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Doctoring Health Care Health Care Reform

RightCare Action Week — a broken healthcare system

I am proud to be part of the Lown Institute. Founded by Bernard Lown, a cardiologist, mentor, activist, and winner of the Nobel Peace Prize, the Lown Institute is an organization committed to making things right in the US healthcare system. In case you wondered, yes, there is right and wrong in healthcare. At this […]

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Health Care Health Care Reform

Do not use the Surgeon Scorecard

(I have updated this post with a link below to my essay on Medscape.) No data is better than bad data. The ProPublica Surgeon Scorecard is not ready for prime time. It was a good effort. I support investigative journalism and ProPublica. We need more transparency in Medicine. I despise the utter lack of meritocracy […]

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Doctoring General Cardiology General Medicine Health Care Reform

The PCSK9 Drugs — Epic success or epic failure?

This week, an FDA advisory committee recommended approval for the potent cholesterol-lowering drugs, evolocumab and alirocumab. The funny-sounding medications are called PCSK-9 inhibitor drugs. (Keep reading; I’ll tell you more.) Advisory committee members felt the benefits of the drugs outweighed the potential risks, especially in high-risk patients, such as those with Familial Hypercholesterolemia (FH). The […]

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AF ablation Atrial fibrillation Cycling Stuff Doctoring Exercise General Medicine Health Care Health Care Reform ICD/Pacemaker Reflection Social Media/Writing/Blogging

Update: Baltimore, Safety in AF ablation, Podcasts, and some personal notes

On Baltimore: Human beings rioting in the streets of an American city forced cancellation of an important cardiology meeting. This is a vivid example that doctors do not practice in a vacuum. We are connected to this world. Here in Louisville, just a few miles north, an HIV crisis runs amok because of IV drug […]

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AF ablation Athletic heart Atrial fibrillation Doctoring General Medicine Health Care Reform Hospice/Palliative Care ICD/Pacemaker Reflection

Update: Social justice of AF care, NOAC monitoring, population health and two new podcasts

Hi All, Here is a short update of the past week. The first thing to say is the Atrial Fibrillation Care: Put the Catheter (and Rx Pad) Down post has gotten a lot of attention. It stayed on the most popular list all week. It has over a 130 comments, and I have received many […]

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AF ablation Atrial fibrillation Cycling Stuff Exercise Health Care Reform Healthy Living Social Media/Writing/Blogging

An update on cycling and writing and video (gulp)

Hi all, Things have changed for me. I have taken on a larger role at theheart.org | Medscape Cardiology. This means I have less time for hefty original posts here. (This site is not closing–just changing.) I write and read a lot more, though. Almost every day. Writing has morphed into what cycling was: a […]

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Atrial fibrillation Doctoring General Medicine Health Care Health Care Reform Knowledge

The trick of hope — and the medical decision

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 […]

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AF ablation Atrial fibrillation Doctoring General Ablation General Cardiology General Medicine Health Care Health Care Reform Healthy Living Knowledge Social Media/Writing/Blogging

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 […]

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Doctoring Health Care Health Care Reform Knowledge

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 […]

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Doctoring Health Care Health Care Reform

Dr. Bernard Lown and the first rule of doctoring

I knock, then enter the exam room. “Hi. My name is John Mandrola.” (Maybe it is my age but I am moving away from calling myself Doctor Mandrola.) “I am a heart rhythm specialist. I have looked at your chart so I know a little about your medical history.” “Can you tell me how you […]

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General Cardiology General Medicine Health Care Health Care Reform

A scary new medical intervention…

This is a story about a new medical intervention. It’s an important story because it affects all doctors—and therefore all patients. 1. It’s expensive. Of course. 2. There is no credible evidence that it works. But its marketing is aggressive. 3. The overwhelming majority of physicians disapprove of it. 4. Cheaper alternatives exist. 5. The […]