Update on Statins

In July of 2015, I wrote a post questioning the recommendations of the American College of Cardiology / American Heart Association (ACC/AHA) to expand statin use in asymptomatic individuals. The reason this topic is so important is that it affects literally millions of people at a cost of multiple billions of dollars. Continue reading

Update on low back pain.

In April, I posted 2 essays on low back pain (“I’m skeptical about … low back pain,” parts 1 and 2). In them, I explained why the American way of treating this ubiquitous disorder is so expensive, wasteful, and ineffective. It relies largely on pharmaceuticals to mask pain, and technologies to image the spine that rarely affect patient outcomes. Continue reading

I’m optimistic about … medical mindfulness.

People don’t like to wait; not for hamburgers, haircuts, or medical care. And more and more, the same assembly line practices applied to the sale of consumer goods are now being brought to bear in the delivery of healthcare—everything from the incorporation of Lean Toyota process improvement practices, to electronic medical records, to hospital billboards with LED displays of ER wait times. Continue reading