Contemplations on Amsterdam and the ISA

Reflecting on the meetings I stare out the window of the restaurant and watch and recall:

The Anne Frank House with its images of a single family destroyed for the crime of being Jewish,
Nazis gathering Jews in the streets
Raping women
Killing children and old men,
Shopkeepers, bankers, doctors, lawyers, street cleaners, teachers;
None was immune.
I stare from the window watching the dog-walkers, bike riders, bustling streets brimming with energy, life, and carelessness.
The same streets just a moment ago were heavy with German tanks and soldiers herding Jews to their death;
For being Jewish.
Dog walkers and bike riders ride carelessly now, oblivious to the history of their streets;
Unaware that they ride and walk over the dried blood of fallen innocents.
The Amsterdam tulips have just finished their showing.
The city drips with life.
And but a few hours from this place are men and women and children being slaughtered today in fashion similar to what took place a short dream ago.
Over and over it goes.
How to stop this merry-go-round is unfathomable.
People who love their children cry when they hurt; they bleed when they are injured; pray to some god for whatever they pray; hope for their better day. Yet they still tear apart the lives of others. Still break the boundaries of peace and liberty, and freedom of thought and belief.
I ride the elevator to John Legend’s song from Selma, “One day, when the glory comes; it will be ours, it will be ours.”
The meetings were wonderful but they are a distraction, a diversion from the ineluctable.
Still, without them we would have only despair as our companion.
How do we disentangle this man-made, endless, seemingly insoluble dilemma?

Learn more about preventive cardiology at www.preventivecardiologyinc.com.

For more information about the supplements and vitamins critical to your everyday health visit www.vitalremedymd.com.

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The 2015 Dietary Guidelines: Defining a Healthful Diet

The 2015 Dietary Guidelines have been released, and some supposedly significant changes, advised. Cholesterol intake is no longer limited. Saturated fat is to represent < 10% of daily caloric intake. Sustainability considerations are now to be considered. Simple sugars are anathema and caffeine is okay. Vegetables and fruits remain highly emphasized. Has much changed? Not really. Most of us in Cardiology and Lipidology dropped the cholesterol ban a decade ago. We typically emphasize fresh fruits and vegetables, low fat meat that is organic and devoid of antibiotics, and a limitation of simple sugar. Most of us don’t consider sustainability issues when advising our individual patients. Many of us believe that world issues – including economics – should stay out of the exam room and remain in the courtroom. (I am a member of that camp). But what is the layperson to do with these Guidelines? Does he or she have to make dramatic changes in his or her diet? The answer of course depends upon the individual patient’s status. Is weight loss necessary; does the patient have cardiovascular disease or very high LDL cholesterol, for instance? Let’s first look at the history of man, briefly examine the state of dietary literature, and then make some generalizations.

Anthropology unequivocally demonstrates that human beings are omnivores. In fact, all of our primate relatives also rely upon meat in the wild. They even need it in captivity. When the Washington DC Zoo attempted to breed the Amazon Golden Marmoset monkey, they failed miserably. It was not until meat was added to their diet that the monkeys begin to thrive and reproduce. Since the beginning of our tour on earth we have also eaten meat. In fact, for the first 4 million years of our existence, meat was our main source of nourishment. About 10,000 years ago we introduced farming and animal husbandry. Most farming was done to feed our animals as they represented our most desirable food source. Recently we have fallen prey to our own impact on nourishment – we have started processing, and ruining, our food. Sugar has been added; nutrients have been stripped from grains; grains are squeezed (instead of eaten whole) to produce oils; and animals have been raised in pens, limiting their ability to develop lean muscle mass, and also often requiring the introduction of antibiotics. We have created a food supply that is most likely killing us.

