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man holding his chest

Advanced Therapies for Massive Pulmonary Embolism

The report by Secemsky et al1 in this issue of Spanking-Videos illustrates the current management of pulmonary embolism at the Massachusetts General Hospital (MGH). A Pulmonary Embolism Response Team sees all patients in whom pulmonary embolism is diagnosed by computed tomography. The team manages these patients during their hospitalization and after discharge for up […]

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William H. Frishman, M.D.

Reform in House Staff Working Hours and Clinical Supervision

  When we were medical interns (WHF and JSA), training in 1969, the weekday work schedule on the ward services was 36 hours on and 12 hours off. Every other weekend, there was a shift from Saturday morning to late Monday afternoon, 56 straight hours. We were off 1 Sunday every 2 weeks. There were […]

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Dr. Joseph S. Alpert

Sloppy, Greedy, or Overworked?

In early 2010, my administrative assistant, Barbara Raney, came into my office with a worried expression on her face. She told me that a lawyer from the Department of Justice (DOJ) in Washington, DC was on the phone and wanted to speak with me. My immediate thought was “What have I done that would raise […]

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Joseph S. Alpert, MD

The Fourth Edition of the Universal Definition of Myocardial Infarction

Recently, the American College of Cardiology, the American Heart Association, the European Society of Cardiology, and the World Heart Federation simultaneously published the fourth document in the universal definition of myocardial infarction series.1 The first document proposing a universal definition was published in 2000 in the European Heart Journal and the Journal of the American College of Cardiology. The […]

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elder woman in eye exam

Prescription of Statins to Women Poses New Clinical Challenges

In women and men, cardiovascular disease is and will remain the leading avoidable cause of premature death in the United States and is rapidly becoming so worldwide.1 Although many women fear breast cancer more than cardiovascular disease, 1 in 8 will develop and 1 in 25 will die of this disease, whereas more than 1 in […]

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Joseph S. Alpert

The Role of the Environment in Health Outcomes

Disparities in health outcomes in the United States and other high-income countries have been widely discussed in recent years.1, 2, 3, 4 Many reasons have been suggested for these disparities, including the income levels of individuals, their educational attainment and employment status, as well as a variety of neighborhood socioeconomic and environmental factors. During my many years of inpatient […]

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