Five lessons from the Niacin failure

This week the New England Journal of Medicine published two studies on the role of niacin in preventing future cardiac events. The short story is that niacin was ineffective and associated with significant harm. A number of excellent summary pieces have been written, and I will reference them at the end. The purpose of writing […]

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 […]

US healthcare, wait times and the truth…

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 […]

Growing doubt on statin drugs — the problem of drug-lifestyle interaction

My mind is changing about statins. I’m growing increasingly worried about the irrational exuberance over these drugs, especially when used for prevention of heart disease that is yet to happen. An elderly patient called my office last week to tell me thank you…not for a successful procedure or surgery, but rather, for helping with a […]

The danger of digital medicine

Sometimes I worry about where technology is leading the healthcare profession. It is not just the distraction of white screens and electronic health records. These are bad, terrible, in fact. The concern I have runs deeper than just monopolistic EHRs. We, and I mean we as in the caregivers, are losing touch with the basics. […]

Be courageous: help stop the pill madness

Medicine people give it a sterile-sounding name. Polypharmacy means giving too many drugs, usually to an elderly person. But this practice is worthy of clearer words: dumb, dreadful or doctoring at its worst. The idea to mention the growing problem of giving too many pills in combination came to me after reading this Medscape coverage […]

Another VA lesson — Healthcare needs to stop being like flying business class

The VA healthcare story has me thinking about the good aspects of delays in medical therapy. Typical American intuitive thinking holds that healthcare waiting lists are a bad thing. The two central tenets of this mindset are that healthcare brings health, and most of medicine is as time sensitive as cardiac arrest or heart attack. […]

The VA healthcare system — Can we handle the truth?

Memorial Day weekend is an apt time to consider the recent accusations of wrongdoing in the VA healthcare system. It’s an opportunity to face the truth. As a free American, I am connected to veterans. It has always been remarkable that young people give their life or health for their country, but now, in this […]

Struggling with the (relative) value of humanistic medical care –

I just arrived in San Francisco. I am here for the 2014 Heart Rhythm Society sessions. The meeting begins today. A poster session this evening is overflowing with notable studies. Stay tuned. I’ll be working hard for theheart.org to bring you the best stories. First, though, here’s a little appetizer. On the eve of the […]