Heart and cardiology

1,642 articles · Since 2004

Articles, page 39

What is your doctor worth per hour in the open market?

October 3, 2012Oct 3, 20125

Recently I was asked to serve as a consultant on a medical matter. Interestingly, they requested my hourly price for my services. I thought about this and wondered, "What am I worth per hour in the open market?" It is…

Recently I was asked to serve as a consultant on a medical matter. Interestingly, they requested my hourly price for my services. I thought about this and wondered, “What am I worth per hour in the open market?”

It is an interesting question to ponder.

I have decided to ask the blog-o-sphere. Call it a bit of “free market economics.” For the record, 100% of my hourly wage for my services will …

Physician voices

Which hospital should I choose? How to use hospital rankings

Ashish Jha, MD, MPH

September 8, 2012Sep 8, 2012

After years of breaking down, my sedan recently died. Finding myself in the market for a new car, I did what most Americans would do – went to the web. Reading reviews and checking rankings, it quickly became clear that each website emphasized something different: Some valued fuel-efficiency and reliability, while others made safety the primary concern. Others clearly put a premium on style and performance. It was enough to …

Patient voices

Why this nurse left the intensive care unit to go into hospice

Gina, RN

September 4, 2012Sep 4, 20127

Earlier this year, I made an announcement that may have made a few people think I was half a bubble off level. I’m leaving CCU. I’ve worked in CCU (and CVICU) for 14 years. 5 years ago I had a…

Earlier this year, I made an announcement that may have made a few people think I was half a bubble off level. I’m leaving CCU.

I’ve worked in CCU (and CVICU) for 14 years. 5 years ago I had a baby, and reduced my hours to one day per week.

It took me just about all of those 5 years to fully comprehend that one just can’t keep up with all there …

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Physician voices

How we die should never be taken lightly

angienadia, MD

September 3, 2012Sep 3, 20127

It was another day in the intensive care unit. The night was clean and calm, ventilators beeping their expected melody, and the laborers of medicine went about their night shifts uneventfully, including me sitting with the obnoxious admission pager attached to my hip. The smoothness of it all shattered when the beeper started screaming – I picked up the phone and soon the emergency room physician was on the line.

“We …

Medical education

The importance of letting go after witnessing a code

Amanda Xi, MD

August 31, 2012Aug 31, 20122

A real code deviates from what they depict in medical dramas like Grey's Anatomy. Television chest compressions are usually too slow and superficial, they are nowhere near forceful enough to sustain blood flow throughout the body. There is no foreboding…

A real code deviates from what they depict in medical dramas like Grey’s Anatomy. Television chest compressions are usually too slow and superficial, they are nowhere near forceful enough to sustain blood flow throughout the body. There is no foreboding soundtrack to hint at what’s coming, only the numbers that appear on the monitor that suddenly dip in the wrong direction.

Although I understood the magnitude of the situation as it …

Physician voices

A connection is lost when we outsource the physical exam

Suzanne Koven, MD

August 27, 2012Aug 27, 20123

I remember my first visit home at the end of my second year of medical school. I’d just received my black doctor’s bag loaded with medical equipment. Like a 16-year-old with a new driver’s license, begging to do the very errands she’ll soon groan about, I went around my parents’ living room and took everyone’s blood pressure, looked in their ears and throats — and then made my “rounds” again.

While …

Physician voices

In a financial squeeze, a way forward for academic cardiologists

Wes Fisher, MD

August 21, 2012Aug 21, 2012

If you want to succeed in academic cardiology, get a federal grant for research. Better yet: get a few well-paid industry grants, too. These days lower-paid academic cardiologists are finding it tougher to find protected time for research and speaking…

If you want to succeed in academic cardiology, get a federal grant for research.

Better yet: get a few well-paid industry grants, too.

These days lower-paid academic cardiologists are finding it tougher to find protected time for research and speaking because grants are harder to come by and money from their academic center is getting tight. For instance, the National Heart, Lung and Blood Institute (NHLBI) of the NIH no longer accepts investigator-initiated innovative …

Drugs and prescribing

Why the drug shortage is leading to desperate measures in hospitals

Al Patterson, PharmD

August 15, 2012Aug 15, 20122

More than 80 percent of the United States supply of heparin, a commonly used blood thinner, originates from pigs reared in farm co-ops in China. Farmers scrape mucus from the intestines and send it to central processing facilities, where heparin…

But in 2007, blue-ear pig disease, causing a respiratory syndrome, became endemic in Asia—leading to a shortage of pigs …

Physician voices

Why are so many doctors complete jerks?

Eric Van De Graaff, MD

August 12, 2012Aug 12, 201230

As odd as this might sound, my mother was upset when I declared my intention to go to medical school. It wasn’t the mountain of debt I was sure to incur since I’d already figured out how to get Uncle…

As odd as this might sound, my mother was upset when I declared my intention to go to medical school.

It wasn’t the mountain of debt I was sure to incur since I’d already figured out how to get Uncle Sam to pick up the bill (a small deal that put me in a military uniform for a decade). It wasn’t the …

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Why are so many doctors complete jerks?

Conditions and diseases

Fat cells are factories of inflammation

John Mandrola, MD

August 1, 2012Aug 1, 20122

The headline called it “the new” science behind America’s deadliest diseases. Wall Street Journal reporter Laura Landro was talking about inflammation and its role in causing human disease. Now, you all know my reaction when a prestigious newspaper features a…

The headline called it “the new” science behind America’s deadliest diseases. Wall Street Journal reporter Laura Landro was talking about inflammation and its role in causing human disease.

