Sensible Medicine

This Fortnight in Medicine XXIII

08 Apr 2026

Contributed by Lukas

Dengue Suppression by Male Wolbachia-Infected Mosquitoes* World Mosquito ProgramAntibiotic Therapy for Uncomplicated Acute Appendicitis This is a publ...

This Fortnight in Medicine XXII

24 Mar 2026

Contributed by Lukas

* Glucagon-like peptide-1 receptor agonists and risk of substance use disorders among US veterans with type 2 diabetes: cohort study* Immediate or Def...

This Fortnight in Medicine XXI

11 Mar 2026

Contributed by Lukas

Sodium Correction Rates and Associated Outcomes Among Patients With Severe Hyponatremia: A Retrospective Cohort Study* A Randomized Trial of Targeted ...

Going Beyond "AI in Medicine"

04 Mar 2026

Contributed by Lukas

Most conversations about “AI in Medicine” bore me. I think this is because either we lack the imagination to consider how AI will change medicine ...

This Fortnight in Medicine XX

25 Feb 2026

Contributed by Lukas

High-Dose Influenza Vaccine Effectiveness against Hospitalization in Older Adults* High-Dose Influenza Vaccine to Reduce Hospitalizations* Efficacy of...

Alternative Modalities for Breast Cancer Screening

18 Feb 2026

Contributed by Lukas

Today on the podcast, I am joined by Dr. Jennifer Rusiecki. Dr. Rusiecki is an Associate Professor of Medicine at the University of Chicago. She is th...

This Fortnight in Medicine XIX

11 Feb 2026

Contributed by Lukas

A Conservative Dialysis Strategy and Kidney Function Recovery in Dialysis-Requiring Acute Kidney Injury: The Liberation From Acute Dialysis (LIBERATE-...

This Fortnight in Medicine XVIII

28 Jan 2026

Contributed by Lukas

No video this week — we had a bit of a computer meltdown — but two interesting articles.As always, thanks for listening. If you have articles you ...

Friday Reflection 56: Comments that Stuck

23 Jan 2026

Contributed by Lukas

In a lifetime of possible memories, only some are accessible. There are a few comments — made by mentors, co-residents, and patients — that have l...

When to treat (or not treat) a high cholesterol

18 Jan 2026

Contributed by Lukas

I was shocked at the comments on this post. Many people, some of them I know to be smart, thought I was nuts for suggesting two middle-aged women who ...

This Fortnight in Medicine XVII

14 Jan 2026

Contributed by Lukas

Medical Management and Revascularization for Asymptomatic Carotid StenosisVagus nerve-mediated neuroimmune modulation for rheumatoid arthritis: a pivo...

This Fortnight in Medicine XVI

31 Dec 2025

Contributed by Lukas

We try to answer the remainder of your AUA questions. We will be back in the new year with more article discussions!Here are a few of the things we re...

This Fortnight in Medicine XI

17 Dec 2025

Contributed by Lukas

We cover questions from Amy J, Benjamin Hourani, Diana Stiles Friou, Chris Costas, Errol Laurie, Jim Healthy, Elizabeth Fama, Never Dull, Rod Rodrigue...

This Fortnight in Medicine XIV

03 Dec 2025

Contributed by Lukas

Vascular and inflammatory diseases after COVID-19 infection and vaccination in children and young people in England: a retrospective, population-based...

This Fortnight in Medicine XIII

19 Nov 2025

Contributed by Lukas

European Study of Prostate Cancer Screening — 23-Year Follow-upAssociation Between Baseline Diastolic Blood Pressure and the Efficacy of Intensive v...

This Fortnight in Medicine XII

05 Nov 2025

Contributed by Lukas

Effects of Intensive Blood Pressure Control in Patients With Frailty: A Post Hoc Analysis From ESPRIT* Lowering systolic blood pressure to less than 1...

This Fortnight in Medicine XI

22 Oct 2025

Contributed by Lukas

Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults* The Ideal Cholesterol Level ... Depend...

This Fortnight in Medicine X

08 Oct 2025

Contributed by Lukas

Two papers this week, with a bunch of articles that we referenced in the conversation. Also, the last Fortnight podcast was accidentally posted behind...

