New post on Medscape/Cardiology: My take of the 2014 Atrial Fibrillation treatment guidelines

Atrial fibrillation affects millions of patients, and its incidence and prevalence are on the rise. It’s a peculiar disease in that it affects people so differently. When populations are studied, AF associates with higher rates of stroke, heart failure and death. But patients aren’t populations. In recent years, the treatment options for this pesky disease […]

A follow-up on the LifeVest…and decision quality

One of the most controversial posts I have ever written concerned Zoll corporation’s wearable cardiac defibrillator, which they have smartly branded the LifeVest. Here is the link to the 2013 post: LifeVest: A Precarious and Unproven Bridge . . . to Somewhere The less-than-glowing assessment brought me a great deal of criticism, both publicly and […]

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 […]

Blaming Obamacare is the wrong diagnosis

The Wall Street Journal began the week by publishing a provocative essay in which a young man suggested Obamacare kept his mother from getting appropriate medicine for her cancer. The writer crafted a poignant story about his mother, who sounds like a good person with a bad disease. Mainstream media buzzes with these types of stories. […]

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 […]

In the treatment of pain, OPIOID helps caregivers weather the regulatory storm

Dr. James Patrick Murphy

What follows is a guest post. James Patrick Murphy, MD, MMM is board-certified in Pain, Addiction, and Anesthesiology. He is President of The Greater Louisville Medical Society and the Course Director for OPIOID — Optimal Prescribing Is Our Inherent Duty. Dr Murphy, a friend, writes on the matter of optimal prescribing of pain therapy. It’s […]

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 The Atlantic — Improving US healthcare by looking at strategies from India

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Some things are hard to see until one leaves his or her normal surroundings. For American doctors, especially procedure-based doctors, it’s easy to get used to the wastefulness and largesse of delivering care.  Then you travel. You go to another healthcare system and are left to gasp. An AF ablation ‘costs’ 100,000 in the US, […]

With vaccines…Is there no middle ground, no room for questions?

“We should be as demanding of ourselves as we are of those who challenge us.” Dr. Jerome Groopman, writing in the New Rupublic Writing about the medical decision-making surrounding vaccines proved to be sketchy. Yesterday’s post brought stinging criticism from both sides of the debate. A pediatrician felt the structure of the post was patronizing. […]

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 […]

New post up over at TheHeart.org-Medscape Cardiology — Part 2 of Progress in Cardiology

Part one of Progress in Cardiology was a sober look at the current lull in innovation. In part 2, as promised, I tell you what is right and optimistic about my field. There is a lot. The post touches on the return of the basics. Basics in doctoring and basics in therapeutics are huge new […]