What we can learn about weight loss from Al Sharpton However you see the Reverend Al Sharpton, one thing is certain: you see less of him now. His Twitter pic tells you he is proud of his 167-pound weight loss. Good for him, he should be. If you care about health, the disappearance of the Sharpton-of-old is worth mention. His story teaches us a lot, and, if one dares to look a little ...

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Let’s be honest. If you are bold enough to hit the "publish" button, it’s normal to care what readers think. I write about medicine: I like doctors, I respect doctors. So it matters how colleagues react to my words. I was both proud and concerned when the Greater Louisville Medical Society decided to republish my "Changing the Culture of American Medicine" piece in their monthly journal, Louisville Medicine. The reaction of my colleagues has ...

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Obamacare is here. It’s really here. You might be wondering what’s been going on in the hospital or office -- the contact points where health care actually happens. The funny thing is: nothing seems any different. And this is the problem with Obamacare. It hasn’t, won’t, or perhaps couldn’t, change the fundamental problem with US health care. Namely, that it is too big, too disruptive, and too devoid of nuance. In this way, health care ...

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Recently, I awoke to a picture of myself in the Wall Street Journal. I was asked to comment on the effects of the coming Sunshine Act. Respected health care journalist Peter Loftus found me through social media channels. What follows are some thoughts about how the Sunshine Act might play out. Every Thursday during my cardiac fellowship training, at noontime, the entire department gathered for an hour-long conference on echocardiography. Unknown ...

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What follows are not complaints. These are just the facts. Here’s a recent exchange from an enlightened physician leader, one who has yet to give up: “My colleagues are discouraged and frustrated every day, leaving the office defeated and fatigued. There are other ways to practice.” High health care costs get most of the attention, but there’s a more important crisis coming your way. First a review, then to the looming crisis. When Americans travel ...

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I used to think medicine would get easier over time. It makes sense, right? You see patterns, you learn how treatments work, and you just get to know stuff. Experience should make it easier to diagnose and treat. That’s not been the case for me. In fact, it’s closer to the opposite. In the exam room, as I look up to the patient from my stool, and before I stand at ...

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It’s been a while since I did a cycling topic. As I was skimming thorough the Journal of the American Medical Association recently, I came across this review article on spinal injection therapy for low back pain. It was a shocker. Two factors brought my attention to the article. First, almost all the cyclists or runners I know have been beset with either back pain or sciatica (referred pain or weakness down the leg). In ...

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Does alarm fatigue really kill? Patient safety and hospital quality is a scary topic. I’ll go easy. I’m just a doctor. I don’t know much. Entire departments, filled with cubicles, computers and well-meaning people, now exist to keep hospitals tightly regulated and running perfectly. There is data to analyze, regulations to read, and oh so many meetings to attend. This place of healing will be safe—and perfect. The ...

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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 and relevant essay. His tone and candor is one of a man who still cares about ...

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Here is an edited email I received from an athletic colleague:

John, A 50 year-old male healthy athlete has the new problem of occasional periods of premature beats. She (or he, doesn’t matter) has visited the doctor and an ECG shows PVCs, or premature ventricular contractions. Otherwise the history, exam, ECG, ECHO and electrolytes are normal. What’s up with PVCs? Why? Could they be 1) consequence of (chronic) exercise or 2) related in ...

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