In response to our understanding of the role cholesterol plays in heart disease – and it does play a significant one – we have introduced guidelines to try to reduce cholesterol. Saturated fat eaten to excess does raise LDL (not a good thing), but cholesterol consumption has little impact on our LDL levels. Therefore the current Guidelines did what was appropriate and removed restrictions on cholesterol consumption while maintaining limitations on saturated fat. They also appropriately implore us to eschew sugar. No one will argue against the latter recommendation (except perhaps the sugar industry). But are there studies to support such advice? Unfortunately, beyond PrediMed (which demonstrated the cardiovascular advantage of a Mediterranean diet) no high level studies have been performed. Many observational studies exist, but doing a solid dietary trial is actually immensely difficult. Thus we are left to rely upon our understanding of basic science, animal experiments, pathophysiology, and anthropology. The conclusion for most of us I believe follows Aristotle’s ancient tenet of moderation. We should consume natural foods whenever possible, avoid processed foods, eat copious quantities of vegetables, consume ample fruit, and don’t worry so much about consuming lean meat, fatty fish, and some chicken as well. We should do this in the context of seeing our physicians, discussing our own personal issues, and modifying our diets to adjust to individual needs when indicated. Eating has become a complex endeavor, yet it ought to be much more straightforward. What we need though is access to the aforementioned natural food, the type of food that has been unscathed by human hands. And therein, unfortunately, lies the rub.

Learn more about preventive cardiology at www.preventivecardiologyinc.com.

For more information more about essential vitamins and supplements visit www.vitalremedymd.com.

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Doctors as a Commodity: the Ruin of Modern Medicine?

Did you ever wonder why doctors are reimbursed on the same fee schedule regardless of their experience, qualifications, knowledge, expertise, or interpersonal skills? Why is it that lawyers, teachers, businesspeople, military personnel, hospital administrators, and virtually every other person in our nation is reimbursed for his or her services on the basis of qualifications and experience, yet physicians – arguably the most highly trained group of the lot – are not? Examine this hypothetical (yet common) scenario. Joe Thomson graduates at the bottom of his medical school class and then completes training in a sub-par general surgery residency. His parents, though not highly educated, are very wealthy – they earned their fortune flipping houses in the early 2000’s. Because of an unforeseen turn of events, they were forced to sell their house-flipping empire just before the market crashed. Fortune indeed smiled upon them. Not having benefited from higher education, they had always had high aspirations for their only son. And so when Dr. Joe was at long last a licensed general surgeon, his parents wanted him to practice in the finest locale. They rented a beautiful Brownstone in Manhattan just across from the most highly regarded general surgeon in the city. And, they employed their marketing skills to spread the word about their up and coming son. Shortly after opening his practice he was called to the Emergency Room to care for a patient who required an extraordinarily complex surgery. This particular surgery is long, intricate, and carries a very high complication rate. Given the mandatory call system in his hospital, it was however the young surgeon’s turn to be “up at bat.” The accomplished surgeon across the street had already done well over 100 of these surgeries while our young doctor had yet to perform a single one on his own. (He had assisted in 3 during his five-year residency).

There are two issues to consider here. First, indisputably the unwitting patient would be better served with the far more experienced surgeon.

Second, both surgeons – one with no experience while the other a veritable expert – will be reimbursed exactly the same for this very difficult operation. You see, the doctors are a commodity – pork bellies, concrete, orange juice etc. Their skills are ostensibly indistinguishable and therefore interchangeable. Now imagine you’re the patient. Which doctor would you choose? If given the opportunity (which you don’t have under current insurance restrictions) would you pay more for one over the other? I know whom I’d choose, even if I had to take out a loan, skip vacations, work extra hours and the like. Here’s an added irony. The experienced doctor is on faculty at a medical school. His hard-earned skills are so great that a competing private hospital purchases his practice (and him), thereby increasing his income three fold. In sum, in order to make more money he left his position at the academic institution where he had used his superior skills to train young doctors. Within two years he becomes so highly respected at the new hospital that he’s advanced further, to the position of hospital CEO. Now he truly earns a hefty income. But, he no longer practices medicine. To “get ahead” monetarily, he had to leave the pool of expert practicing clinicians whose sole purpose is to help patients. To earn more money, our great surgeon had to stop doing surgery. He had to become an administrator.

I know it is considered indecorous for doctors to be concerned about money, but when our incomes fall while expenses rise; when we find it difficult to put our children through college or save enough money for retirement; when we cannot foresee how we will ever repay our college and medical school loans; when we lose our voice in how we are compensated; we have no choice but to become “normal” people and consider our incomes and how to best maintain and even grow them. In truth there is nothing inherently wrong with physicians’ focusing some attention on how much money they earn. In the past though doctors earned enough so as to not care about reimbursement. Their financial contentment yielded great dividends; they devoted all their free time to bettering themselves as physicians. They devoured journals and took medical courses; attended meetings and discussed interesting cases with their colleagues. Though some physicians still practice in this vein, many do not. Instead, most doctors today read Medical Economics and The Wall Street Journal, watch financial news on television, read books about alternate methods to make money, and carefully plan their premature exit strategies from the practice of medicine. The state of Medicine today is nothing short of depressing.

