Time crunch.

It’s often said that prescribing opioids is the easy thing to do. A patient is sitting in your office in pain and desperate for you to do something, and a quick opioid prescription is both simple and likely to help the pain in some way. On the other hand, teasing out safer—and often times more effective and permanent—treatment strategies require time and critical thinking. This thought-provoking cross-sectional study including >678K primary care visits demonstrates that, as appointment times get later in the day, there is a 33% relative increase in opioid prescriptions. What’s more, there is an additional relative increase as appointments ran further behind schedule. TBL: Yet another practical study demonstrates the trade-offs between quality and quantity medicine. | Neprash, JAMA 2019