December 20, 2024

December 19, 2024 Customer Newsletter

By Challenger Corporation · 3 minute read

cust nl dec

Doctor Sued Over Abortion Pills
Turning Patients into OUD Stats
Don't Forget to Use CME Funds
AI Outperforms Resident Physicians
Care Vs. Consumerism
Holiday Giveaway
QUIZ- Test Your Knowledge

divider winter

Texas Sues NY Doctor for Prescribing Abortion Pill by Telehealth

While not the first medical practice civil case filed across state lines since Roe v. Wade was overturned, this one is likely to be the largest. The case is being brought as a civil penalties suit and will serve as the biggest test of shield laws to date. Abortion shield laws are protective measures enacted by many states to prevent precisely this type of prosecution. Both Texas and New York have significant political stakes in the case, with New York's shield law including robust telemedicine protections.

Texas has two legal avenues: invoking extraterritorial jurisdiction (as the case involves a Texas patient) or pursuing long-arm jurisdiction, arguing that New York specifically targeted Texas—the latter being the less likely argument. If the case reaches federal court, the decision will carry significant weight. Should Texas issue a default judgment and disengage, they may score political points, but no legal precedent will be established.

Texas Sues NY Doctor for Prescribing Abortion Pill by Telehealth - MedicalXPress

Dr. Kolodny’s New Math: Turning Chronic Pain Patients into OUD Statistics

Editorial on the ongoing redefinition of Opioid Use Disorder (OUD) into ever broader categories, which now include people that are not misusing or abusing their prescriptions, but have OUD because they are still taking opioids. Also, as mentioned in the article, but without the numbers, illegal smuggling of synthetic opioids, namely fentanyl, account for 79% of all opioid overdoses in the US. This often gets kind of buried in the charts warning about the dangers of OUD.

chart for NL

Dr. Kolodny’s New Math: Turning Chronic Pain Patients into OUD Statistics - American Council on Science and Health

AI Outperforms Resident Physicians in Emergency Medicine Exams, Study Shows

This is a study from Qatar, applied across their residency population—PGY1 through PGY4. The Qatari exam consists of 150 multiple-choice questions, with 3.5 hours allotted to complete them and a passing score set at 65%.

The study highlights a common misconception about how current versions of AI, like ChatGPT (which was used in this context), operate. Large language models (LLMs) are predictive text algorithms, trained on vast amounts of material available on the internet and beyond. If you gave a high school freshman access to Google and ample time, they could also pass the exam. These AIs function as advanced search and summarization engines—exceptionally powerful ones, but still tools. While they will undoubtedly be a boon to medicine and countless other fields, the text on the screen does not mean that ChatGPT “knows medicine better than a doctor.”

For example, if you input “rlq pain, 31, f, hcg+, rebound?” into ChatGPT and ask for the top three diagnoses in probability order, it will provide the correct answers: ectopic pregnancy, ovarian torsion, and appendicitis. This does not mean it is “being a doctor.” Instead, it is predicting the typical response based on patterns it encountered during training.

These tools have enormous potential for reviewing, presenting, summarizing, and translating information. However, it is important to dispel the myth that AI is a clinical expert—because, frankly, we’re growing tired of hearing that misconception. 🙂

AI Outperforms Resident Physicians in Emergency Medicine Exams, Study Shows

Rise of Telehealth: the Blurry Line Between Care and Consumerism

A pretty good (and short) summary of the benefits and dangers of telemedicine, as currently implemented. In, believe it or not, The Teen Magazine. On the one hand, influencer advertising, direct-to-consumer sales by pharmaceutical giants. On the other, much improved access for mental health, and for routine follow for post-surgical care, and routine elder care. We’d like to have less of the first and more of the second.

The FDA is already going after influencer marketing, but hasn’t reacted much yet to the establishment of direct-to-consumer telehealth prescription services by (literally) every major pharmaceutical company.

Rise of Telehealth: the Blurry Line Between Care and Consumerism

divider winter

QUIZ QUESTION

A 30-year-old woman presents with a history of recurrent headaches of variable location

A 30-year-old woman presents with a history of recurrent headaches of variable location associated with new blurred vision and diplopia. She reports associated nausea and vomiting. She denies trauma, eye pain, photophobia, numbness, or weakness.

Her vital signs are normal. Findings on the neurologic examination are normal except for limited lateral eye movement and diplopia with horizontal gaze consistent with a sixth cranial nerve palsy. Conjunctiva is clear. Pupils are equally round and reactive to light. Visual acuity is 20/40 OD, OS, and OU.

Findings on the funduscopic examination are as shown in the image below. See Figure

Computed tomography (CT) of the brain is unremarkable.

Which test is most useful in determining the patient’s diagnosis?