This Fortnight in Medicine IX

24 Sep 2025

Contributed by Lukas

We go all observational this week. A look at data suggesting the safety of GLP-1s and a re-examination of data on patient/doctor race concordance/disc...

Friday Reflection 53: Eradicating the Very Important Patient from the Medical Ecosystem

19 Sep 2025

Contributed by Lukas

NT is a 55-year-old man admitted to the general medicine service with cellulitis of his left leg. When the attending sees him the morning after admiss...

Friday Reflection 52: The Three Worst Phone Calls of My Career

12 Sep 2025

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

This Fortnight in Medicine VIII

10 Sep 2025

Contributed by Lukas

Last week, John was at the European Society of Cardiology conference in Madrid, and Adam was at the Preventing Overdiagnosis 2025 International Confer...

This Fortnight in Medicine VII

27 Aug 2025

Contributed by Lukas

Metformin for Treatment of Knee Osteoarthritis in Patients With Overweight or ObesityOnce-Weekly Semaglutide in Persons with Obesity and Knee Osteoart...

Friday Reflection 50: The Look

15 Aug 2025

Contributed by Lukas

TR is a 72-year-old woman, a retired executive, who had been in excellent health until she began experiencing exertional dyspnea and palpitations. Aft...

This Fortnight in Medicine VI

13 Aug 2025

Contributed by Lukas

A “manel” reviewing trials and studies that explore the benefits and harms of hormone replacement therapy.The Women’s Health Initiative* Risks a...

This Fortnight in Medicine V

30 Jul 2025

Contributed by Lukas

Primary Articles* As-Needed Albuterol–Budesonide in Mild Asthma* Early versus Later Anticoagulation for Stroke with Atrial FibrillationReferenced Ar...

This Fortnight in Medicine IV

16 Jul 2025

Contributed by Lukas

Primary articles discussed:* First myocardial infarction: risk factors, symptoms, and medical therapy* Oral vs Extended-Release Injectable Naltrexone ...

Friday Reflection 49: The Patients of 12 Reisman

11 Jul 2025

Contributed by Lukas

A visit brings back the memories of patients and the lessons they taught. This is a public episode. If you'd like to discuss this with other subscribe...

This Fortnight in Medicine III

02 Jul 2025

Contributed by Lukas

No association between preprocedural fasting and witnessed pulmonary aspiration: A systematic review and meta-analysisHere are a couple of other older...

This Fortnight in Medicine II

18 Jun 2025

Contributed by Lukas

This Substack is reader-supported. If you appreciate our work, consider becoming a free or paid subscriber.Clinical Validation of a Circulating Tumor ...

This Fortnight in Medicine

04 Jun 2025

Contributed by Lukas

We are beginning a new series today. John and Adam will discuss a couple of articles we found interesting. Please let us know your thoughts. This week...

Ask Us Anything

17 May 2025

Contributed by Lukas

This is a long one! 83 minutes. This is the second podcast in which we answer questions from a our “ask us anything” post. We recorded this one be...

Vinay at FDA; what's next for Sensible Medicine; ask us anything answers

08 May 2025

Contributed by Lukas

John and Adam discuss our hopes for Vinay’s tenure at the FDA and how we intend to keep Sensible Medicine a vibrant place on Substack, a place where...

Friday Reflection 48: Linguistics, Diagnosis, and Medical Error

07 Mar 2025

Contributed by Lukas

FH is a 66-year-old woman who comes in for an urgent visit because she has been feeling woozy for two days. She is very anxious, almost distraught, be...

A Conversation with Professor Jeffrey Flier Regarding Changes in NIH Funding

08 Feb 2025

Contributed by Lukas

Professor Jeffrey Flier is a distinguished service professor and Higginson Professor of Physiology and Medicine at Harvard Medical School. He is the f...

RFK Jr hearings/ Eulogy Values & NIH delays

04 Feb 2025

Contributed by Lukas

We are back with a riveting discussion This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes,...

A Conversation with Michael Easter from the TWO/PERCENT

25 Jan 2025

Contributed by Lukas

I recently recorded a conversation with Michael Easter from the TWO/PERCENT, a Substack and podcast. Michael offers “practical, accurate, and useful...

