What IBD Physicians Can Learn from Major League Baseball Managers

Nicholas V. Costrini*

What IBD Physicians Can Learn from Major League Baseball Managers

Yogi Berra philosophized, “You can observe a lot by just watching.”
Physicians managing inflammatory bowel disease 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.

Having a progressively enlarging menu of partially effective drugs is no
longer satisfactory. I give you Major League Baseball.

We appropriately view the physician’s role as that of the manager of the IBD
case and particularly as manager of the medications employed.

As an instruction, I offer what we can learn from MLB managers
as we observe the well-defined strategy in calling Starting and Relief Pitchers to the mound.

Great Pitching beats Great Hitting. Both starting and Relief Pitching are necessary.
In IBD, we have good but not great drugs at the present time.

Gastro Open J. 2019; 4(1): 7-8. doi: 10.17140/GOJ-4-130