Atrial fibrillation Doctoring General Medicine Knowledge

Beta-blockers, Statins, AF, and the Nocebo Effect

Our brains can easily fool us. No experienced doctor would deny the power of the placebo effect. Today I want to discuss the nocebo effect, which occurs when negative expectations of something causes it to have a more negative effect than it otherwise would. Drugs can exert a strong nocebo effect. If your brain thinks […]

Athletic heart Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Doctoring General Cardiology General Medicine Health Care Healthy Living Knowledge Nutrition

Statins, Like All Medicines, Are Neither Good Nor Bad

We have to talk about drugs. No, not illicit drugs, but medications used by doctors and patients. Plaintiff attorneys run ads on TV that fool people into thinking certain meds are bad. The current one I deal with is the clot-blocking drug rivaroxaban (Xarelto.) Before that, it was dabigatran (Pradaxa). If, or when, the makers […]

AF ablation Atrial fibrillation Doctoring General Medicine Healthy Living Knowledge

Four Crucial Questions To Ask Your Doctor

I am seeing an increasing number of patients who did not know they had a choice about taking a medicine or having a procedure. Why did you have that heart cath? A: My doctor said I should. Why are you on that medicine? A: My doctor prescribed it. It’s time we re-review the basic four […]

Doctoring General Cardiology General Medicine Health Care Knowledge

More on the gambling decision to take statins

In my last post, I wrote my initial thoughts of an important new study on how the decision to take a medication or have a screening test in the name of prevention is similar to playing the lottery. I promised to think and write about the study more carefully. My latest thoughts are now published […]

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A new way to discuss statin drugs

A new study published last week in an open heart journal changes the conversation about how patients and doctors think about and discuss preventive therapies–such as statins. Dr. Richard Lehman may be the smartest doctor on Twitter. This is what he said: This is a game-changer — Richard Lehman (@RichardLehman1) March 20, 2016 Most […]

General Cardiology General Medicine Health Care

Medical evidence — Don’t get fooled again

I’ve never been more convinced that the ease with which knowledge is shared in the digital age is a force for good. I loved the video below. These two guys read conclusions of medical studies for humor. That’s a good one. James McCormack is a pharmacist, professor, medication mythbuster, and healthy skeptic at the Faculty […]

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Update: Baltimore, Safety in AF ablation, Podcasts, and some personal notes

On Baltimore: Human beings rioting in the streets of an American city forced cancellation of an important cardiology meeting. This is a vivid example that doctors do not practice in a vacuum. We are connected to this world. Here in Louisville, just a few miles north, an HIV crisis runs amok because of IV drug […]

AF ablation Doctoring General Medicine Health Care Healthy Living

Why don’t people ask their doctors more questions?

I do not get it. Day in and day out, I ask patients why they take a medicine. Many do not know. “My doctor put me on it,” goes the common response. Take statin drugs, for example. I often ask a person why they are taking the drug? With rare exception, the person says it […]

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Athletes, AF, Anticoagulants, Statins, Peanuts, and Dishwashers

Here is an update on my recent writing. Athletes and AF: I was honored to be invited back to the Western AF symposium in Park City, Utah. Last year, I presented on social media. This year, Dr. Nassir Marrouche (University of Utah) asked me to tackle the topic of atrial fibrillation in athletes. This is […]

Doctoring General Cardiology Health Care Healthy Living Knowledge

Does the controversy over statin drugs herald a new era of doctoring?

In July, I wrote a short blog post expressing doubt about the value of statin drugs. Medscape republished it on their website and it went viral–in a medical sort of way. The post has 631 comments. It was Tweeted extensively, page views have been off the charts (for me), and I even received an invitation […]

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Growing doubt on statin drugs — the problem of drug-lifestyle interaction

My mind is changing about statins. I’m growing increasingly worried about the irrational exuberance over these drugs, especially when used for prevention of heart disease that is yet to happen. An elderly patient called my office last week to tell me thank you…not for a successful procedure or surgery, but rather, for helping with a […]