retired doc's thoughts

Sunday, March 29, 2020

Role of masks for COVID prevention outside of hosptial use

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The following is my opnion and not a medical recommendation.  Public face mask use appears to be common in Asian countries and also is n...
Wednesday, March 25, 2020

Do ARBs and ACEis make COVID 19 infection worse?

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A recent article in the BMJ raised concern that drugs that inhibit parts of the RAAS system might be harmful to patients infected with the n...
2 comments:
Thursday, March 19, 2020

Can Asymptomatic persons positive for covid-19 transmit disease

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I believe we need to act as if they can. A report from the chief epidemiologist from China's CDC in early March seemed to be reassurin...
Friday, February 28, 2020

What do Left bundle banch block and traditional right ventricular cardiac pacing have in common?

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Although it was demonstrated at least as early as 1989 by CL Grines et al (1) that left bundle branch block (LBBB) could cause significant f...
Tuesday, January 28, 2020

How Will "medicare for alll" be like the military industrial complex?

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The following quotes are from the blog "on health care technology" written by Margalit Gur-Arie: "Go ask Northrup Grumman ...
1 comment:
Monday, December 16, 2019

Important changes happening(and happened) in Med School Education what is it about?

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Drs. Accad and Koka  discuss  major changes in Medical school education with Dr. Stanley Goldfarb.See here for the podcast. Are the chan...
Friday, December 13, 2019

Should journals always report fragility index on a clinical trial.

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Interesting article in December 2019 Circulation.(See here .) that discusses the "robustness" of a number of cardiovascular disea...
Thursday, December 05, 2019

What could possibly go wrong when legislators think they know how to practice medicine

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Here is another item from the file labelled "I'm so glad I don't practice medicine any longer" A proposed bill from the ...
Friday, November 29, 2019

State legislatures act to increase collateral damage in the opioid epidemic war

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This Thanksgiving I am particularly thankful that I am not a practicing physician any longer and no one in my family suffers from chronic ...
1 comment:
Saturday, November 16, 2019

is Google being a "business associate" of Ascension Health Care something to worry about

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In you are or  have been a patent of Ascension health care system your names,diagnosis, date of birth may be accessible to employees of Goog...
Sunday, November 10, 2019

Could government mandated "quality" programs be bad for your health.

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Dr. Paul Hsieh explains how exactly that has happened in his recent commentary in Forbes. He explains how the Hospital Readmission Reducti...
Thursday, November 07, 2019

The developing Vison of Primary Care in the Big Rock candy Mountain

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Probably the primary care physicians in training who authored a  commentary in the NEJM describing their view of what primary care should be...
1 comment:
Sunday, November 03, 2019

More long time followup on his bundle pacing

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Dr. Francesco Zanon of Italy and Dr. Pugashendhi  Vijayaramen of the Geisinger Clinic in Pennsylvania report on the long term performance an...
Friday, October 25, 2019

Does your doctor really work for a venture capital firm

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Some of the docs who see you in the ER,or read your imaging study, or give you Propofol for an endoscopy may well be the employees of a comp...
Thursday, October 10, 2019

Aristotle trial,bad data from China,but apixaban probably still better than warfarin

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In 2011, the Aristotle trial was published in the NEJM.It demonstrated aprixaban's superiority over warfarin in the treatment of non-val...
Wednesday, October 02, 2019

RPU-responsible physician unit-possible replacement by "systems"

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The following is a re-do of an essay I wrote 14 years ago. In the March 1, 2005 Annals of Internal Medicine the "Improving Pat...
Monday, September 30, 2019

Why have price controls on hospitals not caused a shortage

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Arnold Kling has said that economists do not save the useful economic thoughts and insights for graduate level courses but teach the good st...
Friday, September 27, 2019

Will hospital adverse internists loose their critical care skills

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In the waning years of my professional medical life I witnessed a trifurcation of internists into  three groups, the hospitalists and those ...
Thursday, September 26, 2019

The endless demand for excelence - a burden too great?

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Go to this post by Dr. Jeffrey Parks who blogs under the name "Buckeye Surgeon". He write about the endless demand for excellen...
Monday, September 23, 2019

Is it valid to compare numbers needed to treat (NNT)

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Scattered throughout medical literature is the metric known as number needed to treat or NNT. It has been claimed that in trials in which ...
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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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