Friday Reflection 47: Patients Make the Hardest Decisions

10 Jan 2025

Contributed by Lukas

Doctors often get credit (or blame) for having to make difficult, life-and-death decisions. But really, it is all of us, when we are patients, who ma...

A conversation with Margaret McCartney, MD, PhD regarding evidence-based medicine and conflicts of interest

08 Jan 2025

Contributed by Lukas

I have long followed the work of Dr. Margaret McCartney. She is a general practitioner in Glasgow, Scotland, writer, public speaker, and now PhD. She ...

UCSF hematology oncology interest group

29 Dec 2024

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Adam Cifu Interviewed by Michael Easter on the TWO/PERCENT Substack and Podcast

17 Dec 2024

Contributed by Lukas

I had the pleasure of being interviewed by Michael Easter. Michael is behind the TWO/PERCENT Substack where he offers “practical, accurate, and usef...

A live taping from Wash U, a Sensible Medicine discussion

07 Dec 2024

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

MAHA and Medical Conservatism

14 Nov 2024

Contributed by Lukas

What does our philosophy have to do with RFK Jr and MAHA? This is a public episode. If you'd like to discuss this with other subscribers or get access...

Systematic reviews 101

13 Nov 2024

Contributed by Lukas

4 mistakes people make in systematic reviews This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus epi...

Ask me anything

31 Oct 2024

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Friday Reflection 45: Patients

25 Oct 2024

Contributed by Lukas

The woman with palpitations.The man with whom you used to joke and trade barbs who now sits silently, absent, while you talk to his wife.The woman who...

Sensible medicine ask us anything part 2

24 Oct 2024

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Ask us anything podcast

17 Oct 2024

Contributed by Lukas

This podcast is one of three we will be posting to answer the questions that came to us in response to this post. We had a nice set of questions so we...

Back to Sleep Series in Audio Format

15 Sep 2024

Contributed by Lukas

I learned a lot from Elizabeth Fama’s multipart series on the back-to-sleep recommendation for infants. She agreed to put the entire series into an ...

Friday Reflection 44: Diagnostic Enigma

13 Sep 2024

Contributed by Lukas

Ask general internists what they love about their field, and they are likely to talk about long-term relationships with patients and the pleasure of s...

How can we do better as a county hospital?

31 Aug 2024

Contributed by Lukas

My lecture to the cancer care staff at a county hospital. This is a public episode. If you'd like to discuss this with other subscribers or get acces...

Friday Reflection 43: The Absence of Reassuring Counterfactuals in Clinical Medicine

30 Aug 2024

Contributed by Lukas

Even when a decision is clear, and things turn out badly, the lack of a counterfactual allows endless second guessing. This is a public episode. If yo...

What Medical School Looks For and What Medical School Should Look For

29 Aug 2024

Contributed by Lukas

I discuss how medical students are selected, and perhaps how they should be selected. This is a public episode. If you'd like to discuss this with ot...

The Retirement of Dr. Mark Siegler

26 Jul 2024

Contributed by Lukas

Remarks about a model clinician. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit...

Friday Reflection 42: Patient Approaches to a Doctor’s Visit

19 Jul 2024

Contributed by Lukas

It would be foolish to argue that doctors are unaffected by how they are treated by patients. Their treatment may not affect the care they deliver and...

A Discussion with Professor Venk Murthy on Coronary Artery Disease

26 Jun 2024

Contributed by Lukas

When I type the words coronary artery disease I bet that you picture angiograms with stenotic lesions—blockages in colloquial language. Indeed a hig...

Impella, Mammograms and Med School Fails Students

26 Jun 2024

Contributed by Lukas

VP fixed the audio This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-...

Fear and Opioids in Academic Medicine

21 Jun 2024

Contributed by Lukas

Regard for power implies disregard for those without power; part 3 This is a public episode. If you'd like to discuss this with other subscribers or g...

A discussion with interventional cardiologist Dr David Cohen on medical evidence, TAVR and stroke prevention

16 Jun 2024

Contributed by Lukas

David Cohen is one of the smartest docs on Twitter. I learned a bunch talking with him. The procedure called transcatheter aortic valve implantation o...

