A version of column was published in USA Today on November 20, 2013. I once diagnosed a patient with high cholesterol, and prescribed him a medicine commonly known as a statin.   When I saw him months later for follow-up, he admitted that he didn’t fill the prescription. “I took red yeast rice capsules instead,” he said. When I asked him why, he told me that he was wary of statins’ long list of side effects ...

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New cholesterol guidelines: The statin decision lies with patients The release of the new cholesterol guidelines from the ACC/AHA is big news.  It represents a fundamental shift in how we prescribe statin drugs. As with many sweeping changes, there are some good, and some controversial ideas. I like removing non-statin cholesterol drugs from the recommendations, such as Zetia.  Many haven't been shown to save lives or decrease cardiovascular events. Also, removing LDL targets can simplify ...

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Google Helpouts will bring telehealth to the masses Google Answers was a service that was launched in 2002 where users would pay money to ask questions, and a Google-vetted researcher answer them. As many who have seen me speak know, I was a Google Answers researcher, where I answered health-related questions. Google Answers closed in 2006, but recently, version 2.0 of Google Answers was announced: Google Helpouts. This ...

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Why I recommend LinkedIn to physicians When I talk to physicians about dipping their toes into the social media waters, I advise starting with LinkedIn.  Spend about 45 minutes or so and create a LinkedIn profile, which is essentially a digital translation of your CV.  LinkedIn profiles get ranked highest among the social media platforms, and can push down the influence of negative ...

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HealthCare.gov doesnt need a tech surge, it needs better primary care The Affordable Care Act is off to a rocky start, to say the least. Attention has been focused on HealthCare.gov, where those without employer-provided insurance can shop for health plans.  Finger pointing abounds, with the Centers for Medicare & Medicaid Services and contractors blaming each other. A story in the Wall Street Journal chronicles the debacle:

The contractors said each of their pieces ...

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In case you haven't heard, Malcolm Gladwell recently released his book, David and Goliath.  I'm just about finished reading it. Just as interesting as the book are its reviews.  In a recent post from Slate, Gladwell himself responds to the criticism.  He freely admits that his books should not be held as pinnacles of academic rigor, but should be considered "intellectual adventures stories." He further elaborates on the power of ...

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This column was published in USA Today on September 9, 2013. More patients are coming to my primary care clinic with forms from their employer, asking me to measure their blood pressure, or check their sugar and cholesterol levels. Companies requesting medical data drive employee wellness programs, a booming $6 billion business, with approximately half of large employers offering such plans. Coaching and financial incentives are often offered to help employees meet certain health ...

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Most social media guidelines for physicians, most recently from the American College of Physicians and Federation of State Medical Boards, suggest that doctors separate their personal and professional identity. Until physicians are better educated on how best to act professionally on social networks, keeping their online personal lives private is more likely to keep them out of trouble. But is it time for that recommendation to be revised? In a recent JAMA perspective ...

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Many physicians continue to be fearful of online rating sites, despite evidence that they don't have anything to worry about. Multiple studies, including one from the Journal of General Internal Medicine (saying that 88% of physician reviews were positive), to a more recent one from the Journal of Urology (86% positive), say that the majority of physician ratings are better than most doctors would think. Reconcile these findings with ...

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Drug store retail clinics for primary care? Not so fast A version of this column was published in USA Today on July 3, 2013. One recent day in my primary care clinic, I had a full schedule and was unable to see a patient for her cough.  She instead sought medical care at a local drugstore, where she was treated for bronchitis. Normally housed in pharmacies and department stores like Target or Walmart, ...

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