When an employee leaves a position, management might conduct an exit interview. The idea is obvious: one can learn a lot from those who are free to speak candidly. This is why I think it’s worth listening to doctors who no longer practice medicine. Enter Dr. Ed Marsh, a former pediatrician, who writes this poignant […]
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How safe is a Z-pak?
Text message: “John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.†If you write a blog on medical decision-making and heart rhythm matters, it seems an incredible omission not to opine on the FDA warning concerning the commonly used antibiotic […]
Before I start, let’s do a disclaimer: I, myself, John Mandrola, having practiced for nearly 16 years, and having saved and lived frugally, am going to be okay. In the game of medical practice, I am in the sixth or seventh inning. I’m almost done. I write such healthcare essays then, not so much because […]
I’ve said it before here many times over. In achieving quality of medical care, information and transparency are fundamental. Knowledge empowers patients to share in their medical decisions. Doctors have always been teachers, but with the explosion of medical treatment options, this role has never been more important. Currently, in most of the real world, […]
May I tiptoe onto a ledge for a moment? Some (just-back-from-Europe) thoughts on health care policy, perhaps? One of the many differences between the European Society of Cardiology Congress and a typical American cardiology meeting was the scarcity of healthcare policy sessions at ESC. That’s hard to explain; perhaps European countries are settled on their […]
If you have not already heard, there was more news (see theHeart.org) on the troubled St Jude Medical Riata family of ICD leads. The high voltage leads were recalled in December of 2011 and estimates are that 79,000 remain implanted. Perhaps more problematic for the company is the structural similarity of its current ICD lead […]
On the surface, both WSJ articles painted a gloomy and depressing picture of US healthcare, now and beyond. That wasn’t my take. I felt a rush of optimism. Let me explain. In, ObamaCare’s Lost Tribe: Doctors, deputy WSJ editor Daniel Henninger wrote about the (forgotten) plight of doctors in the Affordable Care Act. He critiqued […]
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Standing up for a Harvard Doctor
There was a very important article written in the NY Times today. It highlighted a common medical scenario in my world—the defibrillator (ICD) world. I am going to talk about ICDs here, but the big picture inherent in this story illustrates the important issue of how best to apply invasive therapy to elderly and sicker […]
Tough week. Sometimes the catheter falls into place easily, and sometimes it does not. This week, ‘not’ dominated. I wish it was just the procedures. Difficult cases that string together–and for some reason they tend to come in clumps–was not the hardest part of the week. Hardly. The real tension-inducer was fending off, dealing with, […]
To those who submitted posts, I say thanks. I appreciate that you did. Medical Grand Rounds keeps going because of you, the medical blogger. Your voice, your impressions, your passions and your human stories make our field such a great canvas. Let’s get it started: A Hand of Hearts: I was delighted that one of […]
You have probably read that experience makes for better doctors. And of course this would be true–in the obvious ways, like with the hand-eye coordination required to do complex procedures, or more importantly, with the judgment of when to do them. There’s no news here: everyone knows you want a doctor that’s been out of […]