With practice consolidation, your competitors become your colleagues. Do you trust each other? And where should dissatisfied patients turn?

A 55-year-old man came to the emergency room complaining of aching chest pain radiating to the back. The pain had started the day before and recurred several times. It seemed to worsen with exertion and resolve with rest. One resting episode was associated with diaphoresis. Exam, EKG, and cardiac enzymes were normal. A portable chest X-ray showed a slightly widened mediastinum. The ER resident ordered a CT scan of the chest, and the preliminary report was negative for aortic dissection but showed a small pericardial effusion. The patient was placed… Continue Reading

Editor’s Note: This contribution from Christopher R. Seymour, Executive Director of the National Lipid Association, is a response to Larry Husten’s October 13 blog post titled “National Lipid Association Expert Panel Has Many Deep Ties to Industry.” On behalf of the National Lipid Association (NLA), I want to address your inquiry regarding the paper titled “Clinical Utility of Inflammatory Markers and Advanced Lipoprotein Testing: Advice from an Expert Panel of Lipid Specialists.” To begin, this paper is not a guideline. Rather, it is a statement to the NLA membership. Our… Continue Reading

What one patient witnessed when he observed his physicians trying to interact with their electronic medical records systems

[Editor's note: see here for a reply post to this news story by Chrstopher Seymour, MBA, Executive Director of the National Lipid Association]. An “expert panel” assembled by the National Lipid Association (NLA) is recommending a dramatic expansion in the use of new biomarkers for the diagnosis and management of cardiovascular disease. The recommendations, if widely adopted, would significantly increase not just the use of these diagnostic tests but also lead to much greater use of lipid-lowering drugs. But every member of the panel  has extensive ties to industry, and the… Continue Reading

Dr. Wes explores the features of a “full-disclosure” patch heart monitor that doesn’t seem to miss asymptomatic arrhythmias.

Discussing how medical practitioners use intuition and cognitive shortcuts (heuristics) to make decisions can elicit strong reactions. Some people heartily agree that reflecting on their use is informative and helpful; others believe that to entertain this topic is to condone sloppy thinking and to renounce rationality and hard science. These critics are concerned that heuristic shortcuts are quick and dirty, favoring speed over accuracy. But research in cognitive psychology suggests otherwise. Take, for example, a study in which Dawes and Corrigan compared the accuracy of the tallying heuristic (discussed in… Continue Reading