At nearly the same time I posted yesterday, The Lancet published this editorial from Swedish epidemiologist Prof Johan Giesecke. Some excerpts: It has become clear that a hard lockdown does not protect old and frail people living in care homes—a population the lockdown was designed to protect. Neither does it decrease mortality from COVID-19, which […]
On Telehealth, an older couple asked me a tough question about COVID19. They asked whether this virus would either be gone or less dangerous in 6 months to a year. It was a curious question. I replied, Why do you ask? Doc, we have a big family with many children and grandchildren, most of whom […]
I discussed the use of hydroxychloroquine and azithromycin for patients with COVID19 on my March 27th edition of This Week in Cardiology Podcast. This is an important topic not only because of the specifics of treating patients but also vital because it shows how easily human beings can be misled. Here is a an edited […]
When my favorite podcaster, the economist Tyler Cowan, asked Dr. Ezekiel Emanuel what nonobvious advice he would give to medical students today, the answer surprised me. The famous bioethicist said: I do think that this is probably the most exciting time in American medicine in a century, since really about 1910, 1920. And it causes a […]
I received a good question(s) from a reader: In your “Changing the culture” posting there is the comment: “Patients seeking medical treatment should not assume a prescribed therapy is beneficial just because a doctor says it is.”… How then does a patient evaluate a proposed treatment in a way that they aren’t thwarting a doctor from performing what may […]
This week on my podcast, I deviated briefly from cardiology to discuss a shocking and sad study highlighting the vital nature of doing randomized controlled trials in the practice of medicine. The reason I mentioned a trial comparing 2 types of hysterectomy (removal of the uterus) in women with early stage cervical cancer was not to […]
During a recent office visit an older women recited to me what I had said to her over a decade ago on the day she came to the hospital. The detail of her memory gave me pause. I could not remember the scenario but she said that my words had become part of her family’s […]
My editors at Medscape warned me years ago that many people, especially younger ones, read a lot less. This saddened me because I’ve spent a great deal of time learning to write. One of America’s most accomplished writers, Malcolm Gladwell, began his podcast because he worried about not reaching younger people. Each week, I spend a […]
I am planning a column on the role of experts in translating medical evidence. Evidence is important because it’s how doctors know they are helping not harming people. It’s hardly news that the new (digital) democracy of information has changed the rules of influence in Medicine. In the days of old, academic doctors generated, analyzed […]
A reader asked an excellent question on my last post. Roy wondered if further research in elderly patients would identify a subset of patients that would benefit more from anti-coagulation. My answer is… not likely. The reasons involve three oft-forgotten concepts. See below. To Roy, I say it is unlikely that further research will address […]
An elderly man with atrial fibrillation (AF) asks whether to continue taking a clot-blocking drug to prevent stroke. This is the gist of a case my colleague Dr Anish Koka recently posted on Twitter. It’s a great thread. Click here to get to the discussion. The first question Anish raised was whether you would keep […]