Primary articles discussed: * First myocardial infarction: risk factors, symptoms, and medical therapy * Oral vs Extended-Release Injectable Naltrexone for Hospitalized Patients With Alcohol Use DisorderA Randomized Clinical Trial Articles referenced: * Pharmacotherapy for Alcohol Use Disorder: A Systematic Review and Meta-Analysis * General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis This is a public episode. If you'd l...
Jul 16, 2025•36 min
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 subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe
Jul 11, 2025•11 min
No association between preprocedural fasting and witnessed pulmonary aspiration: A systematic review and meta-analysis Here are a couple of other older articles to give you the history of preprocedural fasting. Reducing the Risk of Acid Aspirations During Cesarean Section Fasting from midnight — the history behind the dogma CT Angiography, Healthy Lifestyle Behaviors, and Preventive Therapy This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus epis...
Jul 02, 2025•40 min
This Substack is reader-supported. If you appreciate our work, consider becoming a free or paid subscriber. Clinical Validation of a Circulating Tumor DNA–Based Blood Test to Screen for Colorectal Cancer If you want a deeper dive into cancer screening, we have covered the topic a lot on Sensible Medicine. There is a video debate Vinay, John, and Adam had about colon cancer screening. We also posted two follow-up articles for that debate. Adam has written six different articles about screening. T...
Jun 18, 2025•38 min
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: Phase 3 Trial of Semaglutide in Metabolic Dysfunction–Associated Steatohepatitis Tiotropium Initiation and Dementia Risk in Chronic Obstructive Pulmonary Disease 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...
Jun 04, 2025•37 min
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 before our most recent podcast — kind of like Abbey Road and Let it Be — so we were still graced by Vinay’s presence. In fact, we recorded it in his studio. We still have about a half dozen questions to answer; we will cover those on an upcoming podcast. Enjoy. This is a public episode. If you'd like to discuss this with other subscribers or get access t...
May 17, 2025•1 hr 24 min
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 we will continue to showcase a range of ideas and opinions about all things bio-medicine. We also answer some of the questions from our recent “ask us anything” post. 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...
May 08, 2025•37 min
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, because she thinks these symptoms are the same as the ones that her sister had before she died of a hemorrhagic stroke. Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber. A few years ago, a team building exercise was proposed at a meeting I was attending. To say I hate team bu...
Mar 07, 2025•7 min
Professor Jeffrey Flier is a distinguished service professor and Higginson Professor of Physiology and Medicine at Harvard Medical School. He is the former dean of Harvard Medical School. We talked about the recent (and sudden) change in NIH funding. First a note on Professor Flier. He is not a normal medical school dean. He is active online. He speaks candidly, often critically. He and Vinay wrote together in STAT news during the pandemic. It was a great honor to talk with him for 47 minutes ab...
Feb 08, 2025•47 min
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, visit www.sensible-med.com/subscribe
Feb 04, 2025•37 min
I recently recorded a conversation with Michael Easter from the TWO/PERCENT , a Substack and podcast. Michael offers “practical, accurate, and useful health, performance, and mindset information,” and in a space where there is a lot of drive, I find him remarkably thoughtful. Our conversation is on the podcast feed. Below are my notes for our conversation with links to many of the things we discussed. Adam Cifu, MD Sensible Medicine is a reader-supported publication. If you appreciate our work, ...
Jan 25, 2025•23 min
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 make the bravest decisions that carry the highest stakes. 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
Jan 10, 2025•7 min
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 is a fierce advocate for evidence-based medicine. She holds highly skeptical views of screening for disease—which, to my surprise is quite common in the UK. Her recently finished PhD sought empirical evidence regarding declaration of conflicts of interest in the UK. Here is a link to the document . Screening for atrial fibrillation is a focus of th...
Jan 08, 2025•45 min
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
Dec 29, 2024•43 min
I had the pleasure of being interviewed by Michael Easter. Michael is behind the TWO/PERCENT Substack where he offers “practical, accurate, and useful health, performance, and mindset information.” I’ve listened to, and read, a bunch of Michael’s content. Not only is it enjoyable but it seems, well, sensible. Our conversation was inspired by my Coming Out Against the Healthy Lifestyle post. I hope you enjoy our conversation and maybe find another substack to follow. Adam Cifu Sensible Medicine i...
Dec 17, 2024•39 min
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
Dec 07, 2024•45 min
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 to bonus episodes, visit www.sensible-med.com/subscribe
Nov 14, 2024•50 min
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 episodes, visit www.sensible-med.com/subscribe
Nov 13, 2024•49 min
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
Oct 31, 2024•27 min
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 whose depression dominates every visit; her depression being the one problem she refuses to address. The man whose joy and charisma makes every visit an absolute pleasure, despite his painful disability about which you can really do nothing. The man who never complains. Well, not never. The two times he did complain he ended up with emergent bypass ...
Oct 25, 2024•5 min
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
Oct 24, 2024•37 min
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 will certainly be doing it again. 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...
Oct 17, 2024•26 min
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 audio file. Here you go. JMM Sensible Medicine is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. 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...
Sep 15, 2024•1 hr 6 min
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 solving clinical puzzles. 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
Sep 13, 2024•9 min
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 access to bonus episodes, visit www.sensible-med.com/subscribe
Aug 31, 2024•42 min
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 you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe
Aug 30, 2024•6 min
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 other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe
Aug 29, 2024•29 min
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 www.sensible-med.com/subscribe
Jul 26, 2024•5 min
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 only affect how they feel at the end of the day. It is probably impossible to know. 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
Jul 19, 2024•7 min
When I type the words coronary artery disease I bet that you picture angiograms with stenotic lesions— blockages in colloquial language. Indeed a high grade plaque from atherosclerosis in the inside of a coronary artery can limit flow to the heart muscle. But. But. Not as much as you think. You know why? Because there is something called the coronary microcirculation. Before blood gets to the beating heart muscle it has to go through small blood vessels. So small that you can’t see them. A study...
Jun 26, 2024•26 min
