What IBD Physicians Can Learn from Major League Baseball Managers

Abstract

Yogi Berra philosophized, “You can observe a lot by just watching.”
Physicians managing inflammatory bowel disease (IBD) patients
are constantly exposed to the recent literature, the visiting
pharmaceutical representatives, and to the valuable presentations
by the academic experts at the annual meetings. In my opinion,
these presentations too often are advanced in a vacuum of unconvincing
compartmentalization rather than as a well-choreographed
management strategy that considers both the impact of any IBD
drug and the nearly certain likelihood of a patient’s failed response
or eventual relapse. Stated another way, what is most often missed,
only mentioned as an aside, and almost never clearly defined is
an agent’s place within the context of management of the entire
course of the disease. Twenty years into the new century with the
current and evolving list of IBD drugs, it would be valuable to
much more often and with authority present specific management
algorithms that offer the highest likelihood of remission.1,2 Having
a progressively enlarging menu of partially effective drugs is no
longer satisfactory. I give you Major League Baseball (MLB).