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Authors found that in 23.6% of a random sample of 2,809 admissions, there were at least one adverse event. 316 of the 978 adverse events were classified as having a significant or higher severity level, and 222 were deemed to be preventable. In 6.8% of all admissions, an adverse event that could have been avoided happened, and in 1% of those cases, the incident had a serious or higher severity rating. Seven people passed away, one of which was thought to be avoidable. The most frequent adverse events (representing 39.0% of all occurrences) were adverse medication events, which were followed by surgical or other procedural events (30.4%), patient-care events (15.0%), and infections related to medical care (11.9%).

Who is at fault when the patient is injured when only partially following the doctor’s orders regarding limiting activity? The doctor hadn’t discussed all the potential adverse effects (e.g. dizziness and fainting) from medical therapy but had warned the patient to strictly moderate their activity level. Read the case and the court ruling.

Today’s understanding is that “pimping” on rounds and similar tactics tend to inhibit rather than promote learning. Yet residents and fellows, and to a lesser extent medical students, continue to complain of demeaning interactions in medical learning environments. Icahn School of Medicine instituted a system to take in reports of such behavior in an attempt to improve the educational environment there. In their model, the instructor is informed that an individual perceived a degrading interaction. The purpose is to allow the instructor to be aware and make changes as needed. But institutions who want to follow the example of the school need to be prepared to allocate the needed resources to do this follow up if the system is to have any benefit.

Given the global shortage of nirmatrelvir–ritonavir for COVID, alternative antivirals are in demand. This phase 3 randomized trial compared VV116 to nirmatrelvir–ritonavir for adults with mild-to-moderate COVID-19 at risk for progression. The trial was conducted during Omicron strain prevalence (B.1.1.529). Time to clinical recovery was 4 days with VV116 versus 5 days with nirmatrelvir–ritonavir. AEs were seen in 67.4% and 77.3% of the VV116 nirmatrelvir–ritonavir groups, respectively.

Monty Python fans may benefit from more than just a healthy laugh. These authors rigorously studied the impact on VO2 and energy expenditure of 3 different walking styles: normal gait, “Putey” walk, and teabag walk. Their findings might change how you think about your daily stroll.

What’s expected for medical practice in 2023? Worker shortages will persist, with the biggest gaps being nonprofessional staff. Shortages will drive competition to attract even workers with entry-level skills, which will generate wage increases and turmoil as workers move to take advantage of better offers. Wage and goods inflation will continue to press on profits. The move to value-based fee structures will increase. And there will likely be a focus on better integrating merged organizations instead of the prior frenetic acquisition land grab.