Kevin Thomas is a cardiac electrophysiologist at Duke University Hospital.  Watch his journey.  Courtesy of Black Men In White Coats and Diverse Medicine.

A friend asked me recently about statins. He takes a statin for primary prevention but is concerned that he has muscle pain and weakness as a side effect. So he posed the question: “How important is the statin?” The Washington Post had this recent article: "Who should take statins? A vicious debate over cholesterol drugs."

But while nearly all experts agree that statins are beneficial for people at a substantial ...

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“Beep,” went the machine. I left a message and hung up. My patient, Mr. G, had just been denied a medicine by his health insurer. It’s the same medication for the same condition that he had been taking last year. I was leaving a message on his behalf. You can be assured that if you hand an insurance card to the front desk employee at your doctor’s office, your doctor deals with health insurers ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 51-year-old man is evaluated during a follow-up visit for management of newly diagnosed hypertension and diabetes mellitus. He has started a program of lifestyle modification for his diabetes but has not yet started antihypertensive therapy. He is currently taking no medications. On physical examination, blood pressure is 148/92 mm Hg, and ...

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It is the beauty of evidence-based medicine (EBM) that a scientist can at once be a Pope and a Galileo. His transmutation is as effortless as it is discretionary. If you think you’ve met Galileo -- a rebel, a free thinker, a rocker of the establishment -- the following week he is a Pope, castigating detractors, censoring critics, and celebrating uniformity. He changes by a roll of the dice. His ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 74-year-old woman is evaluated during a routine examination. Her medical history is significant for hypertension and obesity. She is a former smoker, stopping 5 years ago. Medications are amlodipine, lisinopril, and aspirin. On physical examination, she is afebrile, blood pressure is 136/78 mm Hg, pulse rate is 68/min, and respiration rate ...

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Alvion Barr had a four-month delay in his diagnosis. He is technically a patient of my colleague. But he had drifted between two of our regular doctors and a locum tenens physician we hired to work during March, when both other doctors were on vacation. I saw him late Thursday afternoon for a rash, but he also asked what he could do about his heartburn. “Tell me more about your heartburn,” I said. What followed ...

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I was called at 4:30 a.m. for a patient with tachycardia in the hospital, and as I logged into my EMR from home, I saw this on Twitter: https://twitter.com/EM_Educator/status/759297946160656384?ref_src=twsrc%5Etfw In under two hours, there were 15 retweets, 44 "likes," and 19 comments that appeared on Twitter (so far), most wishing the patient the best, looking forward to pictures of the angiogram, etc. This is the lovely world of social media, but it also demonstrates his ...

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She fit into the palm of his hand. That long nine months. Waiting desperately for that baby they thought they could never have. Jeff, football player from his high school days, met the love of his life, Bridget, at the school party. She was smart and beautiful; Jeff was big and burley, but as kind and gentle as a kitten. They hung out through their college days.. And finally said their ...

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A few years ago, I missed a diagnosis.  I know that’s not earth-shattering, but the stakes are high for a cardiologist.  Ms. A was an 82-year-old woman with chest pain. She underwent a transcatheter aortic valve replacement (TAVR) for severe aortic stenosis.  The pre-procedure coronary angiogram showed no coronary artery disease and the echocardiogram post TAVR was perfect. However, a few months after the procedure, she reported arm pain.  It was ...

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