabetics quickly die … Read more

Non-specific vaccine effects, with Dr. Christine Stabell Benn

Christine Stabell Benn is a physician, a professor at the University of Southern Denmark, and a vaccine researcher with almost thirty years of experience in the field. The focus of her research is non-specific vaccine effects, i.e. all those other effects, both positive and negative, that vaccines have on our immune systems and overall health, beyond their very specific ability to protect against one infectious … Read more