Non-physicians probably won’t want to hear what I’m saying. They might quip that doctors should be above money or that doctors make more than “enough” as it is. Be that as it may, the reality is that as a consequence of changes in medical economics as well as an explosion in the bureaucracy involved in private practice, many of the up and coming “best and brightest” are flocking to finance and business, and away from medicine. And that will leave us all at a distinct disadvantage when we seek and require top quality doctors down the road. Like it or not if we hope to bring back the doctors of yesteryear, we must face facts and acknowledge why so many doctors today are unhappy. We must identify what it will take to rejuvenate the medical field, and make it once again an enticing and challenging goal to which our young will aspire.

Learn more about preventive cardiology at www.preventivecardiologyinc.com.

For more information more about essential vitamins and supplements visit www.vitalremedymd.com.

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More Evidence that the Hallowed RCT is Just a Demigod

I know I’ve written about this issue before – and I guarantee I will write about it again – but I assure you it is important enough to be discussed until even after it has been resolved. The Randomized Controlled Trial (RCT) has become something greater than life. It is the foundation of all Guidelines; it is the subject of Board test questions; it is the trump card in all roundmanship controversies. RCTs have taken on a power beyond all other aspects of medical knowledge. And I am sure this fact represents one of Medicine’s most perilous errors. Instilling RCTs with veto power across all lines of medical debate has relegated such things as clinical acumen, understanding of pathophysiology, and good old-fashioned common sense to second-rate skills. Endowing the RCT with omnipotence has all but eliminated the need for doctors and other health care practitioners to read extensively and understand the fundamental principals of medicine. Two recent examples plainly illuminate this problem.

In one case, a woman with a history of breast cancer as well as ASCVD finished her fifth year of Arimidex. Should she continue was the question, even though the medication might have been making it more difficult to effectively manage her lipids. No study had resolved this issue and so she decided to discontinue the medication. Troubled by her decision I contacted her oncologist and asked him what his gut suggested we do. He favored continuation of the medication. We listened to his well-honed instinct and simply fought a bit harder to control her cholesterol. Last week she was one of the first to have a test to predict the value of Arimidex continuation beyond year five. It turns out that she has a very high risk of breast cancer recurrence in the absence of drug. In other words, the oncologist’s gut was spot on. Perhaps the decision saved her life.

In another case, a friend recently told me that since our conversation regarding his atrial fibrillation four years ago – when I had suggested he stop drinking seltzer and also increase his magnesium intake – he completely stopped experiencing episodes of Afib. At the time he was having such frequent bouts of arrhythmias that radiofrequency ablation was strongly advised by all his physicians. Fortunately he tried an unproved treatment (which I, an electrophysiologist, had seen work in other patients) and it was entirely effective.  By trying something safe yet unproved, he was spared a potentially life-threatening procedure.

Reflecting on how we all practice medicine, I cannot but acknowledge the fact that most of our decisions are based upon data distinct from what can be found in the RCT. The bottom line: let’s respect and honor that which makes doctors more than just a commodity – our knowledge, instinct, clinical acumen, common sense, and sometimes our depth of caring.

Learn more about preventive cardiology at www.preventivecardiologyinc.com.

For more information more about essential vitamins and supplements visit www.vitalremedymd.com.

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The National Lipid Association – A Glimmer of Hope

The field of Medicine is undeniably in turmoil. Patients are unhappy with long wait times in doctors offices coupled with ever shortening visits with their physicians. Doctors are dismayed by their unprecedented spike in “busy work,” instigated predominantly by insurance companies and governmental mandates. The fallout from more time spent on paperwork is of course less time spent with patients. There are after all only 24 hours in a day.  So it is eminently fair to say that neither doctors nor patients find themselves happy with the current course Medicine is following. Oftentimes outlooks are so bad that many of us in the field feel there is no hope. In essence we believe the battle has been lost; there is no chance of recovery.

