Crowdsourcing a consumer safety issue — EMI interference and cardiac devices

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What follows is a guest post from Dr. J Rod Gimbel, a cardiac electrophysiologist from Knoxville, TN. Dr. Gimbel has written extensively on the issue of electronic surveillance systems and electromagnetic interference (EMI) with cardiac implantable electronic devices, such as pacemakers and defibrillators. **** I’d like to express my appreciation for allowing me to guest […]

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 […]

2014 Heart Rhythm Society Sessions — My massive recap:

Hey Everyone, I recently returned from the Heart Rhythm Society meeting in San Francisco. I attended the meeting as both a physician-journalist-columnist for theHeart.org and as a practicing electrophysiologist. As it so often is with international meetings, I returned energized and rejuvenated about the practice of medicine. Medical meetings are great this way. It’s quite […]

Cardiology and stewardship — New post up at Medscape|Cardiology

One of the definitions of the noun steward is a person whose responsibility it is to take care of something. Wikipedia calls stewardship an “ethic that embodies the responsible planning and management of resources.” These apply well to cardiologists–who use powerful (and expensive) tools in the care of fellow humankind. The internal cardiac defibrillator, or […]

Important lessons from the collapse of NHL player Rich Peverley

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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 […]

New post up at Medscape/Cardiology — Heart Rhythm Society’s Choosing Wisely List is tentative and cursory

The Choosing Wisely campaign began in 2009 when the American Board of Internal Medicine (ABIM) Foundation invited medical societies to own their role as “stewards of finite healthcare resources.”  The movement aims to promote care that is supported by evidence, not duplicative, free from harm and truly necessary. That sounds delightful, and I wrote enthusiastically […]

ICD and Pacemaker deactivation: It is neither physician-assisted suicide nor euthanasia

The purpose of this post is to clarify important issues about cardiac devices as they relate to deactivation. As I wrote yesterday, Paula Span of the NY Times covered this important issue earlier this week. Her coverage came about because of this Mayo Clinic paper published in JAMA-IM, which showed most patients with cardiac devices […]

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 […]

First ever invited commentary in a medical journal — JAMA-IM

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I’m going to be proud for a moment. Yesterday, the journal JAMA-Internal Medicine published an invited commentary that I co-wrote with Dr. Dan Matlock (@Dan_Matlock) from the University of Colorado. The title of the piece is The Antidote for Unprepared Patients — A Caring Clinician. It’s available for free. Invited editorials in medical journals are often […]

Recap of 2013 American Heart Association Session

Just a few weeks before the 2013 American Heart Association Sessions, Shelley Wood, the managing news editor of theheart.org emailed to ask if I was up for going to the meeting. With trips to San Francisco, Denver, Athens and Amsterdam already in the books this year, I had counted 2013 as a win. I was […]

End of life care – A great American tragedy.

“Why don’t we die the way we say we want to die? In part because we say we want good deaths but act as if we won’t die at all.” Katy Butler, WSJ There is a humanitarian crisis unfolding right now in nearly every hospital in this nation. Aggressive life-prolonging care of the elderly too […]