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 azithromycin (the drug in a Z-pak). Quoting directly from the FDA warning:
[Azithromycin] can cause ...
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My hospital has just weathered an impressive upswing in patient volume. The house was full for weeks. The experience highlights an important aspect about quality care–an obvious one that doesn’t always make headlines.
What I notice when the hospital gets full is that patients are sent to units that they don’t normally go to. For instance, at my hospital, like yours probably as well, there are numerous different types of heart ...
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Every once in a while a news item becomes so big that a threshold is reached. Thinking people must weigh in.
When the US Supreme Court hears two cases involving the rights and treatment of individuals who are lesbian, gay, bisexual or transgender, there is a lot at stake. Our country faces a really important test.
It’s not so much about the specific legal issues, though they are not insignificant. Much more ...
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Every once in a while a topic comes up that takes me back to the origins of this blog. At its core, DrJohnM aims to merge the worlds of athletics, health and medicine. The glue, the secret sauce, is mastery of the obvious.
As an athlete and doctor, I get to see how both plans parallel each other.
Katie Compton is an American ...
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I hope my patients are satisfied. This is everything. Improving the lives of people is why doctors do what they do. How much we help our patients is the metric. It’s the peg we hang our self-esteem on.
So yes, of course, patient satisfaction is really important.
But that doesn’t mean it’s a good idea to link it with dollars.
In fact, on a list of well-meaning but really dumb reform ...
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I grew up in Connecticut. It was in a town just like Newtown. It was safe and it was quiet.
I am a father and a grandfather. My life is surrounded with children.
This weekend has been tough. You try to read or write something, but the mind wanders. Then you feel sadness. The more you think about the specifics, the sadder it gets. Your heart aches.
Our nation feels it. I recently ...
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There was good news recently in the atrial fibrillation world.
Though no surprise to heart rhythm doctors, an FDA investigation reveals no evidence that new cases of bleeding are any higher with dabigatran (Pradaxa) than with warfarin.
The full statement from the FDA is here.
The assessment was undertaken because after approval of the novel anticoagulant (blood-thinner) a large number of adverse events were reported to the FDA. Despite
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Millions of Americans believe in the practice.
Government reformers believe in it.
Doctors too.
Heck, even I, an accused therapeutic nihilist, tracked down a poor soul who agreed to be my primary care doctor. Call it old-fashioned, but I wanted my own doc, and I wanted yearly “checkups.”
No procedure—not even AF ablation–is as good as prevention. Taking your body in for routine checks and scheduled maintenance makes perfect sense. Call such a notion–obvious.
But ...
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Let’s start with a disclaimer: I am not complaining; I’m just stating the facts.
Honest fact: The morale of doctors in the real world is low–and sinking lower.
I know what you are thinking. “Come on Mandrola, you are nuts if you expect us to feel sympathy for doctors–of all professions.”
Well, you can think that if you wish, but I’m calling it as I see them. And here is why it matters:
Because ...
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I am riled up—almost to the point of being inflamed.
I hate it when doctors get dragged through the mud. It’s a matter of pride. Doctors are my team.
The latest kerfuffle centers on how much we should charge for return patient visits. The difference here is between moderate and moderately high visits–or about $30.
When the Center for Public Integrity is investigating your profession, it’s unlikely to be good news. And it ...
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"A comprehensive and extremely useful roadmap for doctors."
-Eric Topol, MD, author of The Creative Destruction of Medicine
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Past 6 Months
Dear lawmakers: This is what it’s like to be a doctor today
Matthew Moeller, MD | PhysicianA gun owner responds to Sandy Hook
Edwin Leap, MD | PhysicianIs Chris Christie too obese to run for president?
Jeffrey Parks, MD | PhysicianIf I’m wrong about guns, can you please explain why?
Claire McCarthy, MD | PhysicianPrimary care doctors may no longer be needed
Doug Olson, MD | PhysicianWalgreens moves into primary care, and it’s our own damn fault
Kevin Pho, MD | Kevin's Take