2018 Medscape Articles that had the Most Impact on Physicians
A Medscape survey taken from November 20 to December 9 of this year asked the publication’s reader base questions about which stories or topics from a list Medscape “provided most inspired, excited, frustrated, or had the most impact on them.” 1789 readers responded and 1704 were physicians.
The juror defibrillation story was the top choice for stories that inspired physicians this year (52% thought it was the most inspiring). This was the report that James Lilja, MD, a San Jose, California, obstetrician/gynecologist and former drummer for the popular punk band The Offspring, performed cardiopulmonary resuscitation (CPR) on a prospective juror in the malpractice case against him. The individual had gone into cardiac arrest and collapsed during a break in the proceedings.
The story was followed by medical personnel joining the “march for our lives” to protest gun violence and call for more research on the topic, which was held in the wake of the Parkland, Florida, shooting (chosen by 50%). The march was organized by Parkland’s high school students after 17 peers lost their lives during the tragedy.
The announcement by New York University that it would offer free tuition to all current and future medical students excited them the most (54%), and this was followed by a report showing chemotherapy was found not to be needed for most patients with early breast cancer (29.8%). More attention to maternal mortality, more pressure to reform maintenance of certification, and advances in immunotherapy in oncology were also exciting pieces.
The Food and Drug Administration’s approval of the first nonopioid drug for opioid withdrawal, lofexidine hydrochloride, in May 2018, had a significant impact on physicians, exciting them. According to the federal agency, “lofexidine hydrochloride is a central alpha-2 adrenergic agonist FDA indicated for the mitigation of opioid withdrawal symptoms to facilitate abrupt opioid discontinuation in adults. It works by binding to receptors on adrenergic neurons, which decreases sympathetic tone and reduces the release of norepinephrine. This is advantageous, because chronic opioid use suppresses noradrenergic outflow and thus norepinephrine release, and during acute opioid withdrawal, adrenergic outflow being restored causes many of the symptoms associated with withdrawal, including diaphoresis, hypertension, nausea, tachycardia, and vomiting. Notably, lofexidine does not suppress psychological cravings.”
The opioid crisis, overall, frustrated readers in the medical field. The substantial increase in overdoses and the increase in suicides were the leading topics in the category of frustration, according to 56% of responders. These issues were followed by reports of drug shortages becoming an urgent public health crisis, according to a report prepared by the American Medical Association (AMA) Council on Science and Public Health. One survey respondent noted, “In the most advanced country in the world medically, it is unconscionable to think we do not have access to medicine for our patients when we need it.”
As to what topic physicians feel had the most impact and they will remember the most from 2018, opioids topped the list, with 49% indicating the story that will stick with them for a long time to come is new legislation passed to combat the opioid crisis (chosen by 48.59%), followed by the surgeon general’s recommendation that more people carry naloxone (33%).