The paper from the New England Journal of Medicine that reports azithromycin might causecardiovasculardeath is not new to electrophysiologists tasked with deciding antibiotic choices in patients with Long QT syndrome or in those who take other antiarrhythmic drugs. Heck, even the useful Arizona CERT QTDrugs.org website could have told us that.What was far scarier to [...]

In our rush to establish a national electronic medical record (EMR) system as part of the American Recovery and Reinvestment Act of 2009, powerful silos of independent EMR systems have sprung up nationwide. While most systems are being developed responsibly, like the Wild, Wild West, many have been developed without an objective eye toward quality [...]

The St. Jude-MDT smackdown on the Riata lead performance continues. (For some background, here’s my original post). After seeking a retraction of Robert Hauser, MD’s paper that identified 22 deaths from the Riata lead in the Heart Rhythm Journal, St. Jude’s attempt to secure the retraction of the peer-reviewed paper that was released electronically is [...]

Slightly over a year ago, the Department of Justice (DOJ) launched an investigation of a large number of institutions regarding concerns that implantable cardiac defibrillator (ICD) procedures were performed for reasons outside of the criteria set forth in Medicare’s National Coverage Decision (NCD). This investigation occurred just after Al-Khatib and others published a report January [...]

After a warm week of unusually warm weather in Chicago, a cool front descended on the city this weekend and in many ways, seemed to descend onthe American College of Cardiology Scientific Sessions this year as well. The mood seemed almost somber on Day 1. Perhaps it was the lack of locals attending the meeting [...]

Patience. You have have to have patience.“It’s got to be me,” I tell myself. “I’m a computer guy. Surely there must be something I’m missing.” “Why would they take away that functionality that we had before?” “Why so many buttons and choices?” “Seriously?”Everyone wants something different from our electronic medical records these days. Administrators want [...]

I thought I’d start the week off right, get up early, have a cup of coffee, and get prepared for the week ahead, Little did I know what was in store for me when I checked my e-mail.Margaret Polanecsky, MD (aka, @tbtam the incredibly bright OB-GYNof The Blog That Ate Manhatan fame) had left a [...]

I guess I’ve now become an “old dog” in medicine. The residents look younger, the fellows, sharp and trim, and some of my contemporary physicians, like well-worn time-pieces, are beginning to complain of sore knees, backs, and declining vision. And then there’s the nocturia… Ugh.But for those of us who’ve been around the block a [...]

The government is remarkably good at kicking cans down the road.This is the single reason is why government-run health care costs so much.For instance, we continue to kick the can down the road for the doctor pay fix. Time and time again, we see the Sustained Growth Rate formula fail to be overturned, and instead, [...]

I am seeing the world of medicine change before my eyes, and I wonder where we’re going.Never before has there been more information at our disposal, yet more confusion. Like molecules being heated, the Brownian motion happening in medicine seems completely ineffectual for those of us on the front lines of care, geared more toward [...]