Dronedarone (Multaq), clinical guidelines and patient safety

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(What follows is a brief introduction for a post I wrote over at Medscape/Cardiology. The link is at the bottom of the page.)  It is appropriate to worry about medical errors and patient safety. Here the low-hanging fruit is plentiful: antibiotic stewardship, automated notification of drug interactions and attention to hand washing all join a […]

The truth about early diagnosis — this is more than just a Mammogram story

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The British Medical Journal published a monumental study on screening mammography this week. It’s garnered a ton of media coverage because the findings provocatively question the sacrosanct idea that early detection of breast cancer saves lives. Imagine that…Imagine if the entire pink machine was misguided. Of course, for people who have been willing to squint […]

NSAIDs — Yet another dubious “health” product at CVS

Now that the ‘healthiness’ of products sold at CVS stores is a matter of public discourse, it seems a perfect time to mention the common pain relievers known as Non-Steroidal Anti-inflammatory Drugs (NSAIDs). It just so happens that two FDA advisory committees are meeting today and tomorrow to discuss the cardiovascular risks of NSAIDs. The […]

The CVS tobacco decision is no small thing — Keep the chips and soda please

Yesterday, CVS Caremark announced that its 7600 stores will stop selling tobacco products. Company leadership said that selling tobacco is not consistent with being a health company. This decision, which takes effect in October 2014, will result in 2 billion less revenue. I am no business person, (though, as an observer of humans, I follow […]

When doctors meet with hospital administrators…

The meeting was remarkable. It’s not normal to get nine cardiologists to sit down with this many important hospital people. There was a CEO and CFO, two vice presidents, and a ‘consultant,’ a man who sported a nice suit but said no words. We gathered to discuss major issues in healthcare, things like budgets, pro […]

The danger of grading doctors…

It goes without saying that caregivers are not interchangeable. Quality matters. What else is there other than our health? From the day I began as a doctor, the absence of a legitimate meritocracy has been a source of inflammation. In 1996, when I started private practice, referrals depended too much on old-boy networks. In 2014, […]

New post up on Cardiology Medscape: Lessons learned from the failure of Renal denervation for high blood pressure

Most people come by it honestly. They eat too much, move too little, skimp on sleep, take on too much stress and then succumb to buying larger clothes. The word we use in medicine is insidious. High blood pressure (hypertension – HTN) is one of the leading cardiovascular problems of this time. Some have called […]

Two gifts and a consolation prize

President Obama has a few good ideas. He wants Americans to discuss healthcare this holiday season. That’s actually a really good idea. This blog aims to do some good in the area of medicine and health. What follows are two incredibly important essays. The consolation prize is an excerpt from my recent Top Ten post. […]

New post up over at The Atlantic — Improving US healthcare by looking at strategies from India

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Some things are hard to see until one leaves his or her normal surroundings. For American doctors, especially procedure-based doctors, it’s easy to get used to the wastefulness and largesse of delivering care.  Then you travel. You go to another healthcare system and are left to gasp. An AF ablation ‘costs’ 100,000 in the US, […]

With vaccines…Is there no middle ground, no room for questions?

“We should be as demanding of ourselves as we are of those who challenge us.” Dr. Jerome Groopman, writing in the New Rupublic Writing about the medical decision-making surrounding vaccines proved to be sketchy. Yesterday’s post brought stinging criticism from both sides of the debate. A pediatrician felt the structure of the post was patronizing. […]

Health lessons from Reverend Al Sharpton…

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However you see the Reverend Al Sharpton, one thing is certain: you see less of him now. His Twitter pic tells you he is proud of his 167-pound weight loss. Good for him, he should be. If you care about health, the disappearance of the Sharpton-of-old is worth mention. His story teaches us a lot, […]