7 Comments

This is what makes a great physician: being curious, individualizing treatment and looking closely at the details of studies which inform practice. In other words getting to the heart of the matter (yes, pun) instead of “this is what we always do.” So grateful for professionals like you!

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I love this idea! I am a Registered Nurse working pediatric emergency since 2011, so Cardiology is not even a field I’m very familiar with, but I love learning what you post about here, as well as everyone at Sensible Medicine. The pandemic really opened my eyes to the faults of modern medicine and public health. Something changed after the pandemic. We are seeing so many more sick people being hospitalized now than I’ve ever seen before. I’m now having to also care for adults because we don’t have rooms for everyone. Adult medicine frustrates me and I constantly question why we do the things we’re doing. For example, why are we prescribing Paxlovid to patients who are vaccinated?! (Well, I know why 🙄) Why are we doing a cardiac work-up in the emergency department on a senior patient even though they came in for a mechanical fall and don’t have any cardiac complaints?! I could go on and on. Then there are the things we do that seem to make sense to me, but does that mean there’s good evidence for it? Not necessarily. And that’s why what you are doing is so important! I love it! I only wish it would be done for every practice. True evidence based medicine. Thank you!

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Hi Dr. Mandrola:

I am a retired cardiologist (Canada). In addition to my fellowship I trained in Epidemiology and Biostats at McMaster with John Cairns (my research supervisor), Sackett, Guyatt, Robin Roberts, Mike Gent, Graham Turpie, etc. It was exciting times in cardiology in the mid-80s. At UWO where I was on-staff I collated the major cardiology trials for the trainees. If you would be interested I would love to participate in your review of the major trials in Cardiology. I did quite a few commentaries for ACP Journal Club.

I have lots of time on my hands and would love to play a small role.

Dave

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Fantastic idea!!! Looking forward to order it!

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Great idea. This will be a great review of the basis for “established practice” and “standard of care”. Plus it might shine a light on some of the silliness that guideline writers engage in from time to time.

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well, i just subscribed to your substack for $ and now your asking for more $ to subscribe to yet another substack. sorry, the economy is just not going to let me continue subscribing. But sounds like a worthy endeavor. best of luck

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Great idea - subscribed!

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