Last night, during the intro show for the PBS documentary, Cancer: The Emperor of All Maladies, a Ken Burns film based on the book by Siddhartha Mukherjee, Katie Couric interviews both Ken Burns and Dr. Mukherjee. The moment occurred about 10 minutes into the video. There is a poignant scene in which two young parents […]
Writing update: Lown Institute Conference and ACC2015
Hi all, I have been busy in the last few weeks. Here is an update of my happenings and posts. From March 8-11, I attended and presented at the third annual Lown Institute Conference in San Diego. I have never felt more at home in a conference than I did at the Lown conference. Take […]
Public trust, the CDC and Tamiflu
Why do doctors lose credibility? Consider the few public doctors out there with millions of followers. The majority of the stuff they recommend is perfect: eat good food, exercise, be nice. and sleep. Check. No problem. Everyone is good with that until they shatter the sense with nonsense. One miracle cure or stupid supplement or […]
Trust in science and medical experts
This week is a good time to talk about trust in expert opinion and science. For the past forty years, nutrition experts in the US have warned us about cholesterol and fat. Eat too much of it and it will block your arteries, was the proclamation. Americans did what the scientists and experts said. They […]
The medical decision as a gamble
The medical decision–to have a screening mammogram, to take warfarin, to undergo a catheter ablation–is, at its core, a gamble. We pit the treasure of the win (benefit) against the pain of the loss (harm). In times past, medical gambles were easier. You took the antibiotic or you lost your leg. Most medical decisions today […]
Opposition to ABIM — A tipping point for physicians?
I know physicians. They are smart, hard-working and prideful. They do a lot of good in this world. But one thing we have been utterly incapable of doing is organizing together and speaking as one voice. The American Board of Internal Medicine may have changed that. The hubris, overreach, and tone-deafness of ABIM may have […]
Viva La Evidence
Hi All, It’s been a while. The hospital is abuzz with electrophysiology problems. I’ve been unleashing some serious medical fury in the past weeks. It has been fun, though it gets in the way of writing and training. James McCormack (@medmyths) is a “Pharmacist, Professor, Medication Mythbuster, and Healthy Skeptic at the Faculty of Pharmaceutical […]
Sudden death and a common antibiotic
The longer I practice medicine, the more nervous I get about medications, especially when patients are already on other drugs for chronic diseases. I much prefer deprescribing. A recent study on the common antibiotic cotrimoxazole, which is a combination of sulfamethoxazole and trimethoprim, and often referred to by its brand name, Bactrim or Septra, lends […]
Medical decisions — tradeoffs, emotions, preferences and experts
Maybe you wonder why a cardiologist writes about vaccines and mammography. It is because I have grown intensely interested in the medical decision. As a doctor in a preference-sensitive field, electrophysiology, how do I help patients understand and choose the best path–of which there are many. This seems like a simple task, but with humans, […]
Does the controversy over statin drugs herald a new era of doctoring?
In July, I wrote a short blog post expressing doubt about the value of statin drugs. Medscape republished it on their website and it went viral–in a medical sort of way. The post has 631 comments. It was Tweeted extensively, page views have been off the charts (for me), and I even received an invitation […]
Vaccine anxiety… A teachable moment for doctors?
I’ve read and re-read Dr. Paul Offit’s WSJ opinion piece, The Anti-Vaccination Epidemic. Dr. Offit is a professor of Pediatrics at a leading hospital in the United States. He is also an author, a scientist, and a vaccine-developer. In short, he is a major physician leader. I’ll come back to that point in just a […]
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