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Doctoring Health Care Health Care Reform

Missing the first US Ebola case – A learning opportunity in patient safety and caregiver distraction

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 […]

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AF ablation Doctoring Exercise General Medicine Healthy Living Nutrition

Let’s stop the unnecessary treatment of heart disease

There are many reasons doctors suffer from burnout and compassion fatigue. One of the least-mentioned of these reasons is that much of what we do is so damn unnecessary. In the US, the land of excess everything, caregivers, especially cardiologists, spend most of our time treating human beings that didn’t need to have disease. Let’s […]

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Atrial fibrillation

Less is more in atrial fibrillation stroke prevention — please, drop the aspirin

A recent study in the Journal of the American College of Cardiology shed more light on the commonly used drug combination of aspirin and a vitamin-K antagonist (such as warfarin).  It was a small registry study from one region of France but I believe it offered confirmatory evidence against this dangerous practice. Investigators followed patients […]

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Doctoring General Medicine Healthy Living Knowledge

Vaccine anxiety… A teachable moment for doctors?

I’ve read and re-read Dr. Paul Offit’s WSJ opinion piece, The Anti-Vaccination Epidemic. Dr. Offit is a professor of Pediatrics at a leading hospital in the United States. He is also an author, a scientist, and a vaccine-developer. In short, he is a major physician leader. I’ll come back to that point in just a […]

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Doctoring Health Care Health Care Reform Healthy Living Hospice/Palliative Care

New post up on theHeart.org — Dr Emanuel’s Death Wish Harms Rather Than Helps

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 […]

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Cycling Stuff Cycling Wed Doctoring Healthy Living Hospice/Palliative Care Knowledge

Guest post — 10 observations from a 49 year-old falls risk.

It finally happened. After years of sitting at John’s bedside through multiple serious bike crashes, I had one of my own. I’ve had plenty of time to build up a ridiculous amount of smugness about why he crashes and I don’t. “John is reckless; Staci is cautious. John rides like an airplane engine on a […]

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Cycling Stuff Cycling Wed Cyclocross General Medicine Reflection

Observations from being “the family.”

It’s been a trying week for our family. You learn things when your people need healthcare. It’s an entirely different perspective. I am doctor; I’ve been a patient, but this was the first time being “the family.” Without going into details, (see her guest post), my wife Staci came to need the best that American […]

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Doctoring General Medicine Hospice/Palliative Care Knowledge

Death-denial is something doctors can change

I’m not sure why so many doctors don’t get it. Death, that is. Where in medical school, or residency, or even in non-medical life, did this many smart people get the idea that death is optional? Theresa Brown is an oncology nurse and a writer. This weekend, her regular column in the New York Times […]

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AF ablation Atrial fibrillation Doctoring General Cardiology Social Media/Writing/Blogging

Review of the 2014 ESC Sessions in Barcelona

Hey Everyone, It’s been a few days since I returned home from Spain. The jet leg has resolved and normal sleep patterns have returned. I’ve had time to review the entire ESC program book. What follows is a review of my work and some notes on the past week in Barcelona. The first thing to […]

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General Cardiology Social Media/Writing/Blogging

On the eve of ESC 2014 — Barcelona Spain

The 2014 European Society of Cardiology Congress begins tomorrow in Barcelona, Spain. I’m here with my colleagues from the theheart.org Medscape | Cardiology to cover the action. ESC is special because it is such a large meeting, with over 30,000 registered attendees and more than 500 journalists. This year’s addition has an added flair–as the […]

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AF ablation Atrial fibrillation Doctoring General Cardiology General Medicine Healthy Living Nutrition

Is this the most important cardiology study of the last decade?

In recent years, progress in the field of cardiology has been painfully incremental. We have enjoyed small gains–a better ablation catheter and mapping system, a couple of new anti-platelet drugs, maybe better stents, and even the highly touted anticoagulant drugs are within 99% in efficacy and safety of warfarin. Major breakthroughs, though, are non-existent. (And […]