Now, you all know my reaction when a prestigious newspaper features a founding principle of this blog. Well, let’s just say it felt awfully nice.

A brief Mandrola review of inflammation is in order.

First, acute inflammation is normal, and required for life. …

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Fat cells are factories of inflammation

Physician voices

The upside of hospital rankings far outweighs the downside

Robert Wachter, MD

August 1, 2012Aug 1, 20122

I knew it would happen sooner or later, and earlier this week it finally did. In 2003 US News & World Report pronounced my hospital, UCSF Medical Center, the 7th best in the nation. That same year, Medicare launched its…

I knew it would happen sooner or later, and earlier this week it finally did.

In 2003 US News & World Report pronounced my hospital, UCSF Medical Center, the 7th best in the nation. That same year, Medicare launched its Hospital Compare website. For the first time, quality measures for patients with pneumonia, heart failure, and heart attack were now instantly available on the Internet. While we performed …

Medical education

EKG reading: It’s shocking what medical residents don’t know

Wes Fisher, MD

July 26, 2012Jul 26, 20123

"Dr. Fisher, can you teach our residents EKG lecture series?" Naively, I said "Sure!" What I didn't realize is how hard this is to do today. Much of this is not residents' fault. They only have so many hours in…

“Dr. Fisher, can you teach our residents EKG lecture series?”

Naively, I said “Sure!”

What I didn’t realize is how hard this is to do today.

Much of this is not residents’ fault. They only have so many hours in so many days to attend lectures while caring for patients. Thanks to residency work-hour restrictions, those hours have become even fewer. To make matters much worse, through the year residents are torn to …

Physician voices

What surfing can teach doctors about patient recovery

Kevin R. Campbell, MD

July 19, 2012Jul 19, 2012

Recently, I decided to take up surfing again. As a 20-year old kid, I was pretty good at most things that required athleticism (even surfing). However, as a 42-year old, things come a little harder. My daughter began taking surfing…

Recently, I decided to take up surfing again. As a 20-year old kid, I was pretty good at most things that required athleticism (even surfing).

However, as a 42-year old, things come a little harder. My daughter began taking surfing lessons about 9 months ago from a young professional surfer. She quickly was able to get up on the board and was soon riding waves (upright) to shore. I decided that …

Physician voices

What can ACO providers do to increase patient engagement?

Steve Wilkins, MPH

July 17, 2012Jul 17, 20125

Accountable Care Organizations (ACOs) and “bundled payments” are set to play a central role in the Affordable Care Act. Under accountable care, physicians and hospitals would be paid out of a “single payment” from CMS or health insurers for all the care needed to treat a clinically defined “episode of care” like a heart attack. The premise is that bundle payments will incentivize physicians and hospitals to deliver more efficient, …

Health policy

Mainstream media can foster an engaged public on health issues

John Mandrola, MD

July 16, 2012Jul 16, 2012

On the surface, two Wall Street Journal articles painted a gloomy and depressing picture of US healthcare, now and beyond. That wasn’t my take. I felt a rush of optimism. Let me explain. In, ObamaCare’s Lost Tribe: Doctors, deputy WSJ…

On the surface, two Wall Street Journal articles painted a gloomy and depressing picture of US healthcare, now and beyond.

That wasn’t my take. I felt a rush of optimism. Let me explain.

In, ObamaCare’s Lost Tribe: Doctors, deputy WSJ editor, Daniel Henninger wrote about the (forgotten) plight of doctors in the Affordable Care Act. He critiqued the mainstream media coverage of the Supreme Court decision because it left out mention of …

Conditions and diseases

How to recognize positional orthostatic tachycardic syndrome (POTS)

Emily Gibson, MD

July 11, 2012Jul 11, 20126

As a college health physician, I see my fair share of fainting patients, including syncopal episodes within the clinic itself, typically while they are using the toilet, or after venipuncture and vaccinations. Our staff is as proactive as possible to avoid these predictable occurrences, listening for problems in the restrooms, putting students in a recliner chair for their blood draws and observing them for awhile post-injection for lightheadedness. Despite taking …

Conditions and diseases

PTSD, stress and anxiety after a major cardiac event

Kevin R. Campbell, MD

July 7, 2012Jul 7, 20125

Having a major cardiac event can be a stressful, life changing occurrence. Often, the psychological impacts of having a heart attack (myocardial infarction) are underestimated and can be long lasting. In fact, there is evidence to suggest that these that the emotional stressors that occur post-MI are consistent with symptoms of post traumatic stress disorder. PTSD has been shown to be associated with higher rates of recurrent coronary events and …

Medical education

The moments that define the job of a physician

Allison Overmon

July 2, 2012Jul 2, 20124

One of the most intense moments of my third-year of medical school was during my internal medicine clerkship when a code blue was called. It was our responsibility as medical students on the inpatient service to report to every code…

One of the most intense moments of my third-year of medical school was during my internal medicine clerkship when a code blue was called.

It was our responsibility as medical students on the inpatient service to report to every code blue while we were on our calls every 4th night. This time was no different, and my call partner and I ran to the code. When we arrived, I recognized the …

Physician voices

The problem of expert witnesses in medical malpractice trials

Jim deMaine, MD

June 28, 2012Jun 28, 201210

I went to court recently sitting quietly in the gallery listening to the testimony of two designated experts who criticized the care of a cardiologist (admired in local medical circles for his brilliance and excellent care of patients). The case on first glance didn’t look very good for this defendant. The patient had presented to the ER with atypical chest pain, was admitted and evaluated with an exercise test and …

Heart and cardiology

Articles, page 39

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