What follows is my latest post on theHeart.org | Medscape Cardiology. It’s weird; the post is one of my favorites, but it’s not made the most read list–at all, not even fifth place. There are thoughtful comments but it’s simply not popular among doctors. **** Imagine this scenario: A learned professor comes to your office […]
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Last night, during the intro show for the PBS documentary, Cancer: The Emperor of All Maladies, a Ken Burns film based on the book by Siddhartha Mukherjee, Katie Couric interviews both Ken Burns and Dr. Mukherjee. The moment occurred about 10 minutes into the video. There is a poignant scene in which two young parents […]
The medical decision–to have a screening mammogram, to take warfarin, to undergo a catheter ablation–is, at its core, a gamble. We pit the treasure of the win (benefit) against the pain of the loss (harm). In times past, medical gambles were easier. You took the antibiotic or you lost your leg. Most medical decisions today […]
Maybe you wonder why a cardiologist writes about vaccines and mammography. It is because I have grown intensely interested in the medical decision. As a doctor in a preference-sensitive field, electrophysiology, how do I help patients understand and choose the best path–of which there are many. This seems like a simple task, but with humans, […]
This is a very short story about a baby bird, a yoga mom and a hawk. I tell it because it made me think about the disordered way we frame healthcare decisions. **** The neighborhood is one of old brick houses, cracked cement sidewalks and tall trees. What was once a suburb is now a […]
How do doctors decide on treatments? How do you decide? And yes, you should decide! What inputs go into making this important decision? Let me make it simple. Basically, there are only four. (As they say in the Hamburg EP lab…â€It’s easy.â€) First, since I am an older doctor, I’ll start with… Risks: In deciding […]
This post introduces a column I wrote over at TheHeart.org | Medscape Cardiology — The good news is that most people infected with coronavirus don’t need a hospital or doctor. But some do. Some get very ill. The maddening thing is that doctors don’t have an effective treatment for the virus. There are no cures. […]
In my last post, I wrote my initial thoughts of an important new study on how the decision to take a medication or have a screening test in the name of prevention is similar to playing the lottery. I promised to think and write about the study more carefully. My latest thoughts are now published […]
Everyone agrees that doctors should be informed and up-to-date. Perpetual medical education has always been a vital component of doctoring. But now, as the rapid pace of healthcare innovation pushes against the limits of biology, and really, our humanity, medical education gains even more importance. Doctors (and patients) must know what can and cannot be […]
I’m going to be proud for a moment. Yesterday, the journal JAMA-Internal Medicine published an invited commentary that I co-wrote with Dr. Dan Matlock (@Dan_Matlock) from the University of Colorado. The title of the piece is The Antidote for Unprepared Patients — A Caring Clinician. It’s available for free. Invited editorials in medical journals are often […]
Perhaps it’s because I love the practice of medicine so much. Or maybe it’s because doctors (and teachers) have always been my heroes. I’m trying to sort out why I feel so offended by Dr. Paul McHugh’s editorial in the Wall Street Journal last weekend. His sensational and paternalistic view of physician-assisted suicide can be […]