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It’s been a banner year for First Opinion. We published nearly 500 essays written by more than 600 authors from industry, academia, government, and private life in the United States and beyond. They took on the mundane, like the implications of the Elijah E. Cummings Lower Drug Costs Now Act (aka H.R. 3), and the fanciful, like why we need a Public Domain Day to highlight when drugs go off patent.

Authors addressed the opioid crisis, patent thickets, the personal toll imposed by drug shortages, drug costs, deaths of despair, the oxymoron of having a waiting room in an emergency department, shoddy production of generic drugs by foreign manufacturers, the burgeoning use of artificial intelligence and machine learning in new drug research and development and health care, and much, much more.

Here are the five most widely read First Opinions of 2019. If you didn’t get to read them when they first appeared, now is as good a time as any:


1. 23andMe had devastating news about my health. I wish a person had delivered it Dorothy Pomerantz thought it would be fun to have her DNA analyzed, so she sent her spit to 23andMe. A link in an email took her to the company’s website, where she learned she was at very high risk of developing breast and ovarian cancer. “I’m not the first person to get surprising and terrible news from an at-home genetic testing company. With the increasing popularity of 23andMe, and other companies like it, I won’t be the last.” But she wished she had gotten the news from a person.

2. Time in range: a new way for people with diabetes to monitor blood sugar More and more people with diabetes are using continuous glucose meters, which measure blood sugar every few minutes. That information offers a new way to evaluate how well someone is controlling his or her diabetes: time in range. The University of Washington’s Dr. Lorena Alarcon-Casas Wright explains how it works.


3. Our child received a devastating diagnosis before she was born. We decided to protect her Allison Chang learned that, at 15 weeks of gestation, her daughter had severe malformations due to trisomy 18, a deadly genetic condition. She and her husband “could not protect our daughter from trisomy 18, but we could shield her from any pain or agony that would come with it.”

4. I have spinal muscular atrophy. Critics of the $2 million new gene therapy are missing the point Nathan Yates has lived with spinal muscular atrophy for all 30 years of his life. He answers critics upset over the $2.1 million cost of Zolgensma, a new drug to treat the condition, and asks them to take into account its long-term benefits.

5. Ghost networks of psychiatrists make money for insurance companies but hinder patients’ access to care When Jack Turban started his training to become a psychiatrist, he went looking for a therapist of his own. What he found were ghost networks of mental health providers.

And here’s a bonus: Published in July 2018, the essay Physicians aren’t ‘burning out.’ They’re suffering from moral injury was the third most widely read First Opinion of 2019.

On to 2020!

  • I really can’t take one more commercial, or article about the
    ” opioid crisis”. Why haven’t I seen anything regarding the millions of people who have chronic pain and because of the first lady, I have to drive an hour to get my medicine and my doctor is fighting with the State and has paid fines so he can continue to write prescriptions to his patients in pain.
    I have been on the same dose for years and I don’t take more than prescribed. It’s the only reason I am able to go to the grocery store a few times a month. Otherwise, I have stopped my life. Medicare has capped what someone who is not in the medical field.
    Why are we being punished for people who are not sick and taking our medicine to get high.
    If you ask anyone who takes opioids legally, they will tell you, we don’t get any pleasure from our medicine.
    Most of us are barely able to function. I have to go without, so on holidays I can take enough to be able to visit with my family.
    I know soon they will stop all of the pharmacies and I have researched how to end my life.
    This is the crisis. Not medicine that helps people who are in constant pain have a small amount of life.
    My parents both had high blood pressure and had to take medicine daily, so I don’t know how they’re not considered addict’s?
    Anyone who depends on medication on a daily basis is addicted, but I guarantee you will never see them cut off from the only thing keeping them alive.
    The worst part? Not once, did anyone consider what we would take to replace our pain meds.
    We’re just being treated like trash.
    I asked my doctor what can I take?
    He doesn’t have an answer.
    I have been treated like a criminal for the past three years when I walk into the pharmacy.
    It’s hard enough to be in constant pain, but now we are labeled addict’s.
    I am counting my day’s, and now my son has my disease. I worry about him and what he will do when he can no longer stand.

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