Robert Shmerling, M.D.

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.


Posts by Robert Shmerling, M.D.

What happens when you faint?

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

About 1 in 3 people report at least one episode of fainting during their lifetime, so it’s surprising that we don’t see people fainting more often. Fainting is usually harmless, the body’s response to emotional or physical stress. But in some cases, fainting can indicate an underlying problem such as heart abnormalities or seizures. And even when the cause of fainting is not that serious, fainting that leads to a fall can cause injury.

Are protein bars really just candy bars in disguise?

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

Eating on the go can be a challenge, so many of us turn to protein meal-replacement bars, or even to the ever-popular candy bar. While the protein bars may be a little better for you in terms of the nutrients they contain, they probably do not offer any significant health benefits, and the occasional candy bar won’t hurt provided you eat a balanced diet most of the time.

The gender gap in sports injuries

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

For a variety of reasons, women are more prone to suffer many of the most common sports-related injuries than men are. This has led to some innovative approaches to prevent injuries among women in sports. Certain strategies, such as muscle conditioning, can help reduce the risk of some injuries. However, more research is needed to help close this particular gender gap.

The myth of the Hippocratic Oath

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

Many people think of the Hippocratic Oath as the embodiment of ideal medical ethics. But today, the original oath is rarely a part of the initiation of new medical students. And despite its original good intentions, it no longer offers adequate guidance for the complex scientific and ethical challenges that arise in the modern practice of medicine.

Can the weather really worsen arthritis pain?

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

Many arthritis sufferers notice a link between the weather and their symptoms. Research supports a connection, though the precise causes and effects aren’t clear. While there is little one can do to control the weather, there is a lot that can be done to relieve the pain and stiffness of arthritis. Don’t put up with arthritis symptoms in any weather — see your doctor to discuss treatment options.

Complementary therapies for neck pain

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

Neck pain is a common, and often frustrating, condition. Although there are many causes of neck pain, in many cases, it can be hard to know the exact reason for the pain. There is no one treatment that is reliably helpful, and treatments can take a long time to work. But a new study suggests that two complementary therapies — acupuncture and the Alexander Technique — may offer a way for neck pain sufferers to find genuine and lasting relief.

The placebo effect: Amazing and real

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

Many people believe that the placebo effect is solely a psychological phenomenon. But for some people, a placebo can have real, measurable therapeutic benefits. The power of the placebo effect is significant enough that it can actually skew study results. Additional research is needed to better understand how to leverage the placebo effect and when doing so might offer real benefits to patients.

Is it hard to decide about total knee replacement? Totally!

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

If arthritis in your knee means you can’t do everything you want, whether that’s walking the dog or playing a game of tennis, you may be considering a knee replacement. But are the benefits “as advertised”? A study published in The New England Journal of Medicine suggests that they may be, but it’s more important to weigh the risks and benefits with your personal preferences in mind.

First, do no harm

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

It’s a common belief that all physicians swear to uphold the Hippocratic Oath and its critical dictum, “first, do no harm.” In fact, the Hippocratic Oath doesn’t include this promise — and many fledgling doctors do not take this oath (or any oath). What’s more, “do no harm” isn’t always a realistic goal in the day-to-day practice of medicine. However, it is an important reminder that we need to learn more about the risks and benefits of any treatment, and to use this information wisely.

Sodium studies blur the picture on what is heart healthy

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

We often look to science to solve life’s difficult questions. But sometimes it hands us more uncertainty. Take three reports in today’s New England Journal of Medicine. One shows that eating less sodium (a main component of salt) could save more than a million lives a year worldwide. A second came to a nearly opposite conclusion — that current average sodium intake is okay for cardiovascular health while getting either too little or too much is a problem. The third study essentially agreed with the second, but found that getting too little potassium may be as bad as getting too much sodium. The findings are certain to fuel the already heated debate on sodium and the international efforts to get people to take in less of it. But until there are good answers to the questions raised by the studies, it’s too soon to throw out recommendations to reduce sodium intake, especially in high-risk groups. Another lesson from the three New England Journal articles worth keeping in mind: getting more potassium from fruits, vegetables, and other foods is a good way to help keep your heart and arteries healthy.