At the risk of exposing my naivete, or being too much like the geeky student who sits in the front of the classroom, I can’t help but welcome the upcoming policing of cardiac device implants. As recently written by Dr Wes, government policing agencies, the DOJ and RAC folks, are planning to focus on […]
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Doctoring in the trenches, using our knowledge and techno-gadgetry to enhance or save lives, is uplifting. Reading news on heath care reform is “not so much.” Reform has yet to begin, but businesses and doctors are already changing their behavior. As chronicled in this depressing piece, it is clear that doctors are joining consolidated practices and […]
Medical advancement stomps on. This week, Genetics takes front stage. Really, it’s cool. I know; I was a skeptic too. That is, until I read this most amazing paper on the real-life clinical utility of knowing the whole genome of a person. It felt like peering into the future of medicine. Background from the real […]
Medical prowess has exploded in the past decade. Â The toolbox of therapeutic options has grown so large that often times, the most challenging aspect of patient care is in matching the right tool to the right patient. Â There is no better example than the expanding capability to ablate atrial fibrillation. Now that I can successfully […]
A patient asks, “Doc, do you ride your bike to prevent heart disease.” I reply, “Heck no, I am hoping to live long enough to get heart disease.” The non-athletic patient looks quizzically at me as if trying to decipher what I mean, or whether I am serious. Â Too long a story, so we move […]
Here is an example of how increased regulation from third parties attempts to control costs, but actually does the opposite. A middle aged patient whom I have seen in the past for benign palpitations called today because of atypical chest pain. Although I have criticized the overuse of nuclear imaging studies, and probably order the fewest of […]
Atrial fibrillation therapy continues to grow in complexity. Â Thus far, an easy cure has remained elusive. Â The potential of discovering an easy cure of AF –and the resultant immense profits –has provided fertile soil for medical device companies. Â But, like in a garden, fertile soil provides for the growth of both beautiful plants and weeds. […]
Why would referring a patient directly to a specialist save money, time and patient outcomes? Exhibit A: A 75 year old male presents to his family doctor with a heart rate of 120. Just some palpitations and a little “funny feeling in my chest.” No pain, no shortness of breath, no dizziness. Examination shows a […]