Tag Archives: Dr. Victor Montori

Statin guidelines we love to hate – and the docs who write them

Posted on by Carolyn Thomas
10

Here at Ethical Nag World Headquarters, it’s been quite the week ever since the American Heart Association and the American College of Cardiology released their new cardiovascular disease treatment guidelines, which I have taken the liberty of sub-titling:

“If you have a detectable pulse, you need to be taking statins!”

For more specifics on the guidelines – including the list of four newly-identified  groups of people whose heart health will benefit from taking cholesterol-lowering medication – oops, I mean statins only – every day for the rest of their natural lives, read yesterday’s Ethical Nag post, Can Statins Prevent My Head From Exploding?

What happens next? Your doctor will now review all 284 pages of the new guidelines, and then, in a bonding moment of shared decision-making, the two of you will soon sit down together to decide upon just the right course of action – oops, I mean drug prescription – based on what the guideline authors have recommended, in turn based on an (allegedly) flawed risk calculator that’s predicted to significantly increase the very large pool of daily statin-using drug takers, even among healthy individuals formerly considered low-risk for future cardiovascular disease.

But first, let’s set off for a behind-the-scenes visit to the people who actually write these treatment guidelines.  Continue reading →

Self-tracking tech revolution? Not so fast…

Posted on by Carolyn Thomas
12

When the report called Tracking for Health was released last month, media headlines announced:

“Over Two-Thirds Track Health Indicators!”

This statistic, borrowed from the Pew Research Center’s Internet & American Life Project’s report, referred to the 69 per cent of people who say they keep track of things like their weight, exercise, heart rate, food, stress or other health indicators. It also, however, includes almost half of self-reporting trackers who, according to Pew’s Susannah Fox, track these health indicators for themselves or others  – but only in their heads.

Surprisingly, very few headlines ran the real news from the report:

“Only 21% Use Technology to Self-Track!”  Continue reading →

The missing link in chronic disease care

Posted on by Carolyn Thomas
15

The cardiologist who had been called to the E.R. looked down at me lying on the gurney, introduced himself, and said quietly:

“I can tell from looking at your T-waves and all of your other cardiac tests that you have significant heart disease.”

“Significant heart disease.”  Significant heart disease? Did he just say “SIGNIFICANT HEART DISEASE”?

Continue reading →

Why do doctors call it “practice variation” instead of poor care?

Posted on by Carolyn Thomas
13

Did you know that your medical treatment may depend on where you live?  It even has a name: doctors call it “practice variation”. A new U.S. study suggests, for example, that a person living in St. Cloud, Minnesota is twice as likely to undergo invasive back surgery as a patient with a virtually identical diagnosis living in Rochester.  There are a number of reasons for this strange disparity, but one might be that Rochester is the home of the non-profit Mayo Clinic, where surgeons are paid a salary. No matter how many surgeries they do, they earn the same paycheque.  But other physicians elsewhere who are paid per surgery may be inclined to do more surgeries.

Such “practice variation” is not just seen at Mayo. Medicare patients in Fort Myers, Florida, are more than twice as likely to receive hip replacement surgeries compared to their counterparts across the Everglades in Miami, according to Dartmouth Health Atlas researchers.

Continue reading →