The Case Against Watchman

Many readers have asked me to update my feelings about Watchman and other percutaneous appendage closure procedures. The short answer is that I remain unconvinced that this is a beneficial procedure. New data has been sparse and unconvincing. I’ve recently started a newsletter on Substack. It’s called Stop and Think. In the latest post, I… Continue reading The Case Against Watchman

Shining Bright Spot of 2020 — The RECOVERY Trial

Take a look at this article in The Times. It tells the story of Oxford professors named Martin Landray and Peter Horby. When they saw the pandemic unfolding in China and Lombardy, their first thought was to design a proper clinical trial to determine what works for COVID19. Normally, it takes a year or more… Continue reading Shining Bright Spot of 2020 — The RECOVERY Trial

No, Young Adults Should Not Live in Fear from Coronavirus

What follows is an OpEd that I co-authored with Andrew Foy, MD, from Penn State University. Andrew is an academic cardiologist who studies the quality of scientific evidence. Two outlets have declined to publish our piece. This is not surprising given that we critique a research letter written by prominent academic leaders. As you read… Continue reading No, Young Adults Should Not Live in Fear from Coronavirus

Follow-up on my Eight COVID Assertions

Yesterday’s post generated some good comments. Two emergency medicine specialists felt that I was both wrong and insulting in saying that hospitals were not overwhelmed. What I meant in the word ‘overwhelmed’ is the notion of not being able to support a sick patient in the ICU or on a vent. That didn’t happen, but… Continue reading Follow-up on my Eight COVID Assertions

What I Got Wrong (and Right) about COVID19

In May, I wrote a column about COVID19 that got some attention. My reason for writing was the change in messaging about the strategy of flatten-the-curve. We were first told to flatten-the-curve to prevent overwhelming hospitals. But then the thinking changed to flatten-the-curve to save lives.  I made eight assertions about COVID19. Let’s see how… Continue reading What I Got Wrong (and Right) about COVID19

New column and podcast up:

Last week, I wrote a column on one of the most controversial clinical trials in cardiology. The EXCEL trial pitted stents vs bypass surgery for people who have left main coronary artery disease. The trial has been beset with controversy. The three areas of debate surround the definition of MI (or heart attack), the increased… Continue reading New column and podcast up:

Lecture on Scientific Bias in Cardiology

Last month I gave a lecture in Brazil (via my house in Kentucky) on scientific bias in cardiology. It’s about 20 minutes. Dr Bob Kaplan from Stanford also spoke on issues relating to how FDA approves drugs–a timely topic. Many of you know that I espouse a medically conservative approach to medical practice. My lecture… Continue reading Lecture on Scientific Bias in Cardiology

Doctoring and Activism

I got myself into a bit of tussle on Twitter today. In a provocative piece on the newsletter Persuasion, Dr. Sally Satel argued for caution in the matter of doctors becoming political activists. I retweeted it below: Most of the replies express extreme disagreement. One question stood out as worthy of a longer reply than… Continue reading Doctoring and Activism

Deeper Worries in America

I worry about the coronavirus. It’s already killed more than 100,000 Americans. The recent protests have created a nerve-wracking public-health situation for the next weeks. I really worry about racism. Not only racism in police systems but more systemic racism in our culture. My friend Dr. Andrew Foy sent me this slide and post showing… Continue reading Deeper Worries in America

Stopping COVID19 in Nursing Homes is No Easy Task

My city, Louisville KY, recently had a spike in COVID19 infections. It came from a handful of nursing homes. That nursing home and long-term care facilities account for large percentages of COVID19 cases has been well documented. In some cities, the majority of cases come from these facilities. These facts have sprouted platitudes about “protecting… Continue reading Stopping COVID19 in Nursing Homes is No Easy Task

More on COVID19 Testing and How This Virus Makes Us Use Our Noggins

My friend Anish Koka, a cardiologist, wrote a beautiful review of COVID testing over at the HealthCareBlog. The great pandemic is wreaking havoc, we are told, because the nation is not testing enough.  The consensus from a diverse group that includes public health experts, economists, and silicon valley investors is that more testing will allow… Continue reading More on COVID19 Testing and How This Virus Makes Us Use Our Noggins