Pillcheck

Eliminate the guesswork 🧬 and get on the right medication 💊 the first time. Pillcheck combines DNA analysis with #telemedicine by expert pharmacists.

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Medications work differently for everyone. 🏹 https://t.co/AgsWdrYO7b

[Heart Surgeon Dr. Philip Ovadia @ifixhearts]

The hopeful part:
Insulin resistance is highly reversible with the right nutrition and lifestyle changes. Inflammation drops dramatically when you fix metabolism. Imaging lets you actually track whether you’re making progress — not just chasing numbers.
Many people can stabilize plaque and dramatically lower their real risk.
You don’t have to wait for symptoms or surgery.
7/8

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How safe are ADHD medications for children? Balancing the benefits and health risks
https://t.co/lyi4ofsB3r

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Two nuns could have identical brain damage on autopsy. 1 would have lived her last years confused, lost. The other lucid and intact. only meaningful difference? depth of the cognitive and emotional architecture each had built across the decades before the damage arrived.

[Nicholas Fabiano, MD @NTFabiano]

Being optimistic is associated with a lower risk of dementia.

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Genetics, endometriosis and mental health: There is a strong link between genetic predisposition to endometriosis and mental health issues. https://t.co/Iryri3dNaT

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Antidepressants come in many different types, and they can have unique impacts on an individual’s sexual health and well-being. Using pharmacogenetics, DNA testing can help identify which medications are the best fit for you personally. https://t.co/xaY7zRXOxr

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Antidepressants and sexual health - How pharmacogenetics can help find the right medication for you https://t.co/CsazHKnfe4

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What is the one orientation question your patients almost never get a clear answer to before they leave the room?
🎯

[Kevin Pho, M.D. @kevinmd]

Medicine has quietly confused two very different things: closing a chart and finishing a visit.

Alan P. Feren, MD watched what happens in the gap between them. His mother-in-law came in with a very high white blood cell count and walked out with one word: cancer. The cancer did not kill her. The visit did.

The diagnosis was a very early form of chronic lymphocytic leukemia. Asymptomatic. Slowly progressive. The textbook approach is watch and wait, with targeted treatment only when the disease starts moving. None of that crossed the room. She left the office with one word and went home to die from a disease she could have lived with for years.

He calls this unfinishedness. It is the gap between administrative closure and clinical closure. The chart says the encounter is complete. The patient does not know what is most likely, what has been reasonably excluded, what would change the plan, or who to call if something shifts.

Most physicians have been the doctor on both sides of that gap. We have all walked out of a busy day and felt the small uneasy thought that one of those visits did not actually finish. It is not because we did not care. It is because the system pays for documentation, not for orientation. The after-visit summary is a legal artifact. It is not a treatment plan a frightened person can repeat back to you in their own words.

Feren has been clear about what his family carried out of that office. "Both my wife and I feel that there was an error in not giving the diagnosis in a way that showed the clinical rationale." Not a malpractice error. A communication error that the chart did not record and the law does not name. It is the kind of error that does not show up in any quality metric we currently measure, and it is the kind of error that quietly kills people who were never supposed to die.

Feren's prescription is structural, not sentimental. Before a patient leaves the room, they should be able to answer five things. What is most likely. What has been reasonably excluded. What remains possible. What would change the plan. Who to call if something changes. If they cannot answer all five, the visit is not finished. Charting it as finished does not make it finished.

I am writing this for the physician who has felt that uneasiness at the end of a long day and wondered whether the case was actually closed. The answer is usually: not yet.

Listen to the full conversation on The Podcast by KevinMD. Link in the replies.

What is the one orientation question your patients almost never get a clear answer to before they leave the room?

#PhysicianCommunication #ThePodcastbyKevinMD

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The single strongest predictor of who would be happy, healthy, and mentally sharp at 80 was the depth and quality of their close relationships. who had at least one person they could call in the middle of the night were measurably healthier 30 years later.

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How cholesterol-lowering medications and precision medicine improve psoriasis treatment
https://t.co/LENGEMOxur

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How do we know that cholesterol-lowering medications are effective for psoriasis?
https://t.co/fAPMrzrKpN

[Eric Topol @EricTopol]

The new issue of Daedalus, the open-access Journal of the American Academy of Arts and Sciences, is chock full of good material on AI. w/@demishassabis @ylecun @alondra @pushmeet and so many others
I wrote about the future of AI-facilitated medicine
https://t.co/UMPKLcpuq5

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Red flags: Should you consider genetic testing before anesthesia?
https://t.co/eYxUdFq0io

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https://t.co/4EHIETRC4B Have you or anyone in your family experienced complications from medical anesthesia? Overall, estimated rates of perioperative complications from anesthesia are between 3% to 16% dependant on a variety of factors.

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@NightShiftMD Here is personalized approach on tapering, taking genetics into the account https://t.co/lOjjuW4TSm

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Discuss recent medication changes with your pharmacist, as some supplements and medicines can influence antidepressant levels in your blood and lead to a setback.

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https://t.co/lOjjuW4TSm

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•Withdrawal symptoms occur in almost half of people when they stop an antidepressant.
•The higher the dose and the longer the treatment duration, the greater the risk of withdrawal symptoms during standard tapering.

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@FarewellSSRI Going slow is smart 🎯How can you reduce the risk and severity of antidepressant withdrawal symptoms? Here is a review how to Decide on a tapering strategy: https://t.co/8UrbXEZSbg

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@AliBeckZeck @FarewellSSRI Consider a personalized approach: https://t.co/lOjjuW4TSm A pharmacogenetic profile could assist your doctor and pharmacist in assessing your risk of withdrawal, which is higher for people with altered metabolism (i.e., for fast or slow metabolizers)