Doctoring General Medicine Hospice/Palliative Care Knowledge

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 […]

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

Hospice/Palliative Care

Hospice and Palliative Care and Cardiology TweetChat Recap

Thanks to Dr Bernadette Keefe (@nxtstop1) last night’s Hospice and Palliative Medicine (#HPM) Tweet Chat has been “storified.” Here you go> [

Hospice/Palliative Care

Join us tonight for #HPM Palliative Care Tweet Chat

Tonight, February 17, at 2100 EST, Staci and I will host a Tweet Chat about cardiology and palliative care. It’s a great way for the general audience to learn from Staci. As a cardiologist married to a palliative care doctor, I get to know things that most cardiologists don’t know. The one-hour session revolves around […]

General Cardiology Health Care Health Care Reform Hospice/Palliative Care

We must inject more care into healthcare

A frail elderly women has a leaky heart valve. It caused her legs to swell and increased her work of breathing when she pushed her walker around the house. One doctor wanted to relieve her suffering. She suggested palliative care; she wanted to make her disease less severe but without removing the cause. Other doctors […]

Doctoring General Cardiology Hospice/Palliative Care ICD/Pacemaker

Avoiding a bad death requires preparation

If there was a hashtag for sub-specialty healthcare and ICU medicine in the United States it would be: #WeCanButShouldWe A recent study led by Dr. Harlan Krumholz (Yale University) showed that we have become more efficient at keeping elders alive. This is not surprising. And it’s good news in the sense that technology–if used wisely–can […]

AF ablation Athletic heart Atrial fibrillation Doctoring General Medicine Health Care Reform Hospice/Palliative Care ICD/Pacemaker Reflection

Update: Social justice of AF care, NOAC monitoring, population health and two new podcasts

Hi All, Here is a short update of the past week. The first thing to say is the Atrial Fibrillation Care: Put the Catheter (and Rx Pad) Down post has gotten a lot of attention. It stayed on the most popular list all week. It has over a 130 comments, and I have received many […]

Doctoring Hospice/Palliative Care Social Media/Writing/Blogging

I will host Hospice and Palliative Care Tweet Chat — #HPM

This Wednesday Feb 11th, at 9 PM EST, one day after PBS Frontline features Dr. Atul Gawande and his new book Being Mortal, I will guest host the Hospice and Palliative Care (#HPM) Tweet Chat. Dr. Christian Sinclair is a physician leader in HPM and a co-editor of Pallimed. He recently commented on my stewardship piece […]

Doctoring Hospice/Palliative Care ICD/Pacemaker

The power of the specialist physician — and stewardship

My latest column over at discusses the disordered balance of power in the doctor-patient relationship. As most of you know, I harbor strong biases about the quality of medical decisions, especially in the elderly. Attached. Yes, I am attached to the issue of decision quality. Nearly all of electrophysiology, and much of cardiology, involves […]

Doctoring General Cardiology General Medicine Health Care Hospice/Palliative Care

Because there is nothing else to do

If you ever hear your doctor say we are going to do something because there is nothing else to do, be afraid. Be very afraid. First of all, it should be self-evident that if caring and empathy and relief of suffering count as doing something, there is always something to do for patients. A growing problem […]

Doctoring General Cardiology General Medicine Health Care Hospice/Palliative Care ICD/Pacemaker

To deprescribe…Adding a new verb to the language of doctoring

What follows is my most recent editorial in the Journal of the Kentucky Medical Association. It is reposted with permission. **** One day every month, my wife Staci, a hospice and palliative care physician, goes to see an elderly woman in the nursing home. The routine has gone on for years, which is surprising because […]