My Facebook feed has been buzzing with news of a breakthrough in the treatment of sepsis–a deadly condition caused by bacterial infection. Do not be fooled. Please. Resist the urge to be duped. A recent study published in the prestigious journal Chest concluded that a combination of high-dose vitamin C, anti-inflammatory corticosteroids and thiamine given […]
Politics and Understanding the Human Condition
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 […]
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 […]
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 […]
Science Needs Data Sharing Like Sports Needs Doping Controls
I’ve got a good story for you. One that goes back to the early days of this blog, a time when I wrote about cycling. It turns out that the biggest medical news thus far in 2016 has a connection, albeit slight, to the recent doping news out of Belgium. You’ve heard the news from […]
Right Care Action Week — Change what we fear
Last night I talked with one of my partners about a few terrible cases of medical harm from unnecessary procedures. He said, “John, people get this stuff done to them because they fear not being healthy. People are scared.” My answer was that people should fear healthcare more than they do disease. That sounds like […]
Right Care Action Week — Let’s make the invisible visible
Seven out of eight patients in his clinic one afternoon had unnecessary care. This from Dr. Atul Gawande, who may be the most respected physician in the world. And he works at Harvard. Overuse wastes resources. Overuse causes harm. Overuse fosters underuse. We must make it visible. The public needs to know. Here you go: […]
Right Care Action Week — Be skeptical
Right Care seeks to be smart care. In the first part of my career, I rarely looked critically at the evidence. I was too busy; and I was more trusting of the vertical hierarchy of medicine. Eminence-based medicine seemed normal. Listen to the experts, for they are experts, went my mindset. Then something happened. When […]
Right Care Action Week – Un-informed Consent
The current state of informed consent in the US is best described as un-informed consent. A study this May reported that only 3% of patients with coronary artery disease received full informed consent before having an invasive procedure. Findings like these, and there are many other similar studies, reflect the ill-health of the medical decision […]
Right Care Action Week — rational care
I wrote yesterday about how a broken healthcare system favors overuse of procedures. Today I will discuss rational care. Remember the goals of the Lown Institute: We think healthcare should be affordable, effective, rational and available to all. Rational means in accordance with reason or logic. Hardly a day goes by that I don’t see […]
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