To the Editor: I am writing to express my gratitude for the insightful article "2023 Update in ambulatory general internal medicine" by Jason T. Alexander, MD, and colleagues 1 published in the January 2024 issue of the Journal.The authors have succinctly addressed the challenges faced by internists practicing ambulatory medicine, emphasizing the overwhelming nature of managing acute concerns, chronic medical problems, and disease prevention within time-pressure constraints. Their review of 5 signifi cant studies from 2022 and 2023 covering chronic kidney disease, secondary cardiovascular disease, kidney stones, obesity, and lipid management provides valuable insights for the ambulatory medical community.The discussion about the use of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, specifi cally em-