practice of medicine changes little but over 5 years there is a revolution. The 2023 edition of Conn’s Current Therapy may prove

the first half of this principle to be wrong.

The pace of change and imperative to adapt in health care has

been breathtaking during each of the last 3 years. As one pundit

put it, “the winds of change are blowing so hard, one must have

nerves of steel . . . just to maintain balance.” Perhaps no other condition has forced us to alter our traditional ways of practice more

than COVID-19. Over 6.5 million people have died worldwide

from COVID-19, with more than 1 million dead in the United

States since the onset of the pandemic 3 years ago. The long-term

complications associated with COVID-19 are uncertain. Novel

vaccinations and treatment options are now available, though we

remain challenged by the emergence of new variants and a significant number (one out of six) of US citizens who have not received

a single COVID-19 vaccination.

Who could have predicted the downstream effects of COVID19? The virus has stimulated the use of telemedicine, insurance

coverage for telemedicine services, sales of medical masks and

other personal protective equipment, virtual meetings, and care

of patients in medical office parking lots. Downstream effects of

the pandemic have led to supply chain shortages of a variety of

medications used in everyday practice and a shortage of health

care workers. Physicians report increased levels of burnout and

job dissatisfaction, which were already at epidemic rates prior to

COVID-19. Physicians and other health care professionals have

not been immune to The Great Retirement.

The pandemic has laid bare the depth of systemic health

inequalities that have been just below the surface of the U.S.

health care system. The pandemic has made it clear that primary

care and public health are under-resourced, undervalued, and

underappreciated, though both are foundational to a health care

system that functions effectively, efficiently, and equitably.

Now, monkeypox and a possible resurgence of polio are at the

doorstep.

That’s not all. The rate of chronic disease remains inordinately

high and continues to increase. The prevalence of obesity in the

United States is now more than 40%, resulting in an increase in

heart disease, stroke, type 2 diabetes and certain types of cancer.

All are among the leading causes of preventable, premature death.

Rates of hypertension, lipid disorders, obstructive sleep apnea,

fatty liver disease, degenerative joint disease, and depression are

downstream effects of the obesity epidemic.

Let’s not forget that the opioid epidemic is worse now than

before the worldwide COVID-19 outbreak. It has been pushed

off the front page of the newspaper and news media websites by

the pandemic. In 2021, there were more than 100,000 drug overdose deaths in the United States.

In 2020, the average life expectancy in the United States

declined by well over a year, the first time it has decreased in

modern times. Some say that today’s children will have shorter

average life spans than their parents. Others say that due to new

medications and technological advances, today’s children will live

longer than their parents and spend their senior years in poor

health burdened by multiple chronic conditions.

The authors of Conn’s Current Therapy 2023 have responded

to the challenge of change in clinical care by reviewing each

chapter of the textbook and updating and rewriting whenever

necessary. For example, the book has chapters on COVID-19,

long-COVID, and multisystem inflammatory syndrome in children (MIS-C), which detail the most current thinking in the management of these conditions. New information about the genetics

of pheochromocytoma, hemochromatosis, and many cancers are

examples of how the Human Genome Project is affecting our

management of disease and our thinking about who is at risk. A

detailed chapter on the care of adult patients with type 2 diabetes

outlines the management of a too-common disease that is, in general, poorly controlled despite an abundance of drug treatment

options.

A new section of the book titled “Emerging Therapies” has

been added to this edition of Conn’s Current Therapy. Our goal

is to help practicing physicians better organize their thinking

about an amazing array of new therapies that were only figments

of the imagination in the not-too-distant past. Monoclonal antibody, genetic, and stem cell therapies are included in this section.

We recognize that the title of this section is a little bit of a misnomer because many of these therapies have already emerged. When

appropriate, authors have updated their individual chapters to

include the use of these therapies in their area of expertise.

This is the 75th year in a row that Conn’s Current Therapy has

been published. It is one of the longest-running continuously published textbooks in world history. Until now, there have only been

five editors: Howard Conn, MD; Bob Rakel, MD; Ed Bope, MD;

Rick Kellerman, MD; and David Rakel MD. This year, we welcome two additional editors: Joel Heidelbaugh, MD, and Ernestine Lee, MD, MPH. Dr. Heidelbaugh and Dr. Lee have already

put their stamp on the history of Conn’s Current Therapy.

Miriam Chan, PharmD, is an indispensable member of the editorial team. Dr. Chan reviews each and every drug mentioned in

the textbook for FDA approval status and dosing instructions.

Dr. Chan is also a direct contributor to the text as a co-author of

the chapter on drug hypersensitivity reactions and the appendix

on popular herbs and nutritional supplements.

Two individuals who help us “keep the trains running on time”

are Katie DeFrancesco, Senior Content Development Manager,

and Kevin Travers, Content Development Specialist. Kevin joined

us this year and immediately fit into the “Conn’s culture.” You

might ask, What does a Content Development Specialist do?

Imagine organizing a textbook that is totally updated each year

with 335 chapters, 1500+ pages, and more than 500 authors during an annual 8-month publication window. The job was particularly difficult this year as a supply-chain shortage of paper

(another downstream effect of COVID-19) forced us to move the

final deadline to have all chapters ready for publication up by 2

months. The medical editors communicate with either Katie or

Kevin almost every day and they are dedicated, organized, skilled,

and fun to work with.

The leader of the team is Charlotta “Lotta” Kryhl, Senior

Content Specialist. Lotta offers sage advice and counsel about

the direction of the book. She listens well during editorial team

discussions and updates us about the larger concerns in the

Preface

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publication industry. She helps us monitor data on electronic

chapter utilization. She manages all the higher-level aspects of the

publication, ensuring that all contracts are finalized.

Doug Turner, Senior Project Manager, goes to work during the

final stages of production when the book is ready for hard-copy

and electronic publication. He works with Renee Duenow, Senior

Book Designer, on all aspects of the layout, front cover, and back

cover design.

There are multiple copyeditors around the world who help us

with Conn’s Current Therapy. We respect and appreciate their

mastery of language, spelling, phrasing, grammar, and punctuation, especially because of the technical nature of medical

writing.

Thank you to each and every one who contributes to the production of this amazing publication.

We dedicate Conn’s Current Therapy 2023 to the doctors,

nurses, and other health care professionals on the frontlines of

the COVID-19 pandemic. They have literally put their own lives

and health on the line, focused their work on the care of patients

and families, and sacrificed their own family and personal time

.and energy to care for others