https://paulnystrom.com/tags/big-medicine/Recent content in Big Medicine on Paul NystromHugoen-usThu, 26 Feb 2026 00:00:00 +0000https://paulnystrom.com/posts/doing-less/Thu, 26 Feb 2026 00:00:00 +0000https://paulnystrom.com/posts/doing-less/<p>My only incentive to do less for a patient is because it’s the right thing to do.</p> <p>A common example is upper abdominal pain most likely from severe gastritis or acid reflux. Patients just can’t believe that their stomach hurts that badly from something like that. They often have a history of acid reflux, but this episode feels different to them. It is lasting longer than usual or is more severe.</p>https://paulnystrom.com/posts/acute-and-next-steps/Sat, 13 Dec 2025 00:00:00 +0000https://paulnystrom.com/posts/acute-and-next-steps/<p>There are many times in the ER when I see a patient and have to pause the conversation to break it into two very distinct parts: the acute problem and the chronic problem. It may not always be a truly chronic condition, so perhaps a better way to frame it is the acute problem and the “next steps” problem.</p> <p>During a shift, I saw two patients with debilitating chronic pain.</p>