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 […]

New post up on theHeart.org — Dr Emanuel’s Death Wish Harms Rather Than Helps

You know the story on US healthcare and the elderly: Our current default is an American tragedy. It’s devoid of truth and candor; it’s inhumane and it’s wasteful. Recent gains in longevity have come by extending the period of disability right before death. Aggressive care treatment is often hoisted onto the frail because caregivers lack […]

Guest post — 10 observations from a 49 year-old falls risk.

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It finally happened. After years of sitting at John’s bedside through multiple serious bike crashes, I had one of my own. I’ve had plenty of time to build up a ridiculous amount of smugness about why he crashes and I don’t. “John is reckless; Staci is cautious. John rides like an airplane engine on a […]

Is this the most important cardiology study of the last decade?

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In recent years, progress in the field of cardiology has been painfully incremental. We have enjoyed small gains–a better ablation catheter and mapping system, a couple of new anti-platelet drugs, maybe better stents, and even the highly touted anticoagulant drugs are within 99% in efficacy and safety of warfarin. Major breakthroughs, though, are non-existent. (And […]

Getting the dabigatran (Pradaxa) story right… Correcting four common mistakes.

This purpose of this post is to clarify misstatements made in a recent New York Times article about the anticoagulant drug dabigatran (Pradaxa). The piece had three major inaccuracies, plus one thought-error from a cardiology leader. I write these words because the most valuable tool in the treatment of AF is knowledge. Getting it right […]

Two AF cases — and my changing view of AF

I receive many emails about AF. I don’t often answer them because it is bad practice to doctor without seeing the person. Recently, however, I received a note with more general questions. The sender suggested I could use the response as a blog post. The reason I am posting these two cases along with my […]

Five lessons from the Niacin failure

This week the New England Journal of Medicine published two studies on the role of niacin in preventing future cardiac events. The short story is that niacin was ineffective and associated with significant harm. A number of excellent summary pieces have been written, and I will reference them at the end. The purpose of writing […]

Alcohol and the risk of atrial fibrillation — it’s different than you may think

Life overflows with choices. And consequences. You can choose to smoke and then not be surprised to die a difficult death from cancer. You can choose to eat more calories than you burn and then buy bigger belts. You can choose to “need” more stuff and then, surely, remain unfulfilled. The more we learn about […]

Growing doubt on statin drugs — the problem of drug-lifestyle interaction

My mind is changing about statins. I’m growing increasingly worried about the irrational exuberance over these drugs, especially when used for prevention of heart disease that is yet to happen. An elderly patient called my office last week to tell me thank you…not for a successful procedure or surgery, but rather, for helping with a […]