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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 […]

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Doctoring General Cardiology General Medicine Knowledge

Lecture on Scientific Bias in Cardiology

Last month I gave a lecture in Brazil (via my house in Kentucky) on scientific bias in cardiology. It’s about 20 minutes. Dr Bob Kaplan from Stanford also spoke on issues relating to how FDA approves drugs–a timely topic. Many of you know that I espouse a medically conservative approach to medical practice. My lecture […]

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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 […]

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Doctoring General Medicine Knowledge Reflection

More on COVID19 Testing and How This Virus Makes Us Use Our Noggins

My friend Anish Koka, a cardiologist, wrote a beautiful review of COVID testing over at the HealthCareBlog. The great pandemic is wreaking havoc, we are told, because the nation is not testing enough.  The consensus from a diverse group that includes public health experts, economists, and silicon valley investors is that more testing will allow […]

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Doctoring General Medicine Knowledge

COVID19 and Finding Effective Medical Therapies

This post introduces a column I wrote over at TheHeart.org | Medscape Cardiology — The good news is that most people infected with coronavirus don’t need a hospital or doctor. But some do. Some get very ill. The maddening thing is that doctors don’t have an effective treatment for the virus. There are no cures. […]

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Exercise General Medicine Health Care Reform Healthy Living

The Case for Opening (some) Pools In COVID19 Pandemic

The COVID crisis has decimated water exercise. Can we rethink pool closures? A significant number of my older patients relied on pools for their fitness. During a pandemic, you can stay active or fit only if you have good legs and joints. Walkers, runners, and cyclists have no problem; they play outside in the Spring […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]