Ms. Smith (name changed) is 82-years-old, but currently looks about a hundred. I met her, intubated, in the ICU two weeks ago. She lived alone, hadn't told family she wasn't feeling well, but had called 911. In the emergency department, she was struggling to breath, and was intubated, having gone into respiratory failure. She was found to have a severe pneumonia affecting the majority of both her lungs. She also went ...

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Recently, CVS Caremark announced that starting October 1, they will no longer be selling tobacco products, including cigarettes, in their CVS stores. Taking a bold and unexpected stance on the issue, CVS’s CEO Larry Merlo reasoned to ABC News that “We’ve come to the conclusion that cigarettes have no place in a setting where health care is being delivered.” What does he mean by that? Here, he is referring to ...

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10 things to know about anesthesia and heart surgeryA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. February is American Heart Month. Unfortunately, heart disease is a major problem in the United States that can result in surgery. In addition to discussing your procedure with your surgeon, you want to be sure to discuss your anesthesia care with your physician anesthesiologist. Here are 10 ...

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By now the world has heard the remarkable news. CVS Caremark will no longer be selling its tobacco products in any of its stores.  Locked and loaded with the news, the American Heart Association, American College of Cardiologists, local public health experts, Phillip Morris, and even the former-smoking president of the United States was quick to applaud the news by publishing press releases. But when press releases and major announcements of ...

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In medicine today diagnostic testing and advanced imaging is readily available and widely utilized in most every clinical setting.  Many physicians have given up the stethoscope and physical exam in favor of an echocardiogram and a CT scan.  Fear of missing something pervades every emergency department and has resulted in hundreds of thousands of unnecessary testing costing billions of dollars in healthcare expenditures. Of course, the driving causes of increased testing ...

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Cardiologists are causing patients to get cancer. It’s true. Cardiologists routinely perform angiograms on patients who have no heart disease whatsoever. As shown in this Harvard newsletter, each angiogram exposes the patients to about 7 mSv of radiation. Add in the myocardial perfusion imaging at another 25 mSv of radiation and you have enough radiation to cause cancer in an otherwise healthy individual. And cardiologists routinely subject patients with normal coronary arteries ...

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Cardiovascular disease -- including coronary atherosclerosis and cerebrovascular disease -- remains the number one cause of mortality in the United States. One out of three people in this country will die of cardiovascular causes.  Although I can’t say that the other top causes of mortality are particularly attractive -- cancer, chronic lung disease, accidents and dementia -- premature cardiovascular death can certainly be very devastating and it makes sense to do ...

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How should patients determine the quality of their doctor? This is an interesting question that has now reached mainstream media status as evidenced by a Wall Street Journal article by Laura Landro, a very accomplished veteran health care reporter. With the best and brightest going in to medicine, the requirement for more rigorous training than anywhere else in the world by (some might say) "exceptional, world class" medical educators and longstanding ongoing mandated continuing medical ...

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Would you tell me, please, which way I ought to go from here? That depends a good deal on where you want to get to. I don't much care where – Then it doesn't matter which way you go. - Lewis Carroll In the new world, payers will increasingly ask before reimbursing medical imaging: why did you bother finding out? This is why we must pay attention to clinical trials. An instructive case is in the ...

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“I used to be strong, I wrestled the bull,” Sumner Ball said, “but now I can’t even wrestle the rooster.” On the far side of eighty-years-old, he looked lively and trim, and his weathered face hinted at a smile as his blue eyes peered straight into mine. “I think these cholesterol pills are hurting my muscles,” he declared. “I don’t think they’re good for me.” “Is it your back?” I scanned through his last ...

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