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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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AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Health Care

Thoughts on the Apple Watch and Mobile ECG

Last week I wrote a column on theheart.org | 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 […]

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AF ablation Doctoring General Ablation General Cardiology

AF Ablation is Overused in the US

A colleague recently asked me if atrial fibrillation (AF) ablation was overused. Yes it is. AF ablation has become the wild west of electrophysiology. There is essentially no scrutiny of this invasive, expensive and risky procedure. I also include here the add-on “maze-like” procedures done during heart surgery for other conditions. I believe they too […]

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Atrial fibrillation Doctoring Knowledge Reflection

Politics and Understanding the Human Condition

I recently received this message: This is not the first time I’ve been scolded for straying from medical topics. Last October, during the Lown Institute’s RightCare Action Week, I wrote about our ailing healthcare system. This prompted a different reader to send a similar message: Stick with topics about atrial fibrillation–went the gist of that […]

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Doctoring Health Care Health Care Reform

Dr. Bernard Lown and the first rule of doctoring

I knock, then enter the exam room. “Hi. My name is John Mandrola.” (Maybe it is my age but I am moving away from calling myself Doctor Mandrola.) “I am a heart rhythm specialist. I have looked at your chart so I know a little about your medical history.” “Can you tell me how you […]

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Cycling Stuff Cycling Wed Cyclocross General Medicine Reflection

Observations from being “the family.”

It’s been a trying week for our family. You learn things when your people need healthcare. It’s an entirely different perspective. I am doctor; I’ve been a patient, but this was the first time being “the family.” Without going into details, (see her guest post), my wife Staci came to need the best that American […]

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AF ablation Atrial fibrillation Social Media/Writing/Blogging

My Social Media Talk at the 2014 Western AF (atrial fibrillation) symposium

 How can social media improve AF patient and provider interaction? It was an honor to speak at the seventh annual Western AF symposium this past weekend in Park City Utah. Once in the shadow of the Boston AF symposium, Dr. Nassir Marrouche (@nmarrouche) and his colleagues at the University of Utah have elevated Western AF […]

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Doctoring General Medicine Health Care Knowledge

With vaccines…Is there no middle ground, no room for questions?

“We should be as demanding of ourselves as we are of those who challenge us.” Dr. Jerome Groopman, writing in the New Rupublic Writing about the medical decision-making surrounding vaccines proved to be sketchy. Yesterday’s post brought stinging criticism from both sides of the debate. A pediatrician felt the structure of the post was patronizing. […]

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Doctoring Healthy Living Knowledge Reflection Social Media/Writing/Blogging

The vaccine debate — Could compassion and nuance be an antidote?

I’ve been thinking a lot about vaccines. As a learner, an observer of humans and our nature, a worshiper of the scientific method, a doctor, a new grandfather, and a member of society, few debates could be more compelling. The kerfuffle over vaccines has it all. It’s the Lance Armstrong story on steroids. (Grin.) The […]

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Doctoring Hospice/Palliative Care Reflection

Take fear and ignorance out of end-of-life decisions — A rebuttal to Dr Paul McHugh’s WSJ editorial

Perhaps it’s because I love the practice of medicine so much. Or maybe it’s because doctors (and teachers) have always been my heroes. I’m trying to sort out why I feel so offended by Dr. Paul McHugh’s editorial in the Wall Street Journal last weekend. His sensational and paternalistic view of physician-assisted suicide can be […]

Categories
AF ablation Atrial fibrillation

Answering the critics of atrial fibrillation ablation

In the gratifying category, few things rank higher than vanquishing atrial fibrillation with catheter ablation. But yet, not everyone thinks so highly of a procedure that has come to dominate my medical career. Dr Rita Redberg, influential cardiologist and editor of the JAMA Internal Medicine “Less is More” series, said this about ablating AF: “Because […]