If Goldilocks Had a Thermometer

Engaging The Patient

Guest Contributor: Corey A. Siegel, MD, MS – Director,  Inflammatory Bowel Disease (IBD) Center, Dartmouth-Hitchcock Medical Center

siegel Corey Siegel

We always want to get it right the first time when treating patients, but the truth is this is difficult. When there is uncertainty of disease course and prognosis, multiple treatment options, and variable responses to therapy this becomes even more challenging. Our typical strategy to making it “just right” isn’t too different from Goldilocks. We have mild treatments (too cold), and aggressive treatments (too hot), and even in the face of ambiguity, we need to start somewhere. This “trial and error” medicine can work, but we need to do better when the stakes are high, disease pace is rapid, and cost-effectiveness a major factor.

With chronic disease this is particularly hard. As a provider, when I meet a patient late in the course of their disease it is easy to…

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