As readers can imagine, few things could interrupt my temporary break from blogging – a break in which I have lost myself in the pleasures of figuring out how best to explain to novice readers the differences between the effective, relative and functional refractory periods of cardiac Purkinje fibers, and a host of other fascinating [...]

It’s just that I am occupied at the moment finishing up the 5th edition of my introductory textbook of electrophysiology. It is a book which aims to simplify and demystify a particularly arcane branch of the cardiologic arts, and it has proven to be quite popular (among a certain type of readership) for nearly 25 [...]

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In his last post, DrRich demonstrated that our modern American healthcare system proposes to treat individual patients as if they were merely members of a herd of cattle or sheep.* ____ *Doctors, on the other hand, will be treated like the border collies who – responding instantly to the various complex whistles, hand [...]

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Farmer Emanuel has 10,000 head of cattle in his beef herd. He prides himself in staying up to date on all the latest methods, so he knows that adding a certain antibiotic to their feed will reduce the incidence of intestinal infections, and will increase his annual overall yield, measured in pounds of [...]

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On the same day that DrRich published his post about the American College of Physicians’ new Ethics Manual, Rob Stein of NPR’s Health Blog did the same thing. In his post, Mr. Stein took particular notice of the ACP’s admonition to physicians that, in order to practice medicine ethically, they must practice parsimoniously. [...]

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The American College of Physicians published the Sixth Edition of its Physicians Ethics Manual yesterday. Regular readers may find it surprising to hear DrRich say that there is little objectionable in it, and actually much to admire – that is, when it is considered as it is written, as a stand-alone document. But [...]

After extensive analysis by a committee of hand-picked experts, with much debate and with some dissension, the following have been identified as DrRich’s Top Ten Posts of 2011. Ten: The Right To Bear Salt Nine: About Those Doctor-Nurses Eight: The Four Ways To Reduce Healthcare Spending Seven: On Killing The Elderly Six: The Real Utillity [...]

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In the tradition of “Yes, Virginia, &c.,” DrRich once again reprises his classic holiday message. ____ ‘Tis once again that time of year when we Americans gather together with our extended families and friends to celebrate the Season. It is a time for catching up – renewing acquaintances and making new ones, sharing [...]

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DrRich wants to record his sympathy for the recommendation, made by the National Transportation Safety Board this week, that all cell phone use by automobile drivers be banned at the federal level. When our government gives us new rules that are for our own good, we should be thankful and not critical. The [...]

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DrRich has written a lot on this blog about the intentional destruction of the classic doctor-patient relationship. That relationship, of course, was a fiduciary one, under which the patient was encouraged and expected to place full trust in the doctor’s sacred duty to put the patient’s own best interests above all other considerations. [...]