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AF ablation Doctoring General Cardiology ICD/Pacemaker

Day 1 ESC — Cardiac Pacing, MRIs and RV lead position

I thought I loved Germany, but this is ridiculous. I love Amsterdam! Yesterday, Michael O’Riordan and I decided to embrace the Dutch mode of transportation. Mike is a real journalist who works for theHeart.org. He’s also a fellow endurance athlete. We got off the congested tram yesterday and decided to rent bikes. This, my friends, […]

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Doctoring General Cardiology Health Care Reform Uncategorized

New post up on theHeart.org: Fee-for-service, AF treatment and the untangling of knots…

Earlier this year a famous group of researchers did a careful study on the relationship between surgical complications and hospital finances. Their findings should jolt you: The average hospital makes money when patients suffer complications from procedures. This is outrageous. It is fee-for-service at its worst. The first thought that popped into my mind after […]

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Doctoring Health Care Health Care Reform

How much sunshine is just the right amount?

This morning I awoke to a picture of myself in the Wall Street Journal. I was asked to comment on the effects of the coming Sunshine Act. Respected health care journalist Peter Loftus found me through social media channels. What follows are some thoughts about how the Sunshine Act might play out. — Every Thursday […]

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Doctoring Health Care Reform Social Media/Writing/Blogging

Eight useful tips for caregivers in a new healthcare environment — Guest post

After reporting recently on how current healthcare reform efforts are extracting humanity from the patient-caregiver interaction, I decided to review other posts I have written on the matter. I found this guest post by Dr. Edward J. Schloss (Twitter ID @EJSMD), medical director of cardiac electrophysiology at Christ Hospital in Cincinnati, OH. It was originally […]

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Doctoring Health Care Reform Reflection

The downside of racing around so fast…

Be sure: what follows are not complaints; these are just the facts. — Here’s a recent exchange from an enlightened physician leader, one who has yet to give up: “My colleagues are discouraged and frustrated every day, leaving the office defeated and fatigued. There are other ways to practice.” High healthcare costs get most of […]

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Doctoring Health Care Health Care Reform Reflection

Exhibit A on how hubris in medicine can be deadly…Let’s take a time out for skepticism

Thanks for all the support on my last post. It’s striking how sometimes pointing out the obvious gets a lot of attention. I have a quick follow-up post. The purpose is to show you a real-life and current example of how medical hubris might have killed thousands of patients. My friend and colleague, Dr. Wes […]

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Doctoring Reflection

Changing the culture of American Medicine — Start by removing hubris

This may be the most important post I have ever published. I’m going to tell you about a study that should change the entire way doctors approach patients, and how patients should think of prescribed treatments. These findings should begin a culture change in American medicine. Background: I used to think Medicine would get easier […]

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Doctoring

New post up at theHeart.org: Practice variation in cardiology signals problems

There’s a problem in the world of cardiology. We used to be leaders in the medical world. Now, I am not so sure. We may be at an inflection point. What would you think if cardiac procedures, like diagnostic catheterization and PCI (stents usually), varied widely depending on a patient’s geography or payment system? Your […]

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Doctoring Hospice/Palliative Care Reflection

Take fear and ignorance out of end-of-life decisions — A rebuttal to Dr Paul McHugh’s WSJ editorial

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 […]

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Doctoring Health Care Reform

Why shouldn’t Cardiology lead the way in shared decsion-making?

Look at this sample question from the American College of Cardiology self-assessment. Tell me whether you see the problem. (It came in a mass advertisement-email, so I don’t think it is a secret.) Sample Question A 75-year-old woman is referred to you with a murmur. She has had the murmur for many years and has […]

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Doctoring ICD/Pacemaker

New post up at theHeart.org — The ethics of ICD decision-making

I’ve got a good one for you. Who is the better doctor? Is it the caregiver who–by whatever means–gets her patient on the best treatment, or, is it the doc who communicates the options most clearly? I ask because the Institute of Medicine has made shared-decision making (or patient-centered care) a major focus of quality […]