Last week, I wrote a column on one of the most controversial clinical trials in cardiology. The EXCEL trial pitted stents vs bypass surgery for people who have left main coronary artery disease. The trial has been beset with controversy. The three areas of debate surround the definition of MI (or heart attack), the increased […]
Lecture on Scientific Bias in Cardiology
Last month I gave a lecture in Brazil (via my house in Kentucky) on scientific bias in cardiology. It’s about 20 minutes. Dr Bob Kaplan from Stanford also spoke on issues relating to how FDA approves drugs–a timely topic. Many of you know that I espouse a medically conservative approach to medical practice. My lecture […]
Doctoring and Activism
I got myself into a bit of tussle on Twitter today. In a provocative piece on the newsletter Persuasion, Dr. Sally Satel argued for caution in the matter of doctors becoming political activists. I retweeted it below: Most of the replies express extreme disagreement. One question stood out as worthy of a longer reply than […]
Deeper Worries in America
I worry about the coronavirus. It’s already killed more than 100,000 Americans. The recent protests have created a nerve-wracking public-health situation for the next weeks. I really worry about racism. Not only racism in police systems but more systemic racism in our culture. My friend Dr. Andrew Foy sent me this slide and post showing […]
Stopping COVID19 in Nursing Homes is No Easy Task
My city, Louisville KY, recently had a spike in COVID19 infections. It came from a handful of nursing homes. That nursing home and long-term care facilities account for large percentages of COVID19 cases has been well documented. In some cities, the majority of cases come from these facilities. These facts have sprouted platitudes about “protecting […]
More on COVID19 Testing and How This Virus Makes Us Use Our Noggins
My friend Anish Koka, a cardiologist, wrote a beautiful review of COVID testing over at the HealthCareBlog. The great pandemic is wreaking havoc, we are told, because the nation is not testing enough. The consensus from a diverse group that includes public health experts, economists, and silicon valley investors is that more testing will allow […]
COVID19 and Finding Effective Medical Therapies
This post introduces a column I wrote over at TheHeart.org | Medscape Cardiology — The good news is that most people infected with coronavirus don’t need a hospital or doctor. But some do. Some get very ill. The maddening thing is that doctors don’t have an effective treatment for the virus. There are no cures. […]
The Case for Opening (some) Pools In COVID19 Pandemic
The COVID crisis has decimated water exercise. Can we rethink pool closures? A significant number of my older patients relied on pools for their fitness. During a pandemic, you can stay active or fit only if you have good legs and joints. Walkers, runners, and cyclists have no problem; they play outside in the Spring […]
Will the Uncertainties of COVID Science Resurrect Blogs?
Health news was popular before the pandemic. Now, almost all news is health news. It’s not only a rapt audience contributing to the deluge of COVID19 news. Two other factors: 1) the availability of preprint servers, digital archives where a scientific paper can be published without formal peer-review and 2) the attention economy. Attention is […]
Like Minds on COVID19
At nearly the same time I posted yesterday, The Lancet published this editorial from Swedish epidemiologist Prof Johan Giesecke. Some excerpts: It has become clear that a hard lockdown does not protect old and frail people living in care homes—a population the lockdown was designed to protect. Neither does it decrease mortality from COVID-19, which […]
Can We Discuss Flatten-the-Curve in COVID19? My Eight Assertions
On Telehealth, an older couple asked me a tough question about COVID19. They asked whether this virus would either be gone or less dangerous in 6 months to a year. It was a curious question. I replied, Why do you ask? Doc, we have a big family with many children and grandchildren, most of whom […]
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