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 […]

New post up on Medscape/Cardiology: Ablation versus medicine as an intitial strategy for treating AF

Earlier this month I promised to put together teaching points from the Rich Peverley story. His was an interesting case of  sudden collapse that likely occurred as a result of atrial fibrillation therapy rather than atrial fibrillation itself. This was my original report: Important lessons from the collapse of NHL player Rich Peverley (BTW: It […]

Dear Girl Scouts: It’s time to cut out the cookies

Screen Shot 2014-03-16 at 10.37.01 AM

It happened while I was leaving a grocery store in the southeastern United States. The young girl who asked me if I wanted to buy Girl Scout cookies was strikingly perfect. She was thin, happy, and well spoken. So were her colleagues. The moms, too, were of healthy weight and cheer. It was as if […]

Important lessons from the collapse of NHL player Rich Peverley

Image from Wikipedia

Last night my Twitter stream lit up with the news that NHL player Rich Peverley collapsed from a heart arrhythmia. Fortunately, he was successfully treated, and is reported to be in good condition. Here is a link to the best story I could find. It sounds awfully significant. [Dr.] Salazar said of the treatment, “We […]

A clear-eyed look at treating the elderly with medicine

A recent case taught me a lot about how people perceive their medicines. I was trying to help a 92-year-old man get off some of his medicine. I can’t go into the details, but suffice to say, there was much opportunity to trim a long list of drugs, many of which were threatening his existence […]

The simple reason the medical-home study failed…

Screen Shot 2014-02-26 at 5.48.51 AM

This week, the Journal of the American Medical Association (JAMA) published a comprehensive study that has major health implications. Major because the negative findings should change how Americans think about health and healthcare. Plus, the findings validate a belief this doctor holds as truth. First my belief, then the study. One blog is enough for […]

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 […]