There is a lot of talk about rewarding value in US healthcare. Don’t believe any of it. It’s not happening. Not even close. This is a post about the real world–where I practice medicine. In a comment on yesterday’s post, Lisa wondered how I connected the current model of employing doctors and paying them on […]
Category: Health Care
What follows is a short intro to my latest column on theHeart.org | Medscape Cardiology. —- The title of the piece is Three Concerning Trends in the Electrophysiology Clinic. I worked on the 750-word piece the entire week. It was hard to get the tone just right. This is because the trends do not reflect […]
In July, I wrote a short blog post expressing doubt about the value of statin drugs. Medscape republished it on their website and it went viral–in a medical sort of way. The post has 631 comments. It was Tweeted extensively, page views have been off the charts (for me), and I even received an invitation […]
What follows is my most recent editorial in the Journal of the Kentucky Medical Association. It is reposted with permission. **** One day every month, my wife Staci, a hospice and palliative care physician, goes to see an elderly woman in the nursing home. The routine has gone on for years, which is surprising because […]
I was pleased when the editors of the TheHeart.org reposted my recent essay, Let’s Stop the Unnecessary Treatment of Heart Disease. As of this morning, there are 167 comments. The majority of them were positive, and supportive of lifestyle promotion. Negative comments represented a small minority, but were notable in their vigor, and occasionally reached […]
It was a mistake to send the Liberian national Thomas Eric Duncan home from a Dallas emergency room after he presented with fever and pain, which were early signs of Ebola infection. It would be a larger mistake to miss an important learning opportunity. This case demonstrates what I believe to be a major threat […]
You know the story on US healthcare and the elderly: Our current default is an American tragedy. It’s devoid of truth and candor; it’s inhumane and it’s wasteful. Recent gains in longevity have come by extending the period of disability right before death. Aggressive care treatment is often hoisted onto the frail because caregivers lack […]
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 […]
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 […]