John Mandrola, MD

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Daily

Medical journal data sharing is seriously disruptive

Medical science is in the midst of a confidence crisis. One problem is replication. More and more, one group's discoveries cannot be replicated by another group. Another problem with medical science is that negative studies get published less often than positive studies.

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Never forget: People are not diseases

Research now indicates 50% of middle–aged people live with one chronic disease. Translation: half of middle-aged people are not healthy. (You don’t need a reference there. Just walk out into the world and look around.) This new normal creates a challenge for caregivers. How will we care for the onslaught of chronic disease? Surely not […]

Daily

3 words guaranteed to infuriate a physician: maintenance of certification

This is a story about a new medical intervention. It’s an important one because it affects all doctors—and therefore all patients. 1. It’s expensive. Of course. 2. There is no credible evidence that it works. But its marketing is aggressive. 3. The overwhelming majority of physicians disapprove of it. 4. Cheaper alternatives exist. 5. The […]

Daily

Vaccine anxiety shows that doctors need to find a more helpful tone

I’ve read and re-read Dr. Paul Offit’s WSJ opinion piece, The Anti-Vaccination Epidemic. Dr. Offit is a professor of Pediatrics at a leading hospital in the United States. He is also an author, a scientist, and a vaccine-developer. In short, he is a major physician leader. I’ll come back to that point in just a […]

Daily

Dr Emanuel’s death wish harms rather than helps with end-of-life issues

You know the story on US healthcare and the elderly: Our current default is an American tragedy. It’s devoid of truth and candor; it’s inhumane and it’s wasteful. Recent gains in longevity have come by extending the period of disability right before death. Aggressive care treatment is often hoisted onto the frail because caregivers lack […]

Daily

Blaming the patient . . . and the philospophy of caring for atrial fibrillation

More than a few commenters recently noted something disturbing in my writing. They said my words are increasingly taking a blame-the-patient tone. That bothers me. Of all people, I know about making imperfect health choices. These comments got me thinking about striking the right balance in writing about health, say, between apathy and defeatism, (oh […]

Daily

Good doctoring is not rocket science — it is also not digital

Sometimes I worry about where technology is leading the healthcare profession. It is not just the distraction of white screens and electronic health records. These are bad, terrible, in fact. The concern I have runs deeper than just monopolistic EHRs. We, and I mean we as in the caregivers, are losing touch with the basics. […]