Enter the National Lipid Association (NLA). Currently boasting over 3,000 active members, the NLA is a group of diverse doctors, nurses, dietitians, scientists, and exercise physiologists whose governing goal in participating in the organization is to improve healthcare. I just returned from the 2014 Annual NLA meetings in Orlando Florida and was once again struck by the authenticity of this sentiment. Meetings began as early as 6 AM and extended well into the evening hours. And the seats were not bare. They were filled by groups of highly focused and engaged individuals. Ranging from Cholesterol Guideline discussions, to basic science talks on drugs’ mechanisms of action, to lectures reinforcing the need to amplify our efforts to identify and treat patients with the not so rare but highly lethal disorder Familial Hypercholesterolemia, the topics were fascinating and irrefutably pragmatic. The attendees were riveted. Side conversations were plentiful, including promises of new clinical trials and better ways to help our patients. The pace was quick and the excitement, palpable. All this at a medical meeting!

Although uniformly doctors are troubled by Medicine’s fall from grace, rays of hope were clearly visible at the NLA meeting. Beneath our acrimony doctors, nurses, and others in medicine still have at their core the desire to help. We genuinely want to be the ones who people look to during their oftentimes-darkest moments. We also most definitively strive to keep people from experiencing such grim periods. The best way to achieve these goals is to continuously learn. Curiosity, inquiry, dialogue, knowledge, and caring are the cornerstones of the practice of Medicine. And these are the elements that beat at the heart of the National Lipid Association.

Learn more about preventive cardiology at www.preventivecardiologyinc.com.

For more information more about essential vitamins and supplements visit www.vitalremedymd.com.

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Legalizing Marijuana, What Might the Future Hold?

With all the excitement and controversy swirling around the legalization of Marijuana, as a physician I have no choice but to consider what negative ramifications might be in store for our country. Here are just a few of the many issues we must all consider.

What could be the adverse health consequences of rampant and regular marijuana use? Over the past few years, studies have begun to demonstrate unfavorable psychiatric fallout from marijuana. Schizophrenia, and other disorders of psychosis, it seems can be expressed in predisposed individuals who utilize the drug. The incidence of schizophrenia is already one in a hundred. The toll this disease takes on not only the patient, but also the entire family, is enormous. A life-long disease with no cure in sight, schizophrenia leaves its victims unable to function adequately in society, often leading to homelessness and premature death. There is also of course an associated financial burden our society bears from the disease. Imagine then the consequence of even a minor uptick in the frequency of this disorder. Anyone who understands schizophrenia would agree that saying it would be horrific is a gross understatement.

Then there is heart disease. Just last week a study was published citing an association of marijuana with premature heart attacks. Right when doctors are making inroads into reducing heart disease, we may now be unleashing a new and previously unrecognized threat. Remember the days of the great cigarette ads, “LSMFT. Lucky Strike means fine tobacco.” In days of old, tobacco use was the norm; nearly everyone smoked. Socially, it was the thing to do. Then came the studies proving the relationship between tobacco and heart attacks, strokes, chronic obstructive lung disease, and of course death. Following the studies there were lawsuits. The tobacco industry paid dearly for being less than forthright about the potential downside of smoking. The attorneys did quite well, bringing in personal gains of a billion dollars. Tobacco’s victims however did not do so well.  Will marijuana become the tobacco of our future? Have we just begun yet another global experiment testing the effects of a substance on us, the American populace? If so, let’s at least prepare for the fallout.

To protect our society as best as we can, I propose the following. Wherever marijuana becomes legalized, set aside a large portion of tax revenue for future payment of medical expenses related to marijuana’s use. Also, be sure to allocate enough funds to cover the lawsuits that will surely follow our inevitable acceptance of marijuana’s health dangers. Perhaps not just the marijuana sellers will be held accountable. If a government earns revenue through taxation of marijuana, might not the government be liable through complicity? I would also recommend that all marijuana users be forced to sign a waiver of liability. Let the finest attorneys craft this document so it can be as solid as is legally possible. Then, when the lawsuits start flowing in, marijuana enthusiasts will have a much tougher time blaming others for their choice. They need to be fully informed of the potential risks of marijuana, and their understanding must be well documented. Let’s not repeat the tobacco experiment with all its attendant errors. If marijuana is to be the next widespread health hazard, let’s at least protect the nation’s financial interests. Clearly our country is not in a position to take on any more debt.

Learn more about preventive cardiology at www.preventivecardiologyinc.com.

For more information more about essential vitamins and supplements visit www.vitalremedymd.com.

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Is Marcus Welby, MD Resuscitatable?

