I recently received this message: This is not the first time I’ve been scolded for straying from medical topics. Last October, during the Lown Institute’s RightCare Action Week, I wrote about our ailing healthcare system. This prompted a different reader to send a similar message: Stick with topics about atrial fibrillation–went the gist of that […]
Should AF ablation require approval from a heart team?
A patient presents with atrial fibrillation (AF) and a rapid rate. He doesn’t know he is in AF; all he knows is that he is short of breath and weak. The doctors do the normal stuff. He is treated with drugs to slow the rate and undergoes cardioversion. During the hospital stay, he receives a […]
Is AF ablation a big placebo?
Turkish authors boldly raised this question in a recent editorial. They likened AF ablation to renal denervation, a procedure in which RF ablation in the kidneys was felt to reduce BP. Many studies showed kidney ablation markedly lowered BP. Then a trial was done with a sham control (people got part of the procedure but […]
Big news in AF ablation from HRS 2016
I have recently returned from the 2016 Heart Rhythm Society Sessions in San Francisco. I wrote three articles for Medscape. I also did two podcasts from HRS. I will link these below. You need to sign up for Medscape (free) to read the essays and listen to the podcast. In the first article, I discussed […]
Wisdom…
…the quality of having experience, knowledge, and good judgment. I read today a collection of words that exude wisdom. I share it with you because the purpose of this blog is to do create value through education. Peggy Girshman was an award-winning health journalist. When ill with a life-limiting illness, she wrote her own eulogy. […]
Right Care — There is always something to do
Some of my most poignant moments in medicine happen after the ablations and devices are finished. That’s when I go visit with patients up in the medical wards. My legs are fried from standing all day. So I sit, a key move because then you are ready to listen. One good thing about computers in […]
Another thing to fear in healthcare: Getting an Xray
I head to Chicago this weekend for the 4th Annual Lown Institute Conference. The Lown Institute seeks to catalyze grassroots movements for transforming healthcare systems and improving the health of communities. For those of you who want to be on the right side of the street of history, Dr. Bernard Lown, a cardiologist, activist, and […]
More on the gambling decision to take statins
In my last post, I wrote my initial thoughts of an important new study on how the decision to take a medication or have a screening test in the name of prevention is similar to playing the lottery. I promised to think and write about the study more carefully. My latest thoughts are now published […]
A new way to discuss statin drugs
A new study published last week in an open heart journal changes the conversation about how patients and doctors think about and discuss preventive therapies–such as statins. Dr. Richard Lehman may be the smartest doctor on Twitter. This is what he said: This is a game-changer https://t.co/WgGdLlodbL — Richard Lehman (@RichardLehman1) March 20, 2016 Most […]
Thoughts on Justice Scalia’s Death
When I heard Justice Antonin Scalia had died suddenly, presumably of cardiac causes, I spent time reading and thinking about the famous judge. Three themes seemed worth putting down in writing. Read more here: Justice Scalia’s Death: Three Lessons for the Healthcare Community JMM
VA hospitals do not deliver inferior care
Bernie Sanders has intensified the debate about US healthcare. Specifically, he has people talking about a single-payer government-controlled system. Critics, uninformed as they are, point to the VA system as an example of inferior care. A well-conducted study refutes such misthink. Yale researchers performed a massive cross-sectional study to compare outcomes among older men in […]
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