retired doc's thoughts

Wednesday, December 27, 2017

You are only as young as your legs

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A high school friend once told me that one of his football coaches told him that wind sprints were important and you were only as young as y...

Which master should physicians serve-Dr.Martin Samuels' thoughts

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I have written before about what I believe the wrong headed and dangerous views expressed in the Physician Charter.See here. http://mdredu...
Tuesday, December 26, 2017

Inadequate warfarin dosing may be worse than no warfarin in regard to stroke severity

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Sokomoto et al (1) investigated the relationship between adequacy of warfarin dosing and severity of stroke in patients with atrial fibrilla...
Friday, December 22, 2017

All Left bundle Branch Blocks are not the same

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The vast majority of patients with an EKG pattern of LBBB have structural heart disease,that is myocardial disease as opposed to disease onl...
Monday, November 27, 2017

How often does the Evidence in EBM turn on statistical subtleties?

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A few years ago I posted a piece about the effects of antioxidants on GI tract cancers.There was a reported small increase in Relative Risk ...
Saturday, November 25, 2017

How to survive under socialized medicine

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Here is a quote which to me seems may have high titer of deep insight.(my bolding) "In many areas of medicine, particularly those rela...
Friday, November 17, 2017

The division of internist into hospitalist and "officist" and its demise.

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It is the 20th  anniversary of the birth of the hospitalist.A recent article describes what was presented as a fairly widespread feeling amo...
Monday, November 13, 2017

James Gailbraith combines a belief in perpetual motion machine with believe in there IS a free lunch in his economic advice

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Dr. James Galbraith is the son of John Kenneth Galbraith and here the apple falls very close to the tree. See here for his  thoughts publis...
Wednesday, November 08, 2017

Before Obamacare it was other people's money effect -Afterwards more so

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 When something is being payed for with other people's money, more will purchased. This is also true if you merely think someone else...
Monday, November 06, 2017

What is the evidence that prolonged endurance execise damages the conduction system of the heart.

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In 1985, RJ Northcutt studied 20 males endurance athletes that were recruited from a Scottish Harrier's club. All were  older than 45 ...
Monday, October 30, 2017

Cognitive dissonance and medical practice conformity and different visions

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Anyone who has practiced medicine for more than a week, or observed its practice as a medical student may recognize the truth of the followi...
Thursday, October 26, 2017

Has medical care been reduced to Leave a message or call 911?

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When I contact some medical practices by phone that is exactly what seems to be the situation. Case in point- When recently  I developed a ...
Wednesday, October 25, 2017

The heart will remodel itself whether you exercise a lot or not at all

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Remodeling of the heart will occur whether you do anything about it or not. What you do about it may  determine what type of remodeling you ...
Tuesday, October 24, 2017

Can an individual's risk of a given disease ever be "determined"?

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The risk assessment of an individual.that is determining a person's risk of a given disease has been described a peculiar,elusive,ambigu...
Monday, October 23, 2017

The marked variability of subclinical atrial fibrillation makes risk assessment difficult

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A post  hoc analysis (1) of the TRENDS study concluded "significant temporal variability of AF burden exists when measured continuously...
Saturday, October 21, 2017

Detailed cardiac study on a group of really extreme endurance athletes

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Much has been written about the issues of what is the point beyond which exercise is no longer health promoting but rather damaging to the h...
Thursday, October 19, 2017

Biggest change in medicine in 40 years-loss of autonomy and change in ethics

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In regard to what has changed most in the last near half century some would answer medical advances, mainly in diagnostic techniques and the...
Tuesday, October 17, 2017

The basic narrative of medical collectivism as voiced by the ACP and ABIMF

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The following two paragraphs are from a viewpoint commentary  entitled  "Resolving the Tension between Population Health and Individual...
Sunday, October 08, 2017

Is a sedentary life style and not resistance exercise a cause of concentric cardiac hypertrophy?

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Following the 1975 echocardiographic study by Joel Morganroth of endurance athletes and resistance exercise athletes and several cross secti...
Friday, October 06, 2017

Will 2-3 hours a week of aerobic exercise keep your heart from getting stiff?

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Will a few hours of aerobic exercise per week practiced over along period of time (years) prevent the ventricle from becomes stiff and could...
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About Me

james gaulte
Trained in and practiced internal medicine and pulmonary disease.interested in endurance exercise,economics and gerontology
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