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Health Care Reform Healthy Living Nutrition

Obesity: Finding hope in a seemingly hopeless struggle

I like positive thinking. Optimism helps keep inflammation at bay. You can’t be a heart doctor and think problems are hopeless or that bad outcomes will occur. But…I have to tell you, obesity and its flume of chronic diseases makes it tough to stay upbeat. As an office doctor, obesity frustrates; as an internationalist, working […]

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Atrial fibrillation Health Care Reform

New Post up on Trials and Fibrillations: My Choosing Wisely list for electrophysiology

In the Choosing Wisely initiative, nine medical groups have contributed their list of five misused and overused tests and treatments. Some of the highest cost-of-care groups are on board–cardiologists, oncologists, radiologists, nephrologists (kidney) and gastroenterologists. Front line doctors, like internists and family doctors, have also weighed in. Coming soon are lists of five from the […]

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Doctoring Health Care Reform Healthy Living

Good sleep and good choices

I like to tell my patients that good health, at its root, comes from just three things: good movement, good food, and good sleep. At least these are the three they can control. Good luck and good genes are beyond our control. On our Easter: The world looks and feels like a different place after […]

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Health Care Health Care Reform

“Choosing Wisely”–A great name for a great plan.

Cycling Wednesday has to be postponed this week. There is indeed a more pressing and relevant health matter that has come to light today. I am talking huge news; a story ripe with optimism and hope. Let me tell you about a possible paradigm-changing idea in the seemingly hopeless matter of controlling runaway healthcare costs—a […]

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Health Care Reform ICD/Pacemaker

When the Feds Come Knocking

Slightly over a year ago, the Department of Justice (DOJ) launched an investigation of a large number of institutions regarding concerns that implantable cardiac defibrillator (ICD) procedures were performed for reasons outside of the criteria set forth in Medicare’s National Coverage Decision (NCD). This investigation occurred just after Al-Khatib and others published a report January […]

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Atrial fibrillation Health Care Reform

How the treatment of genital warts impacted AF therapy…

I know the title sounds crazy, but this isn’t just a headline grabber. It is real. Here’s the story: Tambocor is the brand name version of the helpful AF drug, flecainide. “Flec,” as we call it, helps control AF episodes in patients with atrial fibrillation (AF) AND a structurally normal heart. Its patent long expired; […]

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Health Care Reform ICD/Pacemaker

Can heart-rhythm doctors practice parsimoniously?

Two studies published today really gave my thinking brain a workout. The first study: The prestigious medical group, the American College of Physicians (ACP) provocatively decreed, in its recent ethical guidelines, that doctors have a responsibility to use parsimony in the diagnosis and treatment of patients. As reported today on the NPR health blog, Shots, […]

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Doctoring Health Care Reform

When religion intersects healthcare reform

The gusty winds of healthcare reform have recently swept through my city, Louisville KY. Similar to what is happening across the US, hospitals in Louisville seek consolidation. Strength be in numbers and in control of patients. The problem with merging University of Louisville Hospital (public), Jewish Hospital and St Mary’s and Elizabeth Hospital (both private) […]

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Doctoring Health Care Reform

The parallax of healthcare reform: A real-life story

My last post centered upon the funny-sounding word, ‘parallax.’ I was using it to describe how middle-age athletes see their sport. But it seems to me that parallax relates to healthcare policy. First, the definition: Parallax: an apparent change in the position of an object resulting from a change in position of the observer. Here […]

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Doctoring Health Care Reform Healthy Living Knowledge

Work-life balance in Medicine–Maybe the young are on to something?

I read an interesting story about young doctors today. American Medical News reported that the changing desires of resident doctors poses recruiting challenges for practices. It’s an eye-opener–a look into the future of healthcare. It seems young docs want unusual things from their career in Medicine. The new generation of doctors seek employment, not partnership, […]

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Health Care Reform ICD/Pacemaker

A new ‘message’ on expensive medical devices: The ICD as an example

Nearly six months have passed since “emergency” meetings were called. Gosh, if I had a dollar for every emergency meeting. It’s amazing how looking back at these crises makes our angst seem silly. Like many things medical, time and deep breaths have a way of sorting things out. The latest heart-rhythm crisis centered on the […]