Avoiding a bad death requires preparation

If there was a hashtag for sub-specialty healthcare and ICU medicine in the United States it would be: #WeCanButShouldWe A recent study led by Dr. Harlan Krumholz (Yale University) showed that we have become more efficient at keeping elders alive. This is not surprising. And it’s good news in the sense that technology–if used wisely–can […]

Recap of 2015 European Heart Rhythm Association Meeting — Milan

Selfie at the MiCo convention site

I recently returned home from Milan, Italy. I was covering the 2015 European Heart Rhythm Association (EHRA) sessions. My favorite part of the congress, as it always is with medical meetings, was connecting with old friends, and making new friends. I had coffee, lunch or dinner with colleagues from Australia, Netherlands, France, Italy, Belgium, Frankfurt, […]

Update: Baltimore, Safety in AF ablation, Podcasts, and some personal notes

On Baltimore: Human beings rioting in the streets of an American city forced cancellation of an important cardiology meeting. This is a vivid example that doctors do not practice in a vacuum. We are connected to this world. Here in Louisville, just a few miles north, an HIV crisis runs amok because of IV drug […]

Update: Social justice of AF care, NOAC monitoring, population health and two new podcasts

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Hi All, Here is a short update of the past week. The first thing to say is the Atrial Fibrillation Care: Put the Catheter (and Rx Pad) Down post has gotten a lot of attention. It stayed on the most popular list all week. It has over a 130 comments, and I have received many […]

The power of the specialist physician — and stewardship

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My latest column over at theHeart.org discusses the disordered balance of power in the doctor-patient relationship. As most of you know, I harbor strong biases about the quality of medical decisions, especially in the elderly. Attached. Yes, I am attached to the issue of decision quality. Nearly all of electrophysiology, and much of cardiology, involves […]

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 […]