Prophylactic Salpingectomy?

Should we perform prophylactic salpingectomy whenever possible to reduce the risk of ovarian cancer? Over the last five years, many gynecologists have made it routine practice to perform bilateral salpingectomies at the time of hysterectomy whenever possible to reduce the risk of ovarian cancer, and some have extended this to making bilateral salpingectomies their method…

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The Hippocratic Oath

NB: This is not normal howardisms fare, but I needed to put it somewhere for reference by others. Don’t feel obligated to read it unless you’re interested in the topic. The Hippocratic Oath: A Commentary and Translation Introduction The Hippocratic Oath is one of the most popular selections of ancient literature, even though the original…

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Fake News (aka, Ob/Gyn Clickbait)

I think a lot about how and where doctors get the information that informs how they practice medicine. In medical school, doctors learn information in the basic sciences that is often a few years out of date. They usually have too much belief in the principles they learn in the basic sciences, because that information…

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The Facts Speak For Themselves

I recently went to an ACOG-endorsed educational activity in Washington DC. The speaker, from a nearby local university, fancied himself an expert on the subject matter. The subject matter itself is quite controversial, so his opinions about it are not the opinions of all experts. At one point, he presented two papers which disagreed with his…

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Is Howard Lazy?

It’s the third week of February, and prior to today, there were only three new posts on howardisms (there are two new posts today, of course). This led a few readers to question whether I was alive. One just assumed I was lazy. Anyway, just to let those concerned readers know, I have been doing…

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Four Types of Physicians

Some people are just overwhelmed by the idea of evidence-based medicine. They notice two themes when reading about EBM: 1) a lot of what we do is wrong, and 2) getting the right answer requires a lot of work. We know that “half of what physicians do is wrong,” and “less than 20 percent of what…

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Bed Rest

It’s amazing to me that this is something still worth writing about, but unfortunately obstetricians and high-risk OB specialists around the country continue to use and prescribe bed rest or activity restriction to treat various conditions of pregnancy, including preterm labor, premature rupture of membranes, placental abruption, preeclampsia, threatened abortion, intrauterine growth restriction, oligohydramnios, multiple…

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Unintended Consequences

We all know the story of the Titanic, at least everyone who has seen the movie – which I think is everyone. The boat carried 2,224 passengers and crew but only had lifeboats for 1,178 people. Of course, the ship sank after hitting an iceberg and as you might predict from this mismatch, 1,514 people toied….

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