Is healthcare careful? Is it kind?

Research now indicates 50% of middle–aged people live with one chronic disease. Translation: half of middle-aged people are not healthy. (You don’t need a reference there. Just walk out into the world and look around.) This new normal creates a challenge for caregivers. How will we care for the onslaught of chronic disease? Surely not […]

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 […]

Medicine, lifestyle disease and the pool-safety post

What follows is an introduction to my most recent post on theHeart.org | Medscape Cardiology. It was published yesterday. Many of the comments are excellent. The link is at the end of this post. You might wonder what pool-safety has to do with lifestyle disease. Here is how they relate: I am currently reading an […]

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 […]

Will wearables and other gadgets make us healthier?

Is good health really all that digital? I am not so sure. I am a skeptic. I realize this is a risky thing to say these days. It’s hard to bet against Apple. And It was only seconds after Tweeting such doubt that John Nosta, an expert in digital health technology, tweeted back: @drjohnm Health […]

The year in Cardiology 2014 — a top-10 list

When the editors at Medscape asked me to put together an essay on the Top 10 stories in cardiology in 2014, I thought it would be an easy project. I was wrong. It turns out there was a lot to say about the happenings in cardiology this year.  In the end, the final essay had 37 references–a […]

Opposition to ABIM — A tipping point for physicians?

Dr Wes Blog

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 […]

Undisclosed conflict of interest in the FDA review process

A report from the WSJ this week detailed the fact that FDA reviewers had significant and undisclosed financial ties to industry. I found this discovery remarkable, especially the undisclosed part. But perhaps more remarkable was the lack of reaction it created. The article has only 39 comments, paltry numbers of Tweets and FB shares and […]

Where is Cardiology in 2014? An AHA Review

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Last week, I attended the American Heart Association (AHA) 2014 Scientific Sessions in Chicago. I was there as both a learner and physician-writer for theHeart.org. Here are a few paragraphs on the meeting. The main purpose of this post is to introduce the five editorials I wrote. The links to the posts are at the […]

Staying Alive — Start The Heart Foundation taking off in Louisville

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My friend and colleague William Dillon (@wmdillon) is an interventional cardiologist. He and his wife Sally have started a non-profit foundation called Start the Heart Foundation. Their goal is to improve survival of patients who suffer cardiac arrest in Louisville Kentucky. The odds of surviving cardiac arrest here in Louisville are dismal: more than 90% […]

Because there is nothing else to do

If you ever hear your doctor say we are going to do something because there is nothing else to do, be afraid. Be very afraid. First of all, it should be self-evident that if caring and empathy and relief of suffering count as doing something, there is always something to do for patients. A growing problem […]