Category Archives: Technology

The Future Arrived for Me Last Week

For years, I have been hearing about how new technology will transform every day clinical practice, and I have been looking forward to it. Who wouldn’t want to be able to understand better the basis of human disease based on the “new taxonomy” of precision medicine?  Or offer personalized therapeutics based on full genome sequencing? Or have the ability to predict better which patient will decompensate based on advanced analytics? And yet… most of us are pretty much doing what we have always done – diagnosing disease based on signs and symptoms, prescribing drugs based on their likelihood of efficacy in a population that more or less looks like the patient in front of us, and waiting for patients to decompensate and then reacting to it. Yes, we are doing all this while using (struggling with?) an EMR, but still, the basics are all pretty much the same. Continue reading The Future Arrived for Me Last Week

Practice Guideline Overload

I think I am like many practicing physicians in my “love-hate” relationship with clinical practice guidelines. On the one hand, it is often helpful to look up a set of evidence-based recommendations on a particular clinical issue, and I feel particularly fortunate that the American College of Cardiology and the American Heart Association have collaborated to produce high quality guidelines on a wide-range of subjects relevant to my practice. On the other hand, I am well aware of the shortcomings of practice guidelines, including the limitations of the underlying evidence base, the challenge of synthesizing the available evidence into guidelines, and the often limited applicability of recommendations to clinical practice. Continue reading Practice Guideline Overload