Once again, the Nobel prize for economics–not science and medicine–has immense influence on the practice of medicine. Every day, in fact. This year, Richard Thaler, a behavioral economist at the University of Chicago, won for his work on human biases and temptations. The famous writer Michael Lewis (Moneyball) has a nice essay on Thaler’s work […]
Category: ICD/Pacemaker
I attended the European Heart Rhythm Association meeting last week in Vienna. Here is an update on the stories I found most interesting–the ones I wrote about on the heart.org | Medscape Cardiology. Brain Lesions after AF ablation: Electrophysiologists do not talk much about the small brain lesions that appear after procedures in the left […]
Here is my most recent column on theHeart.org | Medscape Cardiology: Mandrola’s Top 10 Cardiology Stories 2015 What follows below is a short-writing summary of my ten picks. The hyperlinks go to earlier columns I wrote on the topic. 1. The FDA approved two new (injectable) cholesterol drugs. The problem with the PCSK9-inhibitors: the study […]
Right Care seeks to be smart care. In the first part of my career, I rarely looked critically at the evidence. I was too busy; and I was more trusting of the vertical hierarchy of medicine. Eminence-based medicine seemed normal. Listen to the experts, for they are experts, went my mindset. Then something happened. When […]
The current state of informed consent in the US is best described as un-informed consent. A study this May reported that only 3% of patients with coronary artery disease received full informed consent before having an invasive procedure. Findings like these, and there are many other similar studies, reflect the ill-health of the medical decision […]
I wrote yesterday about how a broken healthcare system favors overuse of procedures. Today I will discuss rational care. Remember the goals of the Lown Institute: We think healthcare should be affordable, effective, rational and available to all. Rational means in accordance with reason or logic. Hardly a day goes by that I don’t see […]
What follows is my latest post on theHeart.org | Medscape Cardiology. It’s weird; the post is one of my favorites, but it’s not made the most read list–at all, not even fifth place. There are thoughtful comments but it’s simply not popular among doctors. **** Imagine this scenario: A learned professor comes to your office […]
If there was a hashtag for sub-specialty healthcare and ICU medicine in the United States it would be: #WeCanButShouldWe A recent study led by Dr. Harlan Krumholz (Yale University) showed that we have become more efficient at keeping elders alive. This is not surprising. And it’s good news in the sense that technology–if used wisely–can […]
I recently returned home from Milan, Italy. I was covering the 2015 European Heart Rhythm Association (EHRA) sessions. My favorite part of the congress, as it always is with medical meetings, was connecting with old friends, and making new friends. I had coffee, lunch or dinner with colleagues from Australia, Netherlands, France, Italy, Belgium, Frankfurt, […]
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 […]
Hi All, Here is a short update of the past week. The first thing to say is the Atrial Fibrillation Care: Put the Catheter (and Rx Pad) Down post has gotten a lot of attention. It stayed on the most popular list all week. It has over a 130 comments, and I have received many […]