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Top 10 Things We Should Stop Doing

Mark A Graber, MD and Paul Simmons, MD
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Do you like our “Things I do, but should I?” series? Keeping with this spirit, Paul Simmons and Dr. Mark Graber hone in on the top 10 things we should all STOP doing in clinical practice based on the most recent evidence.

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Ian L., Dr -

Paracetamol was not that great for severe acute back pain which is completly expected but for chronic low intensity pain say 3 -4 out of ten many general practitioners find it is of value particularly paracetamol extended release . It was only one trial an Australian Trial and needs repeating . What is true is that physical therapies stretching abdominal muscle strengthening might also help and this ought be mentioned .

Ian L., Dr -

Further in the paper paracetamol helped with postoperative pain and tooth pain so its failure with all back pain is hard to believe .

Stacy D. -

5. Stop worrying about medication expiration dates.

Does this pertain to OTC meds as well? And how about meds in a liquid suspension, such as pepto. Tobrex, etc.

Thank you!

SLD

Neda F., MD -

Hi Stacy! Here is Paul's response: "Yes, OTC are included so long as they’re tablets or capsules. Expiration dates are less clear with suspensions, liquids, or even topicals. Not a lot of data here, but at the very least they’re likely active well past the expiration date and they’ll become ineffective, not toxic."

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Hippo Primary Care Written Summary June 2021 250 KB - PDF

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