Doctoring General Medicine Knowledge Social Media/Writing/Blogging

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 […]

Doctoring General Medicine Knowledge

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 […]

Doctoring General Medicine Health Care Reform Knowledge Reflection Social Media/Writing/Blogging

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 […]

Doctoring General Cardiology General Medicine Knowledge

The Debacle of Hydroxychloroquine and Azithromycin for COVID19

I discussed the use of hydroxychloroquine and azithromycin for patients with COVID19 on my March 27th edition of This Week in Cardiology Podcast. This is an important topic not only because of the specifics of treating patients but also vital because it shows how easily human beings can be misled. Here is a an edited […]

Doctoring Reflection Social Media/Writing/Blogging

2020 Mandrola Update

Many things have changed in my life. I still practice electrophysiology full-time in Louisville. I still write. And I still love endurance exercise. You haven’t seen many blog updates because my writing has taken different forms. One is academic writing. In 2019, I co-authored 21 academic papers. Here is a link to the papers on […]

Doctoring General Cardiology General Medicine Knowledge

Change and the Case for Being a Medical Conservative:

When my favorite podcaster, the economist Tyler Cowan, asked Dr. Ezekiel Emanuel what nonobvious advice he would give to medical students today, the answer surprised me. The famous bioethicist said:  I do think that this is probably the most exciting time in American medicine in a century, since really about 1910, 1920. And it causes a […]

Doctoring Health Care Healthy Living Knowledge

Questioning Your Doctor is Ok

I received a good question(s) from a reader: In your “Changing the culture” posting there is the comment: “Patients seeking medical treatment should not assume a prescribed therapy is beneficial just because a doctor says it is.”… How then does a patient evaluate a proposed treatment in a way that they aren’t thwarting a doctor from performing what may […]

Doctoring Health Care Knowledge

Grander Lessons from a Failure of Robotic Surgery

This week on my podcast, I deviated briefly from cardiology to discuss a shocking and sad study highlighting the vital nature of doing randomized controlled trials in the practice of medicine. The reason I mentioned a trial comparing 2 types of hysterectomy (removal of the uterus) in women with early stage cervical cancer was not to […]

Atrial fibrillation Doctoring General Cardiology General Medicine Health Care

Thoughts on the Apple Watch

Apple products are cool. I love them. But (even) Apple will struggle delivering health. Making healthy people healthier is fraught with problems. At the core of this issue are the many snags of screening people for disease. Here are 600 words I wrote for Medium: I’m a Heart Doctor. Here’s Why I’m Wary of the New […]

Doctoring Knowledge

On Our Words

During a recent office visit an older women recited to me what I had said to her over a decade ago on the day she came to the hospital. The detail of her memory gave me pause. I could not remember the scenario but she said that my words had become part of her family’s […]

Atrial fibrillation Doctoring General Medicine

How dangerous are NSAIDs in patients with AF?

One of the most commonly asked questions in the office is the treatment of arthritis pain. This comes up because of the concern over taking NSAIDs (non steroidal anti-inflammatory drugs) in patients who are on anticoagulants (such as warfarin, or dabigatran, rivaroxaban, apixaban). My views on this matter have changed. But first, I want to […]