(What follows is a brief introduction for a post I wrote over at Medscape/Cardiology. The link is at the bottom of the page.)Â It is appropriate to worry about medical errors and patient safety. Here the low-hanging fruit is plentiful: antibiotic stewardship, automated notification of drug interactions and attention to hand washing all join a… Continue reading Dronedarone (Multaq), clinical guidelines and patient safety
How should one feel about being quoted in the Wall Street Journal? Nervous. That’s how. This morning’s piece, written by award-winning medical journalist, Tom Burton centered around new reviews of the heart rythm drug, Multaq. Louisville cardiologist John Mandrola said, “I’m surprised that the drug has persisted. I don’t know any of my colleagues who… Continue reading Multaq (and me) in the WSJ
Did you know September is AFib awareness month? As a believer in education as the first, and best treatment of AF, I think it’s great to enhance the public knowledge of this highly-misunderstood disease. By all means… Tell people about AF’s risks: stroke and heart failure. Tell them that their fatigue, poor exercise tolerance and… Continue reading Get back in rhythm: just not with Multaq
What should I have told the doctor who recently asked me about dronedarone (Multaq)? â€œSupposedly, itâ€™s [Multaq] just like Amiodarone, but without the side effects?â€ he asked. Goshâ€¦Should I, or shouldn’t I? I took a big cleansing breath, reminding myself to stay civil, as at least Sanofi-Aventis, the makers of Multaq, sponsor a cycling team.… Continue reading Multaq continues to disappoint
It will not last forever, nothing ever does. Some day I will have to find another big-pharma punching bag. It’s true; our pal dronedarone (Multaq) is back in the news again. This time the Multaq news (as reported on Cardiobrief and Pharmalot) is not about its inefficacy or Sanofi-sponsored professors, but rather concerns about it’s… Continue reading In defense of Multaqâ€¦not really
This week is a good time to talk about trust in expert opinion and science. For the past forty years, nutrition experts in the US have warned us about cholesterol and fat. Eat too much of it and it will block your arteries, was the proclamation. Americans did what the scientists and experts said. They… Continue reading Trust in science and medical experts
In July, I wrote a short blog post expressing doubt about the value of statin drugs. Medscape republished it on their website and it went viral–in a medical sort of way. The post has 631 comments. It was Tweeted extensively, page views have been off the charts (for me), and I even received an invitation… Continue reading Does the controversy over statin drugs herald a new era of doctoring?
Everyone agrees that doctors should be informed and up-to-date. Perpetual medical education has always been a vital component of doctoring. But now, as the rapid pace of healthcare innovation pushes against the limits of biology, and really, our humanity, medical education gains even more importance. Doctors (and patients) must know what can and cannot be… Continue reading Disruption in medical education — Teaching the teachers via social media?
It goes without saying that caregivers are not interchangeable. Quality matters. What else is there other than our health? From the day I began as a doctor, the absence of a legitimate meritocracy has been a source of inflammation. In 1996, when I started private practice, referrals depended too much on old-boy networks. In 2014,… Continue reading The danger of grading doctors…
I made a discovery this week about the novel anticoagulant medications, dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Lixiana). I was looking into the often-asked question of how these new drugs compare to the old standard, warfarin. The discovery felt like a Eureka moment. I ran it by my stats guy–my son–and a couple… Continue reading Are doctors being duped through medical education? Could social media help?
This morning I awoke to a picture of myself in the Wall Street Journal. I was asked to comment on the effects of the coming Sunshine Act. Respected health care journalist Peter Loftus found me through social media channels. What follows are some thoughts about how the Sunshine Act might play out. — Every Thursday… Continue reading How much sunshine is just the right amount?