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    Teachable Moment

    Explore this JAMA Internal Medicine series intended to educate medical trainees about the harms that result from overuse of health services.

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    • Safely Prescribing Nirmatrelvir and Ritonavir—Avoiding Drug-Drug Interactions
      JAMA Internal Medicine
      Opinion
      February 20, 2023

      This Teachable Moment discusses drug-drug interactions with nirmatrelvir and ritonavir (Paxlovid) treatment for COVID-19 and considerations when prescribing.

      Less is More Clinical Pharmacy and Pharmacology Infectious Diseases Adverse Drug Events Coronavirus (COVID-19)
      Full Text | pdf link PDF | CME & MOC is active quiz
    • Time-Limited Trials of Intensive Care Unit Care
      JAMA Internal Medicine
      Opinion
      February 13, 2023

      This Teachable Moment discusses time-limited trials, “an agreement between clinicians and a patient/family to use certain medical therapies over a defined period to see if the patient improves or deteriorates according to agreed-on clinical outcomes.”

      Critical Care Medicine Health Care Quality
      Full Text | pdf link PDF | CME & MOC is active quiz
    • Chemotherapy-Induced Peripheral Neuropathy
      JAMA Internal Medicine
      Opinion
      July 1, 2022

      This Teachable Moment describes a man in his 70s with stage III colon cancer who presented with sensory symptoms after undergoing chemotherapy and was diagnosed with chemotherapy-induced peripheral neuropathy.

      Oncology Adverse Drug Events Neurology Neuropathy
      Full Text | pdf link PDF | CME & MOC is active quiz
    • Inpatient Management of Type 2 Diabetes
      JAMA Internal Medicine
      Opinion
      May 1, 2022

      This Teachable Moment describes treatment plans that reduce the frequency of finger stick blood glucose checks for patients with type 2 diabetes.

      Less is More Nursing Diabetes Diabetes and Endocrinology
      Full Text | pdf link PDF | CME & MOC is active quiz
    • The Harms of Postoperative Antibiotic Prophylaxis: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      May 1, 2022

      This Teachable Moment describes a man in his 70s with coronary artery disease who presented to the emergency department with fever and chills and was diagnosed with Clostridium difficile infection.

      Less is More Perioperative Care and Consultation Antibiotic Use, Overuse, Resistance, Stewardship Infectious Diseases Surgery
      Full Text | pdf link PDF | CME & MOC is active quiz
    • To Restrain or Not to Restrain: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      February 1, 2022

      This teachable moment discusses issues surrounding the use of restraint in patients with delirium in the intensive care unit.

      Less is More Critical Care Medicine Geriatrics
      Full Text | pdf link PDF | CME & MOC is active quiz
    • Management of Malignant Pleural Effusions—The Effusion Strikes Back: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      February 1, 2022

      This Teachable Moment describes a 66-year-old woman with metastatic non–small cell lung cancer who was referred to the pleural clinic for a recurrent malignant pleural effusion.

      Less is More Oncology Pulmonary Medicine Lung Cancer
      Full Text | pdf link PDF | CME & MOC is active quiz
    • Considering Cannabis Use in Differential Diagnosis: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      January 1, 2022

      This Teachable Moment describes why patients with unexplained gastrointestinal symptoms should be asked about cannabis use and how considering a diagnosis of cannabis hyperemesis and withdrawal may avoid recurrent emergency visits, imaging, and hospital admissions.

      Gastroenterology Substance Use and Addiction Medicine Gastroenterology and Hepatology Pediatrics Adolescent Medicine
      Full Text | pdf link PDF | CME & MOC is active quiz
    • Addressing Biased Patient Behavior: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      December 1, 2021

      This Teachable Moment describes ways to handle biased behavior from patients.

      Equity, Diversity, and Inclusion Medical Education and Training Ethics Professional Well-being
      Full Text | pdf link PDF
    • Preoperative Stress Testing Before Elective Arthroplasty: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      December 1, 2021

      This Teachable Moment discusses the role of cardiac stress testing in patients who are undergoing total hip or knee arthroplasty.