Adam and I discuss the week's medical news

30 May 2024

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Cifu, Prasad, Mandrola

27 May 2024

Contributed by Lukas

A spirited discussion of craziness in medicine This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus e...

Friday Reflection #39: What to Expect When You Are Aging

17 May 2024

Contributed by Lukas

MM is 94 years old. Her only active medical issues are hypertension and vitamin D deficiency. She takes only 20 mg of lisinopril and 1000 units of vit...

A Novel Approach to AF Ablation

16 May 2024

Contributed by Lukas

A few short words about our conversation: Two decades have passed and electrophysiologists have learned little about how to ablate atrial fibrillation...

Video version of our podcast

11 May 2024

Contributed by Lukas

We discuss the state of medical education, Harvard music video, causal language at JAMA and more This is a public episode. If you'd like to discuss th...

Cifu, Mandrola, Prasad

10 May 2024

Contributed by Lukas

Video will be available to paid subscribers This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus epis...

A Discussion with Dr. Dena Zeraatkar regarding analytic flexibility in observational studies

30 Apr 2024

Contributed by Lukas

Gosh was this a great conversation about her recent paper on specification curve analysis of nutritional observational studies. Here is Dr. Zeraatkar’...

Friday Reflection 38: Yesterday’s Solutions; Today’s Problems

12 Apr 2024

Contributed by Lukas

The Thomas Sowell quote, “On closer scrutiny, it turns out that many of today's problems are a result of yesterday's solutions” has been ringing i...

Yet Another Excellent Explainer About P-Values in Randomized Trials

04 Apr 2024

Contributed by Lukas

Gosh was I lucky to speak with Professor Erik Van Zwet from Leiden University in the Netherlands. He is the first author on a recent NEJM Evidence pap...

Friday Reflection 37: Why I Teach (acceptable and less acceptable reasons)

08 Mar 2024

Contributed by Lukas

Why have I been committed to medical education? Some of the reasons are admirable but not terribly novel. Others are a bit hard to admit, but just as ...

Friday Reflection 36: Why Don’t Doctors Want to See Patients?

02 Feb 2024

Contributed by Lukas

Friday Reflection 35: Why Don’t Doctors Want to See Patients?I was asked “Why is it that doctors don’t want to see patients?” and I could not ...

New Austrian Study Shows Boosters do NOT reduce COVID19 deaths in people who had COVID

25 Jan 2024

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Math Professor Ben Recht and I Discuss P-values and Confidence Intervals

18 Jan 2024

Contributed by Lukas

Ben Recht is a professor at UC Berkeley. You know, the place that has all those parking spaces for the Nobel laureates. He understands the innards of ...

A discussion with the primary investigator of the world's first placebo-controlled AF ablation trial

22 Dec 2023

Contributed by Lukas

As many of you know, I have long argued (unsuccessfully until now) for a placebo-controlled trial of AF ablation. One group gets the ablation; the oth...

Mandrola and Prasad are back

17 Dec 2023

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Mandrola and Prasad are back

17 Dec 2023

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Friday Reflection 35: Four Who Fired Me

15 Dec 2023

Contributed by Lukas

These patients did the right thing leaving my care. We were wrong for each other, or I had given what I had to offer (at the time) and it was not enou...

Friday Reflection 32: The Trauma of Not Dying Alone

03 Nov 2023

Contributed by Lukas

They say dying alone is sad. They also say we all die alone. There is trauma to not dying alone as well.  This is a public episode. If you'd like to ...

Soren Diederichsen on Atrial Fibrillation Screening

01 Nov 2023

Contributed by Lukas

If you care about AF you will love this conversation. Soren has some interesting ideas about what AF is now vs what AF was in the past. Here are some ...

Andrew Foy has a Different Conclusion on a Big JAMA paper on CV risk reduction

23 Oct 2023

Contributed by Lukas

The study in question is a randomized clinical trial looking at the Million Hearts Model. This model paid health care organizations to assess and redu...

Friday Reflection 31: Senses, Memories, and Medicine

20 Oct 2023

Contributed by Lukas

Friday Reflection 31: Senses, Memories, and MedicineMedical training introduced me to a whole menu of smells -- both diagnostic tools and reminders of...

