MedWorm: Family Physicians

Quashing ptsd

Kevin, M.D. - Medical Weblog — Fri, 16 May 2008 15:00:04 +0100

The government VA is trying to cut costs by influencing diagnosis:A psychologist who helps lead the post-traumatic stress disorder program at a medical facility for veterans in Texas told staff members to refrain from diagnosing PTSD because so many veterans were seeking government disability payments for the condition."Given that we are having more and more compensation seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out," Norma Perez wrote in a March 20 e-mail to mental-health specialists and social workers at the Department of Veterans Affairs' Olin E. Teague Veterans' Center in Temple, Tex. Instead, she recommended that they "consider a diagnosis of Adjustment Disorder." (Source: Kevin, M.D. - Medical Weblog)

MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.

"good doctors are the ones who don't take insurance"

Kevin, M.D. - Medical Weblog — Fri, 16 May 2008 14:30:00 +0100

Really?The theory is that if a doctor is skilled enough, he or she can fill up their practice with private-pay patients without having to rely on an insurance panel. (Source: Kevin, M.D. - Medical Weblog)

Physician ratings

Kevin, M.D. - Medical Weblog — Fri, 16 May 2008 14:00:00 +0100

Like 'em or not, they're here to stay. Reviews of these sites are being index by Google, so physicians should pay attention to them:The “electronic medical grapevine,” to coin a term, is growing in importance. In 2001, the American Medical Association issued a press release suggesting that patients make a New Year’s resolution to “trust your physician, not a chat room.” As with much other New Year’s advice, this proffered piece of wisdom went unheeded. Today, online doctor ratings have become an integral part of an effort to intensify the interactivity of health care sites and thereby make them more attractive to users.(via Our Own System) (Source: Kevin, M.D. - Medical Weblog)

Local shots 11

Baggas' Blog — Fri, 16 May 2008 11:07:39 +0100

Local shots 11 Originally uploaded by baggas This is in one of the better parks in Rockingham, with plenty for the kids to do - but I have no idea what the point is of these totem pole things. Is it some weird new age thing? Do they hold occult fertility rituals or sacrifices here in the dead of the night? Certainly doesn’t look indigenous to here.. strange. Speaking of parks, keep your eye on this blog for some upcoming video of “The Best Playground I Have Ever Seen” and it’s right here in WA. I’ll post it up here over the next few days. Anyway I’m off to dance around the totem poles.. :p (Source: Baggas' Blog)

Twitter

Kevin, M.D. - Medical Weblog — Fri, 16 May 2008 06:00:02 +0100

In case you're looking for other ways to keep up with Kevin, M.D., my posts are now broadcast on Twitter.Of course, you can always subscribe using a variety of newsreaders. (Source: Kevin, M.D. - Medical Weblog)

Insidermedicine: in the clinic - radioembolization

Kevin, M.D. - Medical Weblog — Fri, 16 May 2008 05:00:00 +0100

In the Clinic - Dr. John Louie, MD, discusses radioembolization Thanks to Insidermedicine for their continuing sponsorship at Kevin, M.D. Insidermedicine (www.insidermedicine.com) is a physician-led news organization that brings daily evidence-based updates to patients, doctors and medical students. Also available in Chinese and Spanish. (Source: Kevin, M.D. - Medical Weblog)

MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.

Housekeeping for mybloglog

Fat Doctor — Fri, 16 May 2008 01:29:00 +0100

Undergoing MyBlogLog VerificationNothing to see here, people. Move on along, now. (Source: Fat Doctor)

