This purpose of this post is to clarify misstatements made in a recent New York Times article about the anticoagulant drug dabigatran (Pradaxa). The piece had three major inaccuracies, plus one thought-error from a cardiology leader. I write these words because the most valuable tool in the treatment of AF is knowledge. Getting it right […]
Category: Doctoring
This post is in introduction to my most recent column over at Trials and Fibrillations on Medscape | Cardiology. If I had just one thing to say to patients and doctors about the disease atrial fibrillation it would be this: Be as scared of AF treatment as you are of the disease. Yes, it is […]
The thing about US healthcare that bothers me most is the waste: the nuclear stress tests on demented patients in diapers, the MRIs for every case of back and knee pain, the egregious pre-op tests for low-risk surgeries, the mega-workups for simple cases of AF, the disease mongering in the name of prevention, and most […]
I receive many emails about AF. I don’t often answer them because it is bad practice to doctor without seeing the person. Recently, however, I received a note with more general questions. The sender suggested I could use the response as a blog post. The reason I am posting these two cases along with my […]
The good thing about vacation is that time off is essential. The bad thing is the reentry, which, lately, is harried enough to induce arrhythmia. Almost. Thankfully, I made it through the reentry week and now sit in peace on Saturday morning with my MacBook. I thought I would tell you a little about my […]
This week the New England Journal of Medicine published two studies on the role of niacin in preventing future cardiac events. The short story is that niacin was ineffective and associated with significant harm. A number of excellent summary pieces have been written, and I will reference them at the end. The purpose of writing […]
I received an interesting email this week from the American College of Cardiology. The purpose of the note was to relay the results of a survey regarding member’s views and concerns of the new changes in board certification. Before I tell you about the survey’s striking results and clear message, it’s worth reviewing the contentious […]
It’s time for another post on truth and healthcare. (This almost sounds like a good series.) I’ve recently written that the VA healthcare system represents the truth—and that Americans should get over the Pollyanna view that triage, wait lists, and taking care of increasing numbers of increasingly sick patients can be managed with magic. The […]
My mind is changing about statins. I’m growing increasingly worried about the irrational exuberance over these drugs, especially when used for prevention of heart disease that is yet to happen. An elderly patient called my office last week to tell me thank you…not for a successful procedure or surgery, but rather, for helping with a […]
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 […]
What is the greatest possible thing that could happen to you today? Is it winning a million dollars? Seeing your children smile? Going to a job you love? Perhaps it is waking up next to a spouse whom you love and is also your best friend? These are all winners, for sure. But what if […]