My latest column over at theHeart.org discusses the disordered balance of power in the doctor-patient relationship. As most of you know, I harbor strong biases about the quality of medical decisions, especially in the elderly. Attached. Yes, I am attached to the issue of decision quality. Nearly all of electrophysiology, and much of cardiology, involves […]
Category: ICD/Pacemaker
What follows is a guest post from Dr. J Rod Gimbel, a cardiac electrophysiologist from Knoxville, TN. Dr. Gimbel has written extensively on the issue of electronic surveillance systems and electromagnetic interference (EMI) with cardiac implantable electronic devices, such as pacemakers and defibrillators. **** I’d like to express my appreciation for allowing me to guest […]
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 […]
Hey Everyone, I recently returned from the Heart Rhythm Society meeting in San Francisco. I attended the meeting as both a physician-journalist-columnist for theHeart.org and as a practicing electrophysiologist. As it so often is with international meetings, I returned energized and rejuvenated about the practice of medicine. Medical meetings are great this way. It’s quite […]
One of the definitions of the noun steward is a person whose responsibility it is to take care of something. Wikipedia calls stewardship an “ethic that embodies the responsible planning and management of resources.” These apply well to cardiologists–who use powerful (and expensive) tools in the care of fellow humankind. The internal cardiac defibrillator, or […]
Last night my Twitter stream lit up with the news that NHL player Rich Peverley collapsed from a heart arrhythmia. Fortunately, he was successfully treated, and is reported to be in good condition. Here is a link to the best story I could find. It sounds awfully significant. [Dr.] Salazar said of the treatment, “We […]
The Choosing Wisely campaign began in 2009 when the American Board of Internal Medicine (ABIM) Foundation invited medical societies to own their role as “stewards of finite healthcare resources.” The movement aims to promote care that is supported by evidence, not duplicative, free from harm and truly necessary. That sounds delightful, and I wrote enthusiastically […]
The purpose of this post is to clarify important issues about cardiac devices as they relate to deactivation. As I wrote yesterday, Paula Span of the NY Times covered this important issue earlier this week. Her coverage came about because of this Mayo Clinic paper published in JAMA-IM, which showed most patients with cardiac devices […]
The news came via a direct message on Twitter. “You got a plug in the NY times. Congrats.” (Thanks Dr. Jay Schloss.) Paula Span, author of the NY Times’ The New Old Age Blog, reported today on the issue of cardiac device deactivation in patients who are approaching end of life. The role I had […]
I’m going to be proud for a moment. Yesterday, the journal JAMA-Internal Medicine published an invited commentary that I co-wrote with Dr. Dan Matlock (@Dan_Matlock) from the University of Colorado. The title of the piece is The Antidote for Unprepared Patients — A Caring Clinician. It’s available for free. Invited editorials in medical journals are often […]
Just a few weeks before the 2013 American Heart Association Sessions, Shelley Wood, the managing news editor of theheart.org emailed to ask if I was up for going to the meeting. With trips to San Francisco, Denver, Athens and Amsterdam already in the books this year, I had counted 2013 as a win. I was […]