      Less is More Cardiology Orthopedics Perioperative Care and Consultation
      Full Text | pdf link PDF
    • Reconsidering Reliance on Confirmatory Drug Testing in a Patient With Repeated Positive Urine Drug Screen Results: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      December 1, 2021

      This Teachable Moment illustrates the repercussions of misinterpreted drug testing results and advocates for reconsideration of routine urine drug screening in the absence of other indicators of relapse.

      Substance Use and Addiction Medicine Opioids
      Full Text | pdf link PDF
    • Closing the Osteoporosis Care Gap: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      December 1, 2021

      This Teachable Moment describes the lack of appropriate treatment for osteoporosis after a patient’s initial fragility fracture, which unnecessarily increases the common, costly, and morbid risks of refracture.

      Geriatrics Osteoporosis Orthopedics
      Full Text | pdf link PDF | CME & MOC is active quiz
    • Seronegative Chronic Hepatitis C Virus Infection: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      November 1, 2021

      This Teachable Moment discusses the prevalence of and recommended diagnostic testing for seronegative chronic hepatitis C virus infections.

      Less is More Infectious Diseases Viral Hepatitis Hepatitis C Hepatobiliary Disease
      Full Text | pdf link PDF | CME & MOC is active quiz
    • Electronic Health Record Interoperability—Why Electronically Discontinued Medications Are Still Dispensed
      JAMA Internal Medicine
      Opinion
      October 1, 2021

      This Teachable Moment examines electronic prescription programs used within electronic health records and pharmacy systems.

      Electronic Health Records Health Care Safety Health Care Quality Health Policy Clinical Pharmacy and Pharmacology
      Full Text | pdf link PDF | CME & MOC is active quiz
    • The Key Role of Nonpharmacologic Management of Cachexia in Persons With Advanced Illness: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      July 1, 2021

      This Teachable Moment considers the psychological distress that anorexia and/or cachexia leads to in caregivers and patients with advanced illness, and how clinicians can help without using pharmacologic management.

      Oncology End of Life
      Full Text | pdf link PDF | CME & MOC is active quiz
    • Troponin Testing in Patients With Supraventricular Tachycardia—Are We Overtesting? A Teachable Moment
      JAMA Internal Medicine
      Opinion
      June 1, 2021

      This Teachable Moment describes a man with supraventricular tachycardia who underwent troponin testing.

      Less is More Cardiology Emergency Medicine Rhythm Disorders
      Full Text | pdf link PDF
    • Rethinking Routine Peripheral Intravenous Line Placement: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      June 1, 2021

      This Teachable Moment considers the routine insertion of peripheral intravenous catheters in hospital patients given that the harms sometimes outweigh the benefits.

      Sickle Cell Disease
      Full Text | pdf link PDF | CME & MOC is active quiz
    • Avoiding a Crisis With High-Deductible Insurance Plans: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      May 1, 2021

      This Teachable Moment explores the issues associated with high-deductible insurance plans when a patient delayed diagnosis and treatment because of financial concerns.

      Health Care Economics, Insurance, Payment Health Policy
      Full Text | pdf link PDF
    • Insulin Pump Treatment for the Hospitalized Patient
      JAMA Internal Medicine
      Opinion
      May 1, 2021

      This Teachable Moment describes the necessity for clinician familiarity with insulin pumps because of their increased use among patients with type 1 diabetes.

      Clinical Pharmacy and Pharmacology Medical Devices and Equipment Diabetes Diabetes and Endocrinology
      Full Text | pdf link PDF
    • Missed Opportunity for Fall Prevention: A Teachable Moment
      JAMA Internal Medicine
      Opinion
      May 1, 2021

      This Teachable Moment discusses the experience of a 76-year-old patient with a fractured hip and a history of repeated falls and considers missed opportunities to recommend fall prevention interventions.

      Lifestyle Behaviors Physical Activity Physical Therapy Orthopedics
      Full Text | pdf link PDF | CME & MOC is active quiz
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