It’s time for another post on truth and healthcare. (This almost sounds like a good series.) I’ve recently written that the VA healthcare system represents the truth—and that Americans should get over the Pollyanna view that triage, wait lists, and taking care of increasing numbers of increasingly sick patients can be managed with magic. The […]
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(This blog was born from writing race reports for a masters bike racing team. What follows is of that form. It’s a little longer than I like, and, therefore, as an antidote, no more than a few hundred words occur without an image.) It’s intriguing how experiences get burned into the brain’s memory center. I […]
Students of the obvious might consider the topic of physician satisfaction one of mere folly. The “rich doctor†label is an easy one, and the recent Medicare data dump, which revealed hordes of physicians who were doing quite well, thank you, only strengthened it. Yet, when one moves past intuition, into analytical thinking, the contentment […]
Atrial fibrillation affects millions of patients, and its incidence and prevalence are on the rise. It’s a peculiar disease in that it affects people so differently. When populations are studied, AF associates with higher rates of stroke, heart failure and death. But patients aren’t populations. In recent years, the treatment options for this pesky disease […]
A recent case taught me a lot about how people perceive their medicines. I was trying to help a 92-year-old man get off some of his medicine. I can’t go into the details, but suffice to say, there was much opportunity to trim a long list of drugs, many of which were threatening his existence […]
 How can social media improve AF patient and provider interaction? It was an honor to speak at the seventh annual Western AF symposium this past weekend in Park City Utah. Once in the shadow of the Boston AF symposium, Dr. Nassir Marrouche (@nmarrouche) and his colleagues at the University of Utah have elevated Western AF […]
The Wall Street Journal began the week by publishing a provocative essay in which a young man suggested Obamacare kept his mother from getting appropriate medicine for her cancer. The writer crafted a poignant story about his mother, who sounds like a good person with a bad disease. Mainstream media buzzes with these types of stories. […]
(What follows is a brief introduction for a post I wrote over at Medscape/Cardiology. The link is at the bottom of the page.)Â It is appropriate to worry about medical errors and patient safety. Here the low-hanging fruit is plentiful: antibiotic stewardship, automated notification of drug interactions and attention to hand washing all join a […]
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 […]