2022 in review
Today’s post is a recap of my medical content from the year with a few annotations about what held up and what didn’t.
What I’ll take away from 2022
I think we’ll look back at this year as the year when obesity drugs became mainstream.
Now, I wouldn’t classify 2022 as the year when I started to appreciate the impact, and I have the receipts to prove it, since I wrote about semaglutide (Ozempic) in April of 2021:
But this is the year that they entered the zeitgeist in a way that stuck.
Eric Topol took notice. So did Derek Thompson. So did Elon Musk:
And New York Magazine wrote an exaggerated piece on the nausea that some folks experience on these drugs.
I wrote about Mounjaro (tirzepatide) earlier this year, which I think will be the biggest blockbuster drug in history, since it’s more effective than Ozempic and has a lower incidence of side effects.
Some other stuff I was up to this year:
Podcasts
The Lipid Panel Reimagined - this is a podcast I worked on about a better way to interpret a lipid panel.
I covered some of the content in the newsletter, when I wrote about why most doctors interpret the lipid panel incorrectly.
This podcast covered the way that a lipid panel gives us insight into our own heart disease risk and how I would make it better.
Aspirin for primary prevention - a podcast asking the question, “should you be taking an aspirin to prevent a heart attack?”
The quick summary: aspirin has a small benefit in reducing the likelihood that someone will have a first heart attack or a first stroke.
The art of medicine - and the content of this podcast - is to decide who should be on aspirin and who shouldn’t.
5 Pearls on Guideline Directed Medical Therapy in Heart Failure - a discussion about the nuances of how you get patients with heart failure on the right medications.
This goes into more depth than most of you would probably be interested in, but I really enjoyed talking about the nuances of these drugs in a lot of detail
A Dose of Mentoring and Resilience - a discussion of mentoring in the medical field.
If you haven’t listened to the AugMentors podcast, I’d highly recommend it for insights into human connection and well being.
For anyone who works in an organization of any size, there’s practical info delivered in a humble and authentic package.
Newsletter
I covered a lot of things on this newsletter that I’m really proud of this year. Here are a few of the highlights:
Heart disease:
Most doctors don’t interpret a lipid panel correctly - this was (by far) my most popular post in the history of the newsletter that led to the most views and the most new subscribers.
Screening for heart disease saves lives - a look at a study out of Denmark that suggests we should be doing more population based screening for heart disease
Statins are better than you think they are - the internet’s most hated drug class is actually pretty spectacular if you actually read the data and understand the biology of heart disease
The best tool to prevent heart disease is a polypill - a combination of low doses of different medications all put into one pill markedly lowers heart disease risk
The Impella cardiac pump is amazing when it works and catastrophic when it doesn’t. And no one knows whether it saves lives despite the fact that we spend billions of dollars on it.
The less well known heart disease risk factors - a post looking at the shortcomings of the way we estimate heart disease risk and the individual factors that you need to be aware of that increase your own risk (which your doctor may not be thinking about when counseling you).
Go get your Lp(a) checked - the title here says it all
General medicine:
The biggest waste of time in medicine: preop testing. A look at the absurd theater of preoperative medical clearance. Probably my favorite article of the year.
Taking your health literally but not seriously. A look at the way that too many people want to major in the minor when it comes to their health - an obsessive focus on every little weird sensation or perceived risk without a willingness to change their obesogenic environment or prioritize sleep and exercise
The Medical-Pharmaceutical-Agricultural Complex - big business wants you to be fat, sick, and medicated. No one has an incentive for you to be healthy. And no one is looking out for you here. So you need to be your own advocate.
Supplements:
A critical look at vitamin D supplementation - no one has ever done a study looking at whether fixing vitamin D deficiency makes important health outcomes better. But the absence of a signal that vitamin D supplements have that much impact make me question their widespread use:
Fish oil - the more I get into it, the less I feel like I know.
Thank you all for reading and supporting the newsletter throughout the year.
I have some big plans and ideas for 2023, and I hope that you’ll continue to read, share, and support this newsletter.