A good bye and a thank you…

A little self-absorption tonight.  A pledge to keep this triviality to a minimum going forward, but it is my blog and herein lies the beauty of the blog-o-sphere. Tomorrow is my last day at my current job.  I have worked with the same private practice group since 1996.   The senior partner at the time, Dr […]

General Ablation General Medicine Health Care Knowledge

Streamlined care from a specialist. An example of cost effectiveness: Just knowing…

Why would referring a patient directly to a specialist save money, time and patient outcomes? Exhibit A: A 75 year old male presents to his family doctor with a heart rate of 120.   Just some palpitations and a little “funny feeling in my chest.”  No pain, no shortness of breath, no dizziness. Examination shows a […]

Health Care Knowledge

A bad day for simplicity today…

The daily silliness as pictured on the wall of a heart catheterization lab… Now, one can’t say the words mild, moderate or severe. CMS, the government, or the payer, in describing blockages, no longer recognizes descriptive words. To a non-squisher cardiologist this seems silly. Let it be known that the exact percent blockage of a […]

Doctoring Health Care Knowledge Reflection

The “happiness quotient” and healthcare reform and Tiger…

Here is a surprise: Doctors and hospitals oppose the recent medicare provision. Us cardiologists are also opposed to the looming 50% cuts in medicare reimbursement. Imagine. Is this good news? Certainly not, how would anyone feel about earning 50% less? Will this cause access problems for the 65 and up patients; you bet it will. […]

Health Care Knowledge

A quest for intelligence. A long way off…

While perusing the aisles in Kroger, to an English professor and dean at a local university, I inquire about a writing course, so as to improve the blog. This author labored to a C in English in high school and despite excelling in the sciences in math, struggled like a muscleman on a cx course […]

Doctoring General Medicine Health Care Health Care Reform Reflection

Black Friday in the Cath Lab…

The parking lot is devoid of the usual chaos. The coffee cart is closed. An unusual quiet in the hallway is the norm. Holiday in the hospital. There were dark circles underneath the fatigued eyes and a slowness of gait. A colleague “fixed” four heart attacks on Thanksgiving. Sometimes, I make fun of the “squishers,” […]

General Ablation General Medicine Knowledge

Think critically about treatment recommendations: The H1N1 example…

Patients are asking me about the H1N1 vaccine. Usually, as a “one more thing” question at the tail end of a visit. This question churns the angst machine. The face twists in unknowing. It doesn’t have to be so bad. Could just give the party line and say, “get the shot.” Have a nice day […]

General Medicine Knowledge

Just knowing…

Along the road of learning medicine, there many memorable teachers. Many years ago on a renal (kidney) rotation at IU, my chart notes were criticized for lack of clarity and my signature could not be read. I was told by the intimidating very senior attending physician that a reader of your note should be clear […]


Know the opposite of something and you know something…

I have yet to figure out the theme for the blog. Is it exercise? Or healthy living? Or medical? Cycling? What exactly? So far, in reflecting on the posts, the only consistent theme I can figure is the “master of the obvious” thread. In the electrophysiology (EP) lab, you have to locate where an arrhythmia […]

Doctoring Reflection

A break in the usual morning routine…

I know him well. He lay in the ICU bed with a concerned look. I approach and he makes eye contact. I must have looked worried because he studied me intensely. I say, Mr S, “I am sorry to see you here.” We talk, he tells me the story. I knew the story beforehand. His […]

Doctoring General Medicine Reflection

A Mom takes the Medical Board

Staci takes the Internal Medicine board exam tomorrow; in a cubicle, with a computer. No pencils. No ovals. It has been 12 years since she last took the exam. For 10 years, she stopped doctoring and simply took care of Cat, Will and me. A mom. Moms do that stuff. They are a different species […]