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Doctoring General Cardiology General Medicine Health Care Healthy Living

Should you get a cardiac stress test?

Heart disease remains the leading killer of humans. People want to be protected. The fast-thinking notion is early detection is good, the more knowledge, the better. I wish it were that easy. What follows is my most recent post on WebMD on the basics of cardiac stress testing: **** A middle-aged surgeon recently asked me […]

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Health Care Health Care Reform

Do not use the Surgeon Scorecard

(I have updated this post with a link below to my essay on Medscape.) No data is better than bad data. The ProPublica Surgeon Scorecard is not ready for prime time. It was a good effort. I support investigative journalism and ProPublica. We need more transparency in Medicine. I despise the utter lack of meritocracy […]

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AF ablation Atrial fibrillation Cycling Stuff Doctoring Exercise General Medicine Health Care Health Care Reform ICD/Pacemaker Reflection Social Media/Writing/Blogging

Update: Baltimore, Safety in AF ablation, Podcasts, and some personal notes

On Baltimore: Human beings rioting in the streets of an American city forced cancellation of an important cardiology meeting. This is a vivid example that doctors do not practice in a vacuum. We are connected to this world. Here in Louisville, just a few miles north, an HIV crisis runs amok because of IV drug […]

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AF ablation Doctoring General Medicine Health Care Healthy Living

Why don’t people ask their doctors more questions?

I do not get it. Day in and day out, I ask patients why they take a medicine. Many do not know. “My doctor put me on it,” goes the common response. Take statin drugs, for example. I often ask a person why they are taking the drug? With rare exception, the person says it […]

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Atrial fibrillation Doctoring General Medicine Health Care Health Care Reform Knowledge

The trick of hope — and the medical decision

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 […]

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AF ablation Atrial fibrillation Doctoring General Ablation General Cardiology General Medicine Health Care Health Care Reform Healthy Living Knowledge Social Media/Writing/Blogging

Writing update: Lown Institute Conference and ACC2015

Hi all, I have been busy in the last few weeks. Here is an update of my happenings and posts. From March 8-11, I attended and presented at the third annual Lown Institute Conference in San Diego. I have never felt more at home in a conference than I did at the Lown conference. Take […]

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AF ablation Athletic heart Atrial fibrillation Doctoring General Medicine Health Care Healthy Living Social Media/Writing/Blogging

Athletes, AF, Anticoagulants, Statins, Peanuts, and Dishwashers

Here is an update on my recent writing. Athletes and AF: I was honored to be invited back to the Western AF symposium in Park City, Utah. Last year, I presented on social media. This year, Dr. Nassir Marrouche (University of Utah) asked me to tackle the topic of atrial fibrillation in athletes. This is […]

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Doctoring Health Care Health Care Reform Knowledge

Public trust, the CDC and Tamiflu

Why do doctors lose credibility? Consider the few public doctors out there with millions of followers. The majority of the stuff they recommend is perfect: eat good food, exercise, be nice. and sleep. Check. No problem. Everyone is good with that until they shatter the sense with nonsense. One miracle cure or stupid supplement or […]

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Dabigatran/Rivaroxaban/Apixaban Doctoring Health Care Knowledge Reflection

Trust in science and medical experts

This week is a good time to talk about trust in expert opinion and science. For the past forty years, nutrition experts in the US have warned us about cholesterol and fat. Eat too much of it and it will block your arteries, was the proclamation. Americans did what the scientists and experts said. They […]

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Doctoring Health Care Knowledge

The medical decision as a gamble

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 […]

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Doctoring Health Care Healthy Living

Is healthcare careful? Is it kind?

Research now indicates 50% of middle–aged people live with one chronic disease. Translation: half of middle-aged people are not healthy. (You don’t need a reference there. Just walk out into the world and look around.) This new normal creates a challenge for caregivers. How will we care for the onslaught of chronic disease? Surely not […]