Over the last decade or so doctors have felt their stature steadily slip away. Their significance has of course remained; without doctors healthcare would come to a screeching halt. Newly named “physician extenders” cannot do what most physicians can. They are simply not trained for the task. As important and passionate as they are in healthcare delivery, physician assistants and nurse practitioners possess just a small portion of the training required to become practicing MDs. Doctors often spend more than a decade after college training to a level required to deliver the most sophisticated and complex care. Many laypeople seem oblivious to this fact; some likely have intentionally blinded themselves to it. Physicians are “where the buck stops”. We are the CEOs of our practices, the generals if you will. Yet, the insidious degradation of doctors has led to a variety of deleterious and likely unintended forms of fallout. Most obvious is our title. Once called nothing but “doctor”, we are now dubbed, “health care practitioners”, “health care providers”, and most recently, “EP”s or eligible professionals. This fact may seem trivial, but its reverberations run deep. We have been equated to all others who treat patients – nurses, advanced nurse practitioners, physician assistants, medical assistants, and physical therapists…  Our distinction as leaders in patient care is being eroded. Imagine if the same were true in the military – no more generals, colonels, sergeants or the like. Just “military personnel.” Or, what if we applied the same rule to government – no more senators, congressmen, mayors, governors, or even presidents. Simply “public servants.” There is no doubt such an arrangement would be justifiably unacceptable to those involved. These two systems, like the medical system, would crumble absent titular distinctions. But the damage to medicine dives far deeper than this.

We have just witnessed the release of Medicare payment information for each doctor in the US. Soon the “Sunshine Act” will also become a reality. The amount of money paid to highly specialized doctors to deliver educational talks will become fodder for the public to muse. The lunches, coffee, or even requested medical articles brought to offices by pharmaceutical representatives will soon be open for public scrutiny. Total transparency is a beautiful concept for an ideal world. In such a world everyone would love and respect each other; no one would compete with another; and all would be subject to the same laws and regulations. Such is not the case of course. Do you know what your attorney earned last year, or how much money your grocery store pays for its eggs?  Of course not! We live in a land that purportedly permits freedom to compete. Competition requires a high degree of privacy. Our country was in fact built upon such a premise. How can one dermatologist fairly compete with another if confidential internal financial records become open access? There are far too many financial ramifications to explore in this short blog, but the adverse fallout from such transparency will be pervasive. And it will most certainly include a drastic decline in the education of practicing doctors. That of course will translate into deteriorating quality of care.

The most consequential outcome of medicine’s recent evolution will undoubtedly be decay in heath care delivery. Marcus Welby, MD was an excellent television show because it depicted a dedicated, diligent, assiduous, committed physician. Dr. Welby captured the hearts of viewers because he loved his patients and they loved him. He was honored, respected, appreciated, and yes, even well compensated. The reality, for better or for worse, is that doctors are human beings. They crave recognition and appreciation for their sacrifices. Absent such recognition, and assuming a continued decline in reimbursement as well as the massive increase in federal regulations, the Marcus Welby, MDs of this nation will become extinct. At times this augury feels inevitable. At other times there is hope. Unfortunately however, until the general population recognizes the physician resource it is rapidly losing, I believe the more pessimistic outlook will prevail. Marcus Welby, MD may truly be unresuscitatable.

Learn more about preventive cardiology at www.preventivecardiologyinc.com.

For more information more about essential vitamins and supplements visit www.vitalremedymd.com.

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The Truth about Truth in Medicine

I have read one too many blogs that speak about the “Truth” in one area of medicine or another. As long as such blogs and news reports and even scientific journals perpetuate the notion that in Medicine we have the capacity to know the “Truth” we will continue to have unhappy patients and argumentative doctors. Sadly I have not yet met a man or woman in the sciences who has conversed with god about medical issues (or any other issues, for that matter). Until such time as we actually do find a way to communicate with “the big guy” we must refrain from bolstering our beliefs and contentions into the realm of the absolute. I have stated this before but I believe it requires repeating: Medicine is a process. We are continually learning, creating novel theories and abandoning old beliefs. One day we might be sure of something and the next day we laugh to ourselves as we learn how wrong we were. On a personal note, I spend a great deal of time exploring a variety of health-related issues. My studies often take me to the depths of cell biology and molecular biology. I even find myself immersed in the swamps of genetics. Each time I explore these spheres I gain greater knowledge about that which I am studying. I also reinforce my understanding about how little we (and I) actually know. Even discoveries from our Nobel Laureates become démodé as new Nobel Laureates pave different pathways. This is simply the nature of science and medicine. And it is wonderful. So I implore you to help eradicate the misperception that in Science and Medicine we have access to truth. By so doing, you will help bring a tranquility to the practice of Medicine that will in turn make doctors and patients far more comfortable in their respective roles as teachers and students. We are not and should not be considered members of the clergy.

