What You Should Know: The Pros and Cons of Medical Marijuana

What You Should Know is an ongoing series covering a range of informational topics relevant to current and future healthcare professionals.
The numbers alone make it a significant issue: as of 2015, 23 states and the District of Columbia have legalized the use of medical marijuana – and 9 more states are currently working on legislation to do the same. Two more states – Washington and Colorado – have gone so far as to legalize its recreational use. It is likely, therefore, that medical students today will feel the effects of medical marijuana use when they go into practice for themselves.
Medical – and recreational – marijuana use is a complex issue with medical, political, and social implications. Below are evidence-based arguments for and against this use to give student doctors the opportunity to understand the finer points of this controversy.

Read more

The Fatal Failings of Evidence Based Medicine

The medical system (and much of the culture) these days is focused on group outcomes, not individuals. Personally, I think that stinks.
In medicine, this failing comes from improper use of what was originally a good idea—evidenced based medicine (EBM). EBM was developed to help overcome anecdotal medicine, in which a seemingly successful therapy in one patient gets adopted by a physician as the “way to go” and then preached to his trainees as the management of choice, and over time becomes unexamined gospel. “Anecdote-based medicine” is a form of groupthink, and groupthink is bad in general and particularly bad for the patient sitting in front of us on an exam table.
There needed to be some way to help doctors realize that an individual patient response is not generalizable to others.
EBM evaluates groups of patients to determine statistical responses to interventions. It was created (initially) to help doctors determine whether an intervention is likely to work in an individual patient. In that way, it was originally kind of the obverse of anecdotal medicine.

Read more

20 Questions: John Hunt, MD, Peds Pulmonology/Allergy/Immunology

John Hunt, MD is a pediatric pulmonologist/allergist/immunologist from Charlottesville, VA. He received his bachelor’s degree from Amherst College before going on to George Washington University School of Medicine, where he earned his MD. He served in the Medical Corps with the US Naval Reserve from 1992-2003. During that time he completed his residency in pediatrics at the San Diego Naval Medical Center, and two fellowships at the University of Virginia, one in Allergy and Immunology and one in Pediatric Pulmonology. Since then he served in a number of roles, from professor at the University of Virginia to entrepreneur to researcher to author.
1. When did you first decide to become a physician? Why?
Throughout my childhood I had bad asthma and my pediatrician was wonderful so I decided by fourth grade to be a pediatrician. By 9th grade, I was cured of that desire because there was no way in hell I was going to put up with all the years of school needed to become a doctor. I didn’t even consider medicine again until my college senior year, during which I decided to be a surgeon. But somehow, in the end of it all I grew up into a pediatric asthma specialist. My wonderful childhood pediatrician quit medicine to open a chocolate factory.
2. What surprised you most about your medical studies?
That the premedical work was pretty much unnecessary, and that I was very glad that I studied in college all sorts of broad liberal arts as opposed to wasting excessive time with undergraduate chemistry and biology. You learn what you need to in medical school and then in residency, and then in fellowship and then every day through a medical career. So, take as few pre-med courses as you can and don’t waste your valuable college education being a pre-med major. There is so much to learn in college that will help you be a better doctor that has nothing to do with chemistry and biology.

Read more