Categories
General Medicine Health Care Health Care Reform Healthy Living

Access to healthcare does not deliver health

Stanford economist Raj Chetty and coworkers published an important paper in the Journal of the American Medical Association this week. It’s free. They looked at the association between income and longevity in the US. The results will disrupt a lot of what you might have thought about healthcare. The first finding was not surprising: higher […]

Categories
Doctoring General Medicine Health Care Health Care Reform Healthy Living Knowledge

Another thing to fear in healthcare: Getting an Xray

I head to Chicago this weekend for the 4th Annual Lown Institute Conference. The Lown Institute seeks to catalyze grassroots movements for transforming healthcare systems and improving the health of communities. For those of you who want to be on the right side of the street of history, Dr. Bernard Lown, a cardiologist, activist, and […]

Categories
Doctoring General Cardiology General Medicine Health Care Knowledge

More on the gambling decision to take statins

In my last post, I wrote my initial thoughts of an important new study on how the decision to take a medication or have a screening test in the name of prevention is similar to playing the lottery. I promised to think and write about the study more carefully. My latest thoughts are now published […]

Categories
Doctoring General Cardiology General Medicine Health Care Healthy Living inflammation

A new way to discuss statin drugs

A new study published last week in an open heart journal changes the conversation about how patients and doctors think about and discuss preventive therapies–such as statins. Dr. Richard Lehman may be the smartest doctor on Twitter. This is what he said: This is a game-changer https://t.co/WgGdLlodbL — Richard Lehman (@RichardLehman1) March 20, 2016 Most […]

Categories
Doctoring Health Care Healthy Living Hospice/Palliative Care

Thoughts on Justice Scalia’s Death

When I heard Justice Antonin Scalia had died suddenly, presumably of cardiac causes, I spent time reading and thinking about the famous judge. Three themes seemed worth putting down in writing. Read more here: Justice Scalia’s Death: Three Lessons for the Healthcare Community JMM

Categories
Doctoring Health Care Health Care Reform

VA hospitals do not deliver inferior care

Bernie Sanders has intensified the debate about US healthcare. Specifically, he has people talking about a single-payer government-controlled system. Critics, uninformed as they are, point to the VA system as an example of inferior care. A well-conducted study refutes such misthink. Yale researchers performed a massive cross-sectional study to compare outcomes among older men in […]

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

Science Needs Data Sharing Like Sports Needs Doping Controls

I’ve got a good story for you. One that goes back to the early days of this blog, a time when I wrote about cycling. It turns out that the biggest medical news thus far in 2016 has a connection, albeit slight, to the recent doping news out of Belgium. You’ve heard the news from […]

Categories
General Medicine Health Care

Overdiagnosis and Overtreatment

I’ve never been more concerned about the harms of healthcare. Any exposure to the health care system can get you in trouble. It’s especially scary when healthy people enter the system–often in the name of prevention. Remember that the most likely outcome of a medical intervention in a person without complaints is harm. How can […]

Categories
General Medicine Health Care Health Care Reform Healthy Living

Rethinking Cancer Screening

The purpose of this post is to introduce my latest column on Medscape, which is linked at the end. You might wonder why an electrophysiologist is interested in cancer screening. I am interested because it may be one of Medicine’s largest reversals. A reversal happens when something (testing or treatment) doctors did, and patients accepted, […]

Categories
General Cardiology Health Care

Alzheimer’s disease and macular degeneration concerns with Entresto

Three academic physicians, writing in an editorial in the Journal of the American Medical Association, raised serious (but theoretical) concerns about the risk of Alzheimer’s disease and macular degeneration with long-term use of the new heart failure drug, valsartan/sacubitril (Entresto, Novartis). Here is the translation: Sacubitril is a drug that inhibits neprilysin, which is an […]

Categories
Health Care Healthy Living Reflection

Despair not opioids is killing poor white American men

The news this morning is sobering. Poor, white, middle-aged American men are dying at increasing rates. The report, published in a prestigious medical journal by a recent Nobel Prize winner, has shocked the public health community. It should shock you. NPR covered the story. So did the NY Times. Twitter is abuzz with the news. […]