Doctoring General Medicine Health Care Knowledge Reflection

Follow-up on my Eight COVID Assertions

Yesterday’s post generated some good comments. Two emergency medicine specialists felt that I was both wrong and insulting in saying that hospitals were not overwhelmed. What I meant in the word ‘overwhelmed’ is the notion of not being able to support a sick patient in the ICU or on a vent. That didn’t happen, but […]

Doctoring Health Care

What I Got Wrong (and Right) about COVID19

In May, I wrote a column about COVID19 that got some attention. My reason for writing was the change in messaging about the strategy of flatten-the-curve. We were first told to flatten-the-curve to prevent overwhelming hospitals. But then the thinking changed to flatten-the-curve to save lives.  I made eight assertions about COVID19. Let’s see how […]

General Cardiology General Medicine Health Care Health Care Reform Reflection

Missing an Obvious Cause of Medical Overuse

This post introduces my latest column over at Medscape. I hope you go read the full piece.  Medical overuse bothers me. Consuming medical care that does not improve outcomes makes you poorer, and puts you at risk for being harmed.  I think a lot about why Americans consume more healthcare than our peers in other […]

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 […]

Atrial fibrillation Doctoring General Cardiology General Medicine Health Care Knowledge

How Hubris Impairs the Care of the Elderly

An elderly man with atrial fibrillation (AF) asks whether to continue taking a clot-blocking drug to prevent stroke. This is the gist of a case my colleague Dr Anish Koka recently posted on Twitter. It’s a great thread. Click here to get to the discussion. The first question Anish raised was whether you would keep […]

Doctoring General Cardiology Health Care Health Care Reform

Flat-of-the-Curve Cardiology Practices

If you think about it, you can’t get much done. So you don’t think about it. You just shake your head and keep tapping on the computer; the next patient awaits. To avoid moral distress, to remain employed as a doctor, you don’t think about the high cost and waste of cardiac care. Dr. Andrew […]

General Ablation General Cardiology General Medicine Health Care inflammation

Recap of 2017 in Cardiology

Hi all. | Medscape Cardiology published my picks for the top stories of 2017. Here is the link: Mandrola’s Top 10 Cardiology Stories of 2017 I called it the year of the medical reversal. Medical reversals occur when a superior study contradicts current practice. I love medical reversals. First, they make you think about history. […]

AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Health Care

Thoughts on the Apple Watch and Mobile ECG

Last week I wrote a column on | Medscape Cardiology on the new Apple Watch ECG and Kardia Band. The Tweet I sent out on Saturday has done well — 74 Retweets (without any robots) is pretty good. The Apple Watch ECG — The good, the challenges, and the really scary. My thoughts on […]

Doctoring Health Care Healthy Living

The Truth on Cancer Screening

This week is Cancer Screen Week. It’s a one-sided campaign sponsored by industry and the American Cancer Society that urges people to get screened. The truth is that the scientific evidence for cancer screening is not convincing. What’s more, screening comes with potential harms. I know; it’s counter-intuitive, but it’s what the evidence says. Benjamin […]