You cannot dispute the warning of England’s chief medical officer, Sally Davies, that antibiotic resistance is one of modern health’s greatest threats. Also beyond dispute is her analysis of its causes—the lack of new drugs combined with massive overuse of existing antibiotics. What physicians and policy makers generally overlook, however, is the critical role played by the ongoing overuse of a...

BACKGROUND Little epidemiological information exists on overuse injuries in elite road cyclists. Anecdotal reports indicate anterior knee pain and lower back pain may be common problems. PURPOSE This study was conducted to register overuse injuries among professional road cyclists with special focus on anterior knee and lower back pain. STUDY DESIGN Descriptive epidemiology study. METHODS...

BACKGROUND Given the rising costs of health care, policymakers are increasingly interested in identifying the inefficiencies in our health care system. The objective of this study was to determine whether the overuse and misuse of health care services in the ambulatory setting has decreased in the past decade. METHODS Cross-sectional analysis of the 1999 and 2009 National Ambulatory Medical C...

A columnist at theNew York Times asked readers, “Have you experiencedtoomuchmedicine?”Shereceivedmorethan1000 responses detailing examples ranging fromunnecessary testing and hospitalizations to useless office visits and specialist referrals.1 Patients are not the only ones worried about too muchmedicine: 42%of anational sampleofprimary carephysicians believe that patients in their own practice...

Physeal injuries are common and are crucial to recognize, as morbidity and the sequelae of missed physeal injury are not easily remedied. Trauma, both acute and chronic, is by far the most common cause of physeal injury. While acute traumatic events may result in physeal damage, chronic lowgrade trauma such as in overuse injuries can also injure the vulnerable growth plate. With increasing yout...

BACKGROUND Overuse of short-acting beta-agonists (SABA) is described in asthma, but little is known about overuse of SABA in chronic obstructive pulmonary disease (COPD). METHODS Prospective 3-month cohort study of patients with moderate-to-severe COPD who were provided a portable electronic inhaler sensor to monitor daily SABA use. Subjects wore a pedometer for 3 seven-day periods and were a...