My take: night float, free medical school, triage and disease management

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 19:30:01 +0100

1) After the resident work-hour restrictions were implemented in 2002, there has been more supervision during night float.My take: Good for patient safety, bad for training. Being independent on the overnight cross-coverage team provided one of the best learning opportunities during residency.2) The Cleveland Clinic's medical school is going tuition free.My take: Brilliant. These students will have substantially less debt burden than the average medical student. Hopefully their choice of specialty will have less of a financial motive, increasingly the likelihood they would choose a generalist field.If this trend spreads, top-tier students will find medical school attractive again.3) A reader writes: "I was reading the WSJ saw a full page color ad showing a father and his 3-year-old daughter, saying something like 'when my daughter had a fever of 103 last night, I'm glad I got to speak to nurse instead of an answering machine' . . .. . . These kinds of programs, along with 'disease management' programs for e.g. asthma and diabetes, are bunch of crap. If anything, they only serve to further fracture care . . .. . . I think these programs are really designed to avoid trips to the ER, and ultimately save insurers money."My take: Couple of points here.Not all physician offices use answering machines off-hours. Patients in my practice can reach a doctor 24 hours a day. I agree that one goal of telephone triage is to reduce ED visits, and thus costs. Liability however, becomes an obstacle, as it is impossible to diagnose accurately over the phone. Can you be 100% sure that the child with the 103 degree fever didn't have meningitis? If the health insurer is willing to accept all malpractice liability for their off-hours telephone triage service, I have no problems with it.Disease management programs certainly have their place. Working in conjunction with a primary care physician, they can be helpful adjuncts to ensure that patients are up to date with lab tests and are taking their medications. Problems arise when they intervene with therapeutic decisions independent of the physician. Having a clear, centralized decision maker is a necessity when multiple providers and nurses are caring for the patient. (Source: Kevin, M.D. - Medical Weblog)

Want my take?

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 19:15:00 +0100

This is a periodic open thread to solicit issues people want me to blog about, or to simply ask me a question. Suggest topics and links in the comments of this post, or you can e-mail me.I'll choose a few to put into my regular "My take" feature. (Source: Kevin, M.D. - Medical Weblog)

Congrats to dr. rich

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 19:00:02 +0100

The Covert Rationing Blog turns one year old. See some of his best posts. (Source: Kevin, M.D. - Medical Weblog)

John ritter defendants: "they just lost less"

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 19:00:01 +0100

EM News: "In the Ritter case, the jury agreed with the defendant physicians and exonerated them of any liability. They were lucky. How lucky? They were able to spend four years with attorneys worrying about their future, including the potential that they would be ordered to pay tens of millions of dollars and be left penniless.So, they didn't really win. They just lost less."(via Dr. RW) (Source: Kevin, M.D. - Medical Weblog)

MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.

"trial and error is part of the healing process"

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 19:00:01 +0100

People sometimes forget to realize that medicine is an inexact science. (Source: Kevin, M.D. - Medical Weblog)

Medblog power 8

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 18:30:00 +0100

5/13/2008 - 5/20/2008Next revision: 5/20/2008(Key: Rank, Blog name, Last week's rank, Post of note)1) Health Beat (3), Health Care Reform Via Focus Group2) WSJ Health Blog (2), Doctor Shortage is ‘Coming On Like A Freight Train’3) The Happy Hospitalist (1), Doctoring From The Back Seat4) Musings of a Dinosaur (7), Managing Risk5) DB's Medical Rants (4), Reasons to become a doctor6) Dr. Wes (5), MacGyver Moments in Medicine7) Buckeye Surgeon (-), Surgeon Tryouts8) Not Totally Rad (-), The Radiologic Appearance of Acute Kindle-itisThe MedBlog Power 8 is a list of medical blogs that have had an exceptional week of blogging, based purely on my subjective measures. Factors I consider are how provocative the posts are, the amount of discussion it generates, and posting frequency.The list is revised mid-week and will be published every 1-2 days on Kevin, M.D. If you want me to consider your exceptional week of blogging, you can contact me. (Source: Kevin, M.D. - Medical Weblog)

A disease that needs advertising

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 18:00:03 +0100

How generic Requip may lead to the extinction of restless legs syndrome:Last week, the drug agency approved the first generic versions of ropinirole tablets for four manufacturers. The move is likely to send Requip sales and advertising plummeting, industry experts predicted.At least one sleep disorder specialist expects the focus on restless legs syndrome to fade as rapidly as the Requip television commercials — which have already been pulled from the airwaves. (Source: Kevin, M.D. - Medical Weblog)

Why is the government continuing to fund chelation trials?

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 18:00:02 +0100

Dr. RW: "This tops any example you can trot out about the corrupting influence of Big Pharma. What I didn’t cover in my posts was the extent of the pseudoscientific agenda and conflicts of interest that prevailed throughout the planning and implementation of the study. If you think government funding is the answer to Pharma involvement in research this article will give you pause." (Source: Kevin, M.D. - Medical Weblog)

Dr. anonymous show, live tonight at 9pm est

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 18:00:01 +0100

Dr. A takes your calls and talks about his recent Vegas trip.Here's how to listen. (Source: Kevin, M.D. - Medical Weblog)

MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.

Sword swallowing fluoroscopy

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 17:00:02 +0100

(via Not Totally Rad) (Source: Kevin, M.D. - Medical Weblog)

Surgeons operating on more than one patient at a time

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 17:00:01 +0100

Should they? (Source: Kevin, M.D. - Medical Weblog)

Cool lego heart

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 17:00:01 +0100

(via Street Anatomy) (Source: Kevin, M.D. - Medical Weblog)

Eavesdropping

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 16:00:03 +0100

A drug-seeker listens in on a physician conversation. Mayhem ensues. (Source: Kevin, M.D. - Medical Weblog)

The candidates aren't addressing the physician shortage

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 16:00:02 +0100

Well, it's actually the generalist physician shortage.That's a profoundly troubling oversight, as any attempt to cover the uninsured will stretch the already strained primary care system.This survey suggests that some physicians may quit if universal coverage is enacted:Some 20 percent of doctors say they will quit practicing medicine if universal health-care insurance coverage is implemented under the next president . . .. . . Among nearly 1,400 doctors who answered the survey, 63 percent said they would 'continue practicing like they do today,' 11 percent would change occupations and 9 percent said they would retire. (Source: Kevin, M.D. - Medical Weblog)

MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.

Cbo: prevention does not save money

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 16:00:02 +0100

Merrill Goozner: "On a down note, he added his voice to the growing conventional wisdom that prevention measures will not generate savings for the health care system. All candidates for president have made prevention promotion a central motif in their health care plans, claiming that it will save the health care system money in the long run by promoting healthier lifestyles and arresting ill-health before it progresses to chronic disease." (Source: Kevin, M.D. - Medical Weblog)

Quick blogs for 2008-05-15

Baggas' Blog — Thu, 15 May 2008 15:59:59 +0100

Just had my Thunderbird bass guitar arrive that I picked up cheap on eBay. Can’t wait to get it home and plug in # John Edwards has finally come out and endorsed Obama. Surely this should be close to game over now for the Democratic nomination? # (Source: Baggas' Blog)

Should hospitals be fully staffed 24 hours a day?

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 15:00:02 +0100

Joe Wright: "The hospital is a constant production process. But it's in transition: it inherits many of the features of its pre-industrial roots. A truly efficient production process never stops, but the hospital slows down considerably at night. I think there would be a lot to be said for a truly 24-hour hospital. But that would require more health care workers, more money to pay people extra to work overnight, and a completely different way of arranging care." (Source: Kevin, M.D. - Medical Weblog)

Maybe lawyers need some anti-kickback rules

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 15:00:02 +0100

Lawyers apparently receive referral fees, and can be a third of the award that is won during a case.Pete Stark needs to look into that. (Source: Kevin, M.D. - Medical Weblog)

"compared to working in the fields, it was easy"

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 15:00:01 +0100

An illegal immigrant becomes a neurosurgeon. (Source: Kevin, M.D. - Medical Weblog)

MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.

Placebo television

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 14:09:57 +0100

(Source: Kevin, M.D. - Medical Weblog)

Blogging for human rights

Prudence and Madness — Thu, 15 May 2008 12:12:53 +0100

I’m afraid I have allowed May 15 to come without being fully prepared. I was hoping to post something about the human violations in the Philippines that has continued to proliferate, like the case of missing and killed journalists and other people who have campaigned against the government, the unfortunate children being trafficked by greedy men and women, sold to slavery and prostitution, for money, the untold tales of women being sexually abused, even in their own homes, and are forced to keep quiet in fear of being killed or their loved ones being harmed, and of OFWs being continually abused by their employers and the government not doing enough about it. But because I was busy and lazy, I forgot to do my homework. Hopefully, by reposting the badge as a reminder to those who may be interested in joining or those who may be able to do more to help the cause, I may be able to makeup for what I should have done. Let us be reminded that we do have the power to fight for our basic human rights. All we need to do is to use whatever means within our reach to let everyone who’d care to know that basic human rights are universal. Blogging may be deemed too simple, too tame, to even fight back the big monsters. But, at least, we do and we try. Please do visit Bloggers Unite, blogging for hope. (Source: Prudence and Madness)

Dear angry pharmacist

Musings of a Dinosaur — Thu, 15 May 2008 10:11:00 +0100

I really like your blog. In fact, I rarely comment because I almost always agree with you. Unfortunately, this means I can't remember which form of my Username I used to create an account to allow me to comment; either that, or my new computer has cookie issues. In any event, although your recent post about your hellacious Friday was heartrending -- and didn't actually say anything about me at all -- someone was kind enough (no sarcasm; traffic has been through the roof) to link to me in your comments. Many (many!) others have since come here and commented as well, so I'd like to address those folks directly.I'd just like to point out that obviously many doctors are idiots. Uneducated front office staff calling in prescriptions must be maddening; illegible handwriting, nonexistent dosage forms and ridiculous quantities are certainly infuriating; waiting on hold over and over to clarify these things -- while saving the necks of ungrateful patients -- surely earns you millions of karma points towards your halo. That's why I like your blog; you put those doctors squarely in their place with great anger (obviously) but also with humor and panache.I'm also certain you agree that patients are morons; many so stupid you wonder how they manage to breathe and blink at the same time. Of course they hear what they want to hear; often the exact opposite of what was actually said, whether by you or me.It just so happens that there was this one particular patient who really really really needed a cholesterol medicine, and with whom I spent an inordinate amount of time carefully explaining exactly why he really really really needed it. So when this particular patient reported that a pharmacist (actually not one but two) told him he should stop taking it...I did not in fact go ballistic in front of him, but rather spent another extended visit explaining why he didn't have to take it if he didn't mind being at increased risk for another heart attack; and succeeded in persuading him to go back onto a different statin, as it happened. Still, there was exasperation, and the blog provided a fun way to let it out.So for the record, I'd like to specify some things to those who so graciously commented on my humble rant:I don't see drug reps, nor do I accept anything -- including food -- from them.My handwriting is quite legible.My office phone is answered promptly -- by a person.I prescribe narcotics and other controlled substances with great caution, butI try always to be acutely aware of patients in true pain who are not abusing their drugs.I do not rush patients through my office, and in fact probably see only about half as many patients a day (usually the same day they call) as some other docs; of course I'm only making half as much money, but I believe it's worth it.Some of my best friends are pharmacists; by which I mean that in person I have wonderful, respectful working relationships with my local pharmacists (which actually means I should call the one (or two) this patient spoke with and get their side of the story.)Finally, to all those who called me things like "idiot", "tard", "moron", "lazy", "know-it-all" and "spoiled": please, I beg you, go peruse Cranky Epistles for a little while and come up with some original insults. Heaven knows Cranky Professor has elevated the epithet to an art form! The least you can do is exercise some creativity. (Source: Musings of a Dinosaur)

