The Skeptical EP

The Blog Page of Robert Clare MD

“Questioning medical dogma to improve the lives of patients.”

Skepticism, from the Greek word skepticos (to inquire), is not simply a noun but a process. Skeptics demand evidence before accepting claims of truth; they enjoy the process of inquiry and analysis. Unlike cynics who take a negative view of both the claims of others and the people making them, skeptics are perfectly happy to change their minds when better evidence comes along. For physicians, a questioning attitude is an essential component to decision-making. When faced with increasing pressure from administrators and pharmaceutical companies to “Show me the money!” the best counter from the physician is “Show me the evidence!” The purpose of this blog is to raise awareness through an inquiry of the best available medical knowledge, to foster discussion, and to challenge prevailing truths in order to improve the lives of patients everywhere.

Disclaimer: The opinions put forth in this blog are just that: opinions. They should not be used as a substitute for your own good sense or that of your doctor. Readers of this column do so at their own risk—this blog is not intended to treat or diagnose disease. Information contained here should be considered a “dietary supplement.” None of it is FDA approved. Mistakes in data interpretation are mine alone (I don’t claim to be a statistician), and you should assume that mistakes will occasionally be made. All personal patient information has been altered.

I’m skeptical about … the new hypertension guideline.

Blood pressure is not one pressure but two: the first, termed systolic, represents the arterial pressure during the heart’s active contraction phase when blood is being pumped from the heart to the tissues; the second, termed diastolic, represents the arterial pressure during the heart’s relaxation phase when the heart’s chambers are filling with blood returning from those same tissues. Continue reading

How the Supreme Court Hijacked the Legislative Process on Gun Control

(Note: Although this is a medical blog, I feel this still deserves a place here, as gun violence is unquestionably a public health issue.)

Having slogged through a good number of posts on gun violence since the latest school shootings, I haven’t encountered a single novel argument for, or against, gun control. The arguments on either side remain conventional and threadbare. After the current round of shouting, expect more “crickets chirping,” right up until the next mass casualty. If there is an exceptionalism to Americans, it lies in our intransigence and inability to learn from others. While the rest of the first-world has universal healthcare, we bicker and leave multitudes to do without. Whereas the nations of Scandinavia work to narrow the inequality gap, we elect officials who strive to widen it further. Long after other nations have enacted legislation ultimately proven to have kept their children safe, we continue to cringe, blame, deflect, and debate to no effect. Nothing has been tried. Nothing has been done. Research on the matter was effectively banned by Congress in 1996. How did this happen?

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Influenza Update, 2018

When 10-year old Nico Mallozzi, a vibrant, popular, hockey-playing kid from New Canaan, Connecticut, died less than 72-hours after contracting flu last month, the story made the national news. And scared the crap out of parents all across the nation. The reason this particular boy’s death resonated so loudly was precisely because he was such a typical, normal, all-American kid—healthy in every way. Continue reading