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Caution: When choosing your health insurance remember to look to the future!

The country is in the midst of a monumental healthcare debate. Physicians like me treat individual patients, not populations. Thus this note of caution is meant for you, the individual who now must determine what health insurance plan best suits you and your loved ones. This blog in no way addresses the merits or lack thereof of the Affordable Care Act (ACA). I have been a practicing Cardiologist for over twenty years. During that time, my practice has run the gamut from intervention to prevention. Although it would be hyperbole to say “I have seen it all”, my varied experience has afforded me the opportunity to participate in the most intimate and meaningful aspects of a great many patients’ lives during so many different types of medical trouble. I have also myself unfortunately been a patient with life-threatening ailments on more than one occasion. To say I am an expert in the medical arena is therefore not hyperbole.

Now that many Americans must examine their health insurance with a new perspective I want to raise a single note of caution: When choosing your plan, always look to the future. It is one thing to keep your current doctor; that is indisputably important. Possibly even more consequential though is the fact that many of us ultimately develop complex, serious, and even rare medical disorders. We do this “in the future”, and to make matters worse, we never know when the axe will fall. Sadly but irrefutably we are all vulnerable to this fate. When this occurs, patients invariably and appropriately want to “see the best”. To do so often requires long trips to a variety of places in America (as an aside, it is ALWAYS in America where you will find “the best”). I have patients and loved ones who have traveled to Nebraska and Texas for the treatment of Lymphoma; Sloan Kettering for Neuroblastoma and other cancers; the Brigham and Women’s, Massachusetts General Hospital, Columbia Presbyterian, the Mayo Clinic and Cleveland Clinic for Cardiovascular issues; and many other centers of excellence for a host of other ailments as well. Every time patients travel afar to see the experts they do coordinated research with their physicians in order to identify the doctor and institution best suited to manage a particular condition. This is always a difficult and emotionally challenging task. Now consider this. The majority of plans under the ACA do not have contracts with most of the aforementioned hospitals. In fact, it is my understanding that perhaps the finest cancer center in America is not on ANY of the ACA plans. So, when choosing your health insurance, please focus on what you don’t know. Give the future as much attention as the present. Being unable to see a true expert to treat the disease you have not yet developed (but sadly will most likely afflict you or your loved ones at some point in your life) would be a catastrophic event. Buy your plan with your eyes wide open. Know what you’re getting for now, as well as for the days that lie ahead.

Please read more about preventive cardiology at www.preventivecardiologyinc.com.

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“Find a Doctor You Trust And Trust Him”

woman runner stretching
A patient recently shared advice given him by his close friend (who also happens to be a physician). When my patient questioned his friend about the best way to make medical decisions in the context of today’s information-overload (which can be not only misleading but downright wrong and dangerous) he counseled him to “Find a doctor you trust and trust him.”

This philosophy may appear simplistic, superficial, or even tautological. It is not. Actually, it is brilliant in its simplicity. After all, how is anyone, doctor or layperson, to understand everything about medicine? Advances and discoveries abound. I’ve said this before – but it is certainly worth repeating, – every day hundreds if not thousands of articles are published in the medical space. It is impossible for even the most studious physician to appropriately assimilate such exhaustive data. A judicious doctor will however rigorously read the most pertinent trials and merge them into his well-established and highly-refined approach to health and illness. This approach is founded upon oftentimes decades of combined arduous education as well as invaluable clinical experience. Recognizing everything that goes into a fine physician’s decision-making process how is it remotely possible for even the most voracious reader of internet tomes to come close to the well-considered recommendations of such doctors? It is just not possible. This realty does not imply that patients shouldn’t educate themselves to become their own best advocates. They should; and in fact they must. Knowing more will help patients find those doctors they trust. But at that point patients ought to let their guard down just enough to accept the well-considered advice of their trusted physician. Without doing so, patients leave themselves wide open for not just doubt and concomitant angst, but inferior care as well.

Please read more about preventive cardiology at www.preventivecardiologyinc.com.

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