Sudden cardiac death and arrhythmias in athletes

18 Oct 2023

Contributed by Lukas

Sudden cardiac death due to ventricular rhythm disturbances are rare but highly public. It’s strange and curious because you don’t expect healthy ...

Prasad's lecture gets cancelled/ Cifu Gets COVID

16 Oct 2023

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

New Podcast -- Discussion with Rita Redberg and Angela Lu regarding Their Study on Conflict of Interest

05 Oct 2023

Contributed by Lukas

Angela Lu is training to be a physician. She’s interested in public policy. As a third year medical student, she teamed up with established leaders ...

Foy and Mandrola Talk Coronary Calcium and a New Super-Exciting Approach to Medical Education

27 Sep 2023

Contributed by Lukas

Andrew Foy rejoins the Sensible Medicine podcast. We talk first about coronary artery calcium. Andrew is an expert in this area. We have co-written ou...

Foy and Mandrola Discuss AF, AF-Ablation, Sham-controls, Evidence Translation and Heterogenous Treatment Effects

19 Sep 2023

Contributed by Lukas

This week, I talk with Andrew Foy, who is an academic cardiologist at Penn State University in Hershey, PA. Andrew is one of the smartest voices in me...

Coumadin beats DOAC, ECMO fails, When RCTs needed, Bad COVID Policy

11 Sep 2023

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Friday Reflection 29: The Totally Predictable Doctor as Patient Essay

08 Sep 2023

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Sensible Medicine x Vaccine Curious: Tracy Beth Høeg and Christine Stabell Benn compare US & Danish COVID-19 response and child vaccination policy

29 Aug 2023

Contributed by Lukas

Sensible MedicineSensible Medicine x Vaccine Curious Cross Podcast on the USA vs Denmark, vaccines, etc:Show notes by Dovid Y Rimmer, Tracy Beth Høeg...

Friday Reflection 28: Four of the Things Patients Have Taught Me

25 Aug 2023

Contributed by Lukas

Although it is unoriginal to point out that doctors learn from our patients, here are a few lessons so powerful, so extrapolatable, that I forever ass...

Mandrola & Prasad on Republicans and COVID outcomes, Journals and stenting

23 Aug 2023

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

A Conversation with Professor Robert Yeh

20 Aug 2023

Contributed by Lukas

Here is the profile for Harvard Professor Robert (Bobby) Yeh. His most recent Circulation paper: Bringing the Credibility Revolution to Observational ...

Friday Reflection 27: The Poor Historian

11 Aug 2023

Contributed by Lukas

BW was a 66-year-old woman who presented for an urgent visit to the general medicine clinic. She reported that she had been having dizziness for the l...

Friday Reflection #26: General Internal Medicine in the Time of COVID

28 Jul 2023

Contributed by Lukas

There is something valuable about learning to adapt old skills to novel situations. This is a public episode. If you'd like to discuss this with other...

Podcast discussion on Nutrition Science, HFpEF and the NYT article on treatment of PAD

27 Jul 2023

Contributed by Lukas

Adam and I discuss three topics I) The MIND Trial published in NEJM. Does a special diet reduce the future risk of cognitive decline?II) HFpEF — I a...

Friday Reflection 25: The Advice I’d Like to Give a Student Entering Medical School

14 Jul 2023

Contributed by Lukas

Four pieces of advice nobody asked for.  This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episod...

Friday Reflection 24: I Would Rather Go Back in Time

30 Jun 2023

Contributed by Lukas

KW was a 58-year-old man with long standing type 1 diabetes mellitus and hypertension. He came to an appointment one Friday afternoon with chest pain....

Sensible medicine

28 Jun 2023

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Friday Reflection 23: The Ghost Patient Panel

16 Jun 2023

Contributed by Lukas

This ghost panel is made up of people who used to be my patients but no longer are — people who left my practice without telling me.  This is a pub...

Medical Conservatism, the ELAN Trial, and Residents Striking

13 Jun 2023

Contributed by Lukas

Links The Case for Being a Medical Conservative https://www.amjmed.com/article/S0002-9343(19)30167-6/fulltextELAN Trial https://www.nejm.org/doi/full...

Medical Evidence, Hype, Cancer Drugs, Conflict

05 Jun 2023

Contributed by Lukas

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe