My partner broke her femur in a Zumba class just before Christmas 2025 and had successful surgery. Following successful surgery, physicians prescribed Lovenox (an anticoagulant) and Plavix (an antiplatelet drug), the standard regimen for preventing or treating venous thromboembolism (VTE). However, the intervention proved very risky: She lost three pints of blood into her leg and required a two-pint blood transfusion, direct complications of the Lovenox and Plavix.

A history rooted in logic, not trials

Physicians adopted anticoagulants such as heparin and warfarin in the 1940s to prevent deaths from leg vein clots (deep vein thrombosis, DVT) traveling to the lungs. This was before randomized controlled trials (RCTs) became the benchmark for efficacy. Because DVT patients usually survived, and autopsies of those who didn’t often show fatal clots, clinicians reasoned that thinning the blood was a life-saving necessity. By the 1950s, this reasoning became an unshakeable medical orthodoxy.

A whistleblower doctor’s story

In 1995, during a financial crisis at the LAC-USC Medical Center, administrators closed my palliative care service. I had previously estimated that our hospice-at-home model saved $9 million annually in hospital revenue (a “loss” the administration likely disfavored). Soon following an LA Times op-ed I wrote on LAC-USC Medical Center hospital inefficiencies, I faced retaliation: a malpractice accusation after a patient of mine with DVTs died of clots going to...

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