Doctoring Health Care Health Care Reform Knowledge

Right Care Action Week — Change what we fear

Last night I talked with one of my partners about a few terrible cases of medical harm from unnecessary procedures. He said, “John, people get this stuff done to them because they fear not being healthy. People are scared.” My answer was that people should fear healthcare more than they do disease. That sounds like […]

Doctoring Health Care Health Care Reform Knowledge

Right Care Action Week — Let’s make the invisible visible

Seven out of eight patients in his clinic one afternoon had unnecessary care. This from Dr. Atul Gawande, who may be the most respected physician in the world. And he works at Harvard. Overuse wastes resources. Overuse causes harm. Overuse fosters underuse. We must make it visible. The public needs to know. Here you go: […]

Doctoring General Medicine Health Care Health Care Reform ICD/Pacemaker Knowledge

Right Care Action Week — Be skeptical

Right Care seeks to be smart care. In the first part of my career, I rarely looked critically at the evidence. I was too busy; and I was more trusting of the vertical hierarchy of medicine. Eminence-based medicine seemed normal. Listen to the experts, for they are experts, went my mindset. Then something happened. When […]

AF ablation Doctoring General Medicine Health Care Health Care Reform ICD/Pacemaker Knowledge

Right Care Action Week – Un-informed Consent

The current state of informed consent in the US is best described as un-informed consent. A study this May reported that only 3% of patients with coronary artery disease received full informed consent before having an invasive procedure. Findings like these, and there are many other similar studies, reflect the ill-health of the medical decision […]

Cardiac Stem Cells Cycling Stuff General Cardiology General Medicine Health Care Health Care Reform ICD/Pacemaker inflammation Knowledge

Right Care Action Week — rational care

I wrote yesterday about how a broken healthcare system favors overuse of procedures. Today I will discuss rational care. Remember the goals of the Lown Institute: We think healthcare should be affordable, effective, rational and available to all. Rational means in accordance with reason or logic. Hardly a day goes by that I don’t see […]

Doctoring Health Care Health Care Reform

RightCare Action Week — a broken healthcare system

I am proud to be part of the Lown Institute. Founded by Bernard Lown, a cardiologist, mentor, activist, and winner of the Nobel Peace Prize, the Lown Institute is an organization committed to making things right in the US healthcare system. In case you wondered, yes, there is right and wrong in healthcare. At this […]

Doctoring General Medicine Health Care Reflection

Struggling with the (relative) value of humanistic medical care —

I just arrived in San Francisco. I am here for the 2014 Heart Rhythm Society sessions. The meeting begins today. A poster session this evening is overflowing with notable studies. Stay tuned. I’ll be working hard for to bring you the best stories. First, though, here’s a little appetizer. On the eve of the […]

Doctoring Health Care Reform

Physician satisfaction: Seeing both sides of the debate

Students of the obvious might consider the topic of physician satisfaction one of mere folly. The “rich doctor” label is an easy one, and the recent Medicare data dump, which revealed hordes of physicians who were doing quite well, thank you, only strengthened it. Yet, when one moves past intuition, into analytical thinking, the contentment […]

Doctoring General Cardiology General Medicine Health Care Health Care Reform

New post up over at The Atlantic — Improving US healthcare by looking at strategies from India

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, […]

Doctoring General Cardiology ICD/Pacemaker Reflection

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 […]

Cycling Stuff Cyclocross Reflection

Cicny Weekend—My highlights were not racing…

The mud and course conditions Friday defeated me. Saturday, I felt good warming up, had a decent start and snap-there goes my chain. Raced about 20 seconds. Sunday, they did not call my name at all. Started in last row and by some miracle got up to about 5th or 6th at the first turn. […]