To deprescribe…Adding a new verb to the language of doctoring

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What follows is my most recent editorial in the Journal of the Kentucky Medical Association. It is reposted with permission. **** One day every month, my wife Staci, a hospice and palliative care physician, goes to see an elderly woman in the nursing home. The routine has gone on for years, which is surprising because […]

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 […]

Death-denial is something doctors can change

I’m not sure why so many doctors don’t get it. Death, that is. Where in medical school, or residency, or even in non-medical life, did this many smart people get the idea that death is optional? Theresa Brown is an oncology nurse and a writer. This weekend, her regular column in the New York Times […]

Be courageous: help stop the pill madness

Medicine people give it a sterile-sounding name. Polypharmacy means giving too many drugs, usually to an elderly person. But this practice is worthy of clearer words: dumb, dreadful or doctoring at its worst. The idea to mention the growing problem of giving too many pills in combination came to me after reading this Medscape coverage […]

ICD deactivation in the NY Times — with a quote from a blogger

The news came via a direct message on Twitter. “You got a plug in the NY times. Congrats.” (Thanks Dr. Jay Schloss.) Paula Span, author of the NY Times’ The New Old Age Blog, reported today on the issue of cardiac device deactivation in patients who are approaching end of life. The role I had […]

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. […]

2013: Year-end summary of top cardiology stories

When the editors of Medscape asked me to write a Top Ten article on the best Cardiology stories in 2013, I jumped at the chance. I spent a lot of time thinking about Cardiology this year. I was invested. Plus, 2013 was a year for pivoting–big time pivoting. What made news in 2013 was not […]

New post up over at TheHeart.org: Compassion and Control — Lessons from Dr. Donald Low

Medsape Cardiology

As some of you may know, theHeart.org has merged with Medscape Cardiology. This will be my first post on the new site. Dr Donald Low was a prominent Canadian physician. When Toronto faced a deadly SARS outbreak a decade ago, Dr Low was a voice of calm and reason. His research in cell signaling and […]

Take fear and ignorance out of end-of-life decisions — A rebuttal to Dr Paul McHugh’s WSJ editorial

Perhaps it’s because I love the practice of medicine so much. Or maybe it’s because doctors (and teachers) have always been my heroes. I’m trying to sort out why I feel so offended by Dr. Paul McHugh’s editorial in the Wall Street Journal last weekend. His sensational and paternalistic view of physician-assisted suicide can be […]

Notes from ACC — Day 3 (Final Day)

Sorry this took most of the week to get out. (There was a good reason.) Better late than never I suppose. On Day 3 of the 2013 American College of Cardiology meeting, I woke up well rested and inspired to squeeze in as much learning as possible. The first order of business was putting the […]