I grew up in Maine and wicked is an adverb or adjective meaning “very” or “especially” that can be attached to almost any verb or adjective. Wicked good is by far the most prevalent use though, and so I thought I’d take a minute on what I hope you think is a wicked good health blog to talk about what I think is wicked good medical care.
Let’s talk about what would qualify a specific care as wicked good.
First it would need to have excellent evidence that it is beneficial. In this regard effective treatment of hypertension could qualify as wicked good, but pushing for a HemoglobinA1C or less than 6.5% rather than less than 7% in a diabetic wouldn’t as the evidence for significantly better outcomes is unconvincing. Second it would have to be something that is realistic to do for most or at least many patients.
For example here effective treatment of CHF with an ACE inhibitor or an ARB and a beta blocker would qualify, whereas counseling patients to lose weight by better diet and exercise wouldn’t as it is just something that seldom is successful. The third and most challenging criterion is that it needs to be applicable to a large number of patients. The more patients for whom a medical intervention can be used, the more likely it is to be wicked good medicine. Here is a list of Dr. Pullen’s wicked good medical interventions:
- Flu Shots. Cheap, safe, efficacious. Just do it.
- Aggressive treatment of hypertension. >50% of Americans develop hypertension by age 80. More effective treatment can prevent strokes, coronary deaths, and much misery.
- Beta-blockers, ACE inhibitors and Statins in post MI and coronary recanalization patients. All inexpensive, proven secondary prevention measures.
- CHF treatment with beta-blockers and an ACE or a generic ARB. Reduces hospitalizations, improves function and quality as well as length of life.
- Annual diabetic eye exams: Could nearly eliminate a leading cause of blindness in the US.
- Glaucoma screening and treatment. Get screened every 2 years after age 50. Get treatment if needed.
Stay tuned for some wicked bad options soon. Please leave a comment on the medical blog comment section so I can see what you think warrants being called wicked good medicine.
Ed Pullen, MD, is a board certified family physician practicing in Puyallup, WA. Dr. Pullen shares his viewpoints on medical news and policy from a primary care physician’s perspective at his blog, DrPullen.com.