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Athletic heart Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Doctoring General Cardiology General Medicine Health Care Healthy Living Knowledge Nutrition

Statins, Like All Medicines, Are Neither Good Nor Bad

We have to talk about drugs. No, not illicit drugs, but medications used by doctors and patients. Plaintiff attorneys run ads on TV that fool people into thinking certain meds are bad. The current one I deal with is the clot-blocking drug rivaroxaban (Xarelto.) Before that, it was dabigatran (Pradaxa). If, or when, the makers […]

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Doctoring Reflection

Changing the mind of a doctor — Not an easy matter

Changing one’s mind is hard. Changing the mind of doctors is even harder. Doctors are supposed to be the medical experts. Often we are. But sometimes I wonder whether our attachments to old ideas gets in the way of seeing the obvious. I am reading Michael Lewis’s book The Undoing Project. Learning how Kahneman and […]

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AF ablation Atrial fibrillation

AF Ablation Update – 2016

I do AF ablation. But, similar to my 2015 update, I continue to do fewer of these procedures. What is new in 2016 is more confidence that this is the right approach. My technique for ablating AF has not changed. I do pulmonary vein isolation (PVI) with point-to-point RF. Each burn takes 10-30 seconds, and […]

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AF ablation Athletic heart Atrial fibrillation Doctoring General Medicine Health Care Healthy Living Social Media/Writing/Blogging

Athletes, AF, Anticoagulants, Statins, Peanuts, and Dishwashers

Here is an update on my recent writing. Athletes and AF: I was honored to be invited back to the Western AF symposium in Park City, Utah. Last year, I presented on social media. This year, Dr. Nassir Marrouche (University of Utah) asked me to tackle the topic of atrial fibrillation in athletes. This is […]

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Doctoring Hospice/Palliative Care Social Media/Writing/Blogging

I will host Hospice and Palliative Care Tweet Chat — #HPM

This Wednesday Feb 11th, at 9 PM EST, one day after PBS Frontline features Dr. Atul Gawande and his new book Being Mortal, I will guest host the Hospice and Palliative Care (#HPM) Tweet Chat. Dr. Christian Sinclair is a physician leader in HPM and a co-editor of Pallimed. He recently commented on my stewardship piece […]

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Doctoring General Cardiology General Medicine Health Care Hospice/Palliative Care

Because there is nothing else to do

If you ever hear your doctor say we are going to do something because there is nothing else to do, be afraid. Be very afraid. First of all, it should be self-evident that if caring and empathy and relief of suffering count as doing something, there is always something to do for patients. A growing problem […]

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Doctoring Health Care Health Care Reform

People are not units — US healthcare policy obstructs good doctoring

There is a lot of talk about rewarding value in US healthcare. Don’t believe any of it. It’s not happening. Not even close. This is a post about the real world–where I practice medicine. In a comment on yesterday’s post, Lisa wondered how I connected the current model of employing doctors and paying them on […]

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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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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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AF ablation Atrial fibrillation Doctoring Healthy Living

Two AF cases — and my changing view of AF

I receive many emails about AF. I don’t often answer them because it is bad practice to doctor without seeing the person. Recently, however, I received a note with more general questions. The sender suggested I could use the response as a blog post. The reason I am posting these two cases along with my […]

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Doctoring Health Care

How do doctors feel about the new ABIM board certification requirements?

I received an interesting email this week from the American College of Cardiology. The purpose of the note was to relay the results of a survey regarding member’s views and concerns of the new changes in board certification. Before I tell you about the survey’s striking results and clear message, it’s worth reviewing the contentious […]