Author: John R. Fowler, MD


Absolute vs Relative Risk Reduction: Number Needed to Treat in Hand Surgery

I recently read Overdosed America: The Broken Promise of American Medicine by John Abramson.  The story of the COX-2 inhibitor, Vioxx, is one of the prime examples used in the book to show how pharmaceutical marketing and publication bias can result in disastrous outcomes for the public.  However, the part of the book that I found most interesting was when…

Is the Current Hand Fellowship Interview Process Broken?

Fellowship training in hand surgery has become increasingly popular, resulting in a significant number of applicants failing to obtain a fellowship position.  From 2012-2014, 25% of applicants did not match.  In 2016, there were 199 applicants for only 166 positions; this left 17% of applicants unmatched.1  This competitive environment has led to applicants applying to an increasingly larger number of…

Stop Lamenting the “80-hour Rule”

Although internal medicine programs instituted an 80-hour weekly work limit in 1989, the “80-hour” duty hour limit was formally implemented by the ACGME is 2003. The purpose of the limit was to ensure patient safety and reduce medical errors while protecting the safety of residents by preventing burnout and psychological distress.  While there is conflicting data with respect to whether…