AF ablation Atrial fibrillation General Cardiology General Medicine

AF, Ablation, Stents and Five Nuances

Joan has left an excellent comment on my recent 2019 AF ablation update. She brings up many important issues. Let’s dissect it. Q: Joan asks if it is common to see patients who think they are cured after AF ablation but are still in AF?  A: The scenario I described in my previous post is […]

AF ablation Atrial fibrillation General Cardiology General Medicine

AF Ablation Update 2019

Most years I write an update on any big developments in AF ablation. This year’s version will be a short one. I have little new to report. But it’s worth reviewing some basic issues. We still do not know the cause of atrial fibrillation (AF). That makes it hard to fix with ablation. Knowledge Deficits: […]

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 […]

Social Media/Writing/Blogging Uncategorized

I am not quitting social media

I recently finished an academic review paper on the role of social media in medicine and cardiology. My co-author and friend Piotr Futyma (Rzeszów Poland) and I focused mostly on the upsides of digital media. It’s not yet published but it is accepted.  I was an early and accidental adopter of social media. I used […]

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 […]

Doctoring Knowledge

On Our Words

During a recent office visit an older women recited to me what I had said to her over a decade ago on the day she came to the hospital. The detail of her memory gave me pause. I could not remember the scenario but she said that my words had become part of her family’s […]

Atrial fibrillation Doctoring General Medicine

How dangerous are NSAIDs in patients with AF?

One of the most commonly asked questions in the office is the treatment of arthritis pain. This comes up because of the concern over taking NSAIDs (non steroidal anti-inflammatory drugs) in patients who are on anticoagulants (such as warfarin, or dabigatran, rivaroxaban, apixaban). My views on this matter have changed. But first, I want to […]

Doctoring Healthy Living Knowledge Uncategorized

Cardiology Podcast Every Friday

My editors at Medscape warned me years ago that many people, especially younger ones, read a lot less. This saddened me because I’ve spent a great deal of time learning to write. One of America’s most accomplished writers, Malcolm Gladwell, began his podcast because he worried about not reaching younger people. Each week, I spend a […]

Doctoring General Cardiology General Medicine Knowledge Social Media/Writing/Blogging

Finding Truth: How Much Do We Need Experts?

I am planning a column on the role of experts in translating medical evidence. Evidence is important because it’s how doctors know they are helping not harming people. It’s hardly news that the new (digital) democracy of information has changed the rules of influence in Medicine. In the days of old, academic doctors generated, analyzed […]