I’ve got a good story for you. One that goes back to the early days of this blog, a time when I wrote about cycling. It turns out that the biggest medical news thus far in 2016 has a connection, albeit slight, to the recent doping news out of Belgium. You’ve heard the news from […]
Category: General Medicine
I’ve never been more concerned about the harms of healthcare. Any exposure to the health care system can get you in trouble. It’s especially scary when healthy people enter the system–often in the name of prevention. Remember that the most likely outcome of a medical intervention in a person without complaints is harm. How can […]
The purpose of this post is to introduce my latest column on Medscape, which is linked at the end. You might wonder why an electrophysiologist is interested in cancer screening. I am interested because it may be one of Medicine’s largest reversals. A reversal happens when something (testing or treatment) doctors did, and patients accepted, […]
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 […]
I’ve never been more convinced that the ease with which knowledge is shared in the digital age is a force for good. I loved the video below. These two guys read conclusions of medical studies for humor. That’s a good one. James McCormack is a pharmacist, professor, medication mythbuster, and healthy skeptic at the Faculty […]
Hundreds of thousands of people have undergone surgery or stents to “fix” blockages in their carotid arteries. (The left and right carotids are the main arteries to the brain.) Most of the these people (about 90%) reported no complaints. We say they are asymptomatic. The blockages were discovered on exam or by ultrasound of the […]
One of the most common reasons people require medical care is their medical care. This is a distinctly modern problem. In times past, doctors treated disease. Patients saw their doctor when they were sick. They had a problem; doctors offered help. The doctor of today often improves health by removing healthcare. It’s one of my […]
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 […]
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 […]