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Vitamin D Associated With A Higher Risk Of Atrial Fibrillation

Too much vitamin D can lead to 2.5 times the risk of atrial fibrillation, researchers found.

To determine if there is a correlation between too much vitamin D and increased heart risk, researchers examined blood tests from 132,000 patients in the Intermountain Healthcare Center database. Results were presented at the American Heart Association Scientific Sessions in November, and appeared at the Intermountain website.

Patients did not have any known history of atrial fibrillation, and all had previously received a vitamin D assessment as part of their routine care. Patients were then placed into categories to compare levels of vitamin D: low (less than 20 ng/dL), low/normal (21-40 ng/dL), normal (41-80 ng/dL), high/normal (81-100 ng/dL), and excess (more than 100 ng/dL).

Patients with low, low-normal, normal and high-normal levels of vitamin D had no increased risk of atrial fibrillation. However, atrial fibrillation risk Read more »

*This blog post was originally published at ACP Hospitalist*

Sometimes The Best Thing To Do Is Nothing At All

It’s the hardest thing in the world for a doctor to do.

After all, doctors are do-ers. That is how they have managed to achieve their degrees: hard work, discipline, perseverence. Who else would be willing to memorize all those organic chemistry equations long enough to vomit them back on paper? Who else would tolerate long nights and weekends on a constant basis? But they do it because it’s the right thing to do. They do it because someone has to. People don’t get sick nine to five. They get sick at 2 am. And so, by it’s very nature over the years, medical education becomes a sort of natural selection: only the strong survive.

Historically, doctors endure the system because they know that there are rewards for this hard work personally, professionally, socially, and financially. So throughout their training, doctors learn to perfect the art of doing. That’s what people come to expect. Oh my God, doctor, he’s choking: do something! He’s turning blue: do something! But he fainted, doctor! Do something!

One of the best parts of medical school is learning the answers to these mysteries of medicine and how to fix them. In the past, this gave doctors an aura of deity: they could be trusted to fix just about any ailment that befell man. It was awesome. With time, a sense of invincibility and omnipotence set in.

And like flies to a flame, we bought it. Lock. Stock. Barrel.

In fact, Read more »

*This blog post was originally published at Dr. Wes*

How Do You Measure Success In Medicine?

The staff was concerned that she came to the office without her interpreter.

How would we communicate? How would I assess her symptoms?

“Should we get a translator from the hospital?” they asked.

I knew this patient well. I had done battle with rogue circuits in her left atrium more than once. I could even remember the fractions of the fractionated potentials–the squiggles of the squiggly line. I could recall my body’s joyous sensations when burning that precarious ridge of heart muscle steadied her heart’s rhythm.

“Got it,” we say.

Or Read more »

*This blog post was originally published at Dr John M*

The Case Of The Lost Pager: A New Kind Of Medical Error?

It happens to every doctor at some time in their busy career: the missing pager. Usually, discovering the locale of the digital disrupter is quite simple: you simply page yourself provided, of course, that the contraption is not on “vibrate” mode.

And so it was with me some time ago.

The scene was a familiar one: rushing off to work, heading out the door while contemplating the upcoming caseload of the day with my mind wandering off to great medical thoughts when, suddenly, I reached to my hip to find that I had forgotten my pager.

Dang.

So back to the house I go and scramble for the telephone. My wife, hearing the door opening calls back from upstairs: “Something wrong, dear?”

“No, just forgot my *@#$&#*& pager. No biggie.”

So I called the paging number and waited. (Why it takes so long for electrons to travel to space and back is beyond me.) Some time later I heard in the distance: Read more »

*This blog post was originally published at Dr. Wes*

Why Industry Largess Is A Necessary Part Of Good Healthcare

Largesse: (Form thefreedictionary.com):

1. a. Liberality in bestowing gifts, especially in a lofty or condescending manner.
b. Money or gifts bestowed.

2. Generosity of spirit or attitude.

Two days into last week’s Heart Rhythm Society meeting, Propublica, an independent online investigative journalism-in-the-public-interest endeavor published a series of high profile articles as part of their Dollars for Docs series. Their marquee piece, published prominently in the USA Today, chronicled the strong financial ties (the ‘largesse’) that bind medical societies to industry. Reporters Charlie Ornstein and Tracy Weber highlighted the meeting’s ‘mansion’-sized exhibits, intense advertising, and the fact that most of the opinion leaders, officers of medical societies and guideline writers, the experts, have financial ties with medical device companies. More than half of HRS’ revenues came from industry.

Well.

I’ll offer four simple thoughts about all this conflict:

1. Nothing about industry influence at medical meetings is new news. I have been attending medical meetings for nearly twenty years, and industry has always been there. And here’s something you don’t read much about: it was far worse then. That’s all I will say about that. I won’t tell you how cool it was seeing the Charlie Daniels Band play at a medical meeting for free.

You can quibble with the extent of these current-day “cozy” relationships, or the glitz of exhibits at our gatherings, but you should also know that there is progress. The show is now out in the open. There is infinitely more disclosure. Smart people are now watching, tweeting, and reporting. Any doctor who’s been around more than a few years will agree that things have grown increasing more transparent. Which I believe is an improvement. Read more »

*This blog post was originally published at Dr John M*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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