Adam Cifu+

When does shared decision-making mean recommending ineffective therapies?

What is the differential efficacy between a good treatment and a less good treatment that allows a doctor to completely forgo discussion of the inferior treatment?

Hantavirus, What You Need to Know

Public health messaging around the hantavirus cruise ship outbreak has been, ‘there is an extremely low risk to the general public,’ but this is suboptimal.

I Invented a Headache to Test AI. Here’s What I Found.

Putting AI to the test.

Evidence Appraisal Is NOT like a Rorschach Test

Let me take a break from specific study review to tell you about a comment I heard this week

Shortening Medical School Will Not Improve Medical Education

A bit of a rant

This Fortnight in Medicine XXV

Paxlovid and a Polypill

Empathy in the Age of AI

AI’s challenge to the medical profession requires us to think deeply about what it means to care for patients. The machines sound like they care. The question is whether we can help humans care for real.

Bravery (and Humility) is Needed to do Proper Medical Science

Hundreds of thousands of knee arthroscopic meniscus repairs are done. At a cost of $10,000 per surgery. Now let me tell you about the FIDELITY trial follow-up at 10 years.

Welcome Back Vinay Prasad

A reflection on four years of Sensible Medicine and what is ahead for SM 3.0

How to Avoid Giving a Crap Lecture

‘No Way To Prevent This,’ Says Only Nation Where This Regularly Happens

“It’s in the new guidelines” does not always mean it’s time to change practice.

A primary care physician’s case for critical engagement with clinical practice guidelines

Nirmatrelvir for Vaccinated or Unvaccinated Adult Outpatients with Covid-19

It's mid 2026 and NEJM publishes another decidedly negative Paxlovid trial. A couple of lessons emerge: one about evidence expiration dates and the other about incentives to delay trial publication

“Doc, I got a MyChart alert that I am due for an RSV vaccine, can I get it today?”

How should a doctor respond? An essay and a poll.

This Fortnight in Medicine XXIV

The RSV vaccine and the treatment of intermediate-risk pulmonary embolism

Behind the Magic

When Medical AI Gets the Wrong Answer

The Hubris of Screening for Disease -- Again

JAMA has published an eye-opening analysis of colorectal screening in Veterans. Why doctors cannot see the obvious message continues to surprise me

Long COVID. Alzheimer’s. You Choose.

She had diagnosed herself by the time I saw her.

Private-Mini-Memorials

All that I miss about the lives of my patients

An observational study for left atrial appendage closure supports CLOSURE AF data

Spring weather and travel attacked Sensible Medicine this week.

Reckoning With COVID

Reflections on the Six-Year Anniversary of the COVID Outbreak in New York City

Guidelines, Evidence-based Medicine, and the Practice of Medicine

A meandering meditation on the flaws of guidelines and how evidence often barely affects practice

This Fortnight in Medicine XXIII

Listen now | Dengue Suppression by Male Wolbachia-Infected Mosquitoes

The Illusion of Progression-Free Survival

We want patients to live longer and/or better, and if that’s not the case, keep “First, do no Harm” in mind.

At ACC26, the HI-PEITHO Trial is in a Photo-Finish for Greatest Spin

Pulmonary embolism is a life-threatening condition that often requires more than anticoagulation. Invasive therapies hold promise but must be held to rigorous standards

A Referendum on the Self: On Entering the Medical Profession

I could have been a much better pre-med. But I don’t think it would have made me a better doctor.