The googler-in-chief on the internets

Baggas' Blog — Thu, 15 May 2008 08:08:22 +0100

Came across a video similar to this one on cnn.com today and thought I’d go on The Google and see if I could find a YouTube version to post for y’all. This is not exactly the same but it’s essentially the same basic story - classic Bushims! Ain’t the internets a wonderful thing! http://www.youtube.com/watch?v=_is9YqLj8Mo (Source: Baggas' Blog)

Quirky

Fat Doctor — Thu, 15 May 2008 07:53:00 +0100

Inspired by Sterkworks, I stole her meme.Do you read Sterkworks, the ex-mormon lesbian blogger? If not, you should. She's very raw with her feelings. Her responses to this meme absolutely cracked me up.So, even though I wasn't tagged, I stole it.Six Quirky Things About FDI lay out "fire clothes and shoes" by my bed and then sleep naked.I compulsively pick Big Dog's eye boogers and will dig out his ears with my fingers if I can't find a cotton swab.Whenever I see a police car on the road, I turn onto a side street and my pulse speeds up while I check my rearview mirror to see if it is following me. I'm afraid of live fish and will steer clear of fish tanks. I like to eat dead ones.When I cough up those tonsil chunky things from time to time, I like to dissect them before throwing them away. Sometimes I feel like I'm being watched by ghosts. There you go. Steal it if you want it. Speaking of blogging, my cousin Seattle Redhead has started posting again after an eight month break. Go give her some loooooooove. (Source: Fat Doctor)

MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.

Insidermedicine

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 05:00:02 +0100

I would like to thank Insidermedicine for their continuing sponsorship at Kevin, M.D.Insidermedicine (www.insidermedicine.com) is a physician-led news organization that allows you to keep on top of the latest medical information by watching unique videos that are created each and every weekday by Insidermedicine's team of medical experts. Their goal is to reach patients, medical doctors and students around the world to ensure that each is receiving a daily 'evidence based' health and medical update.Given their wide and diverse audience, Insidermedicine offers health and medical content that is unique for their viewers. Here is a sample of some of their regular programs, which are also available in Chinese and Spanish.Their videos are highly recommended, and I am excited to include them as a regular feature of this blog.Sponsorship opportunities continue to be available. This can be via a Standard Blogad or a customized package. Please visit the advertising information page for further details. (Source: Kevin, M.D. - Medical Weblog)

Change of shift, vol. 2, no. 23

.PARALLEL UNIVERSES. — Thu, 15 May 2008 04:00:00 +0100

Welcome to Change of Shift, a regular rounds of the best posts in the Nursing blogosphere! It is an honor to be the third physician moderator of this grand gathering. This carnival of posts comes to you live from Asia, in the Philippines!I have always held nurses in high esteem even when I was a medical student. Sure, doctors do all the critical medical decision-making, but the nurses play critical roles in making sure that all the important clinical decisions happen. Without nurses, a doctor's life would be empty and crippled.So, on with the show......EDITOR's Choice Post - Do you have anything there to wipe off my tears? Blue. This is truly a heart-breaking post from MonkeyGirl.Purely NursingAs one goes up in the career ladder of nursing and becomes a manager, life does not become easy. Nurse Kathy of NurseConnect discovers the woes of "other duties assigned." She also promotes the need for healthcare organizations to adopt certain practices in their organization related to Relationship and Results Oriented Healthcare to improve practice, patient and physician satisfaction.Nursing work and duties can be exasperating at times. This leads to disillusionment and Nurse Laura, also from NurseConnect offers the solution of role models to relieve the seemingly overwhelming problem.Are nursing orientations only about getting paid for sitting, studying, and reviewing? Miss-elaine-ious has beautiful thoughts on the matter.Where do nurses come from? From equally good mother nurses, of course! Nurse Bear pays tribute to all the wonderful Mama Nurses.Kim, my wonderful nurse-blogger friend who made this hosting possible, offers some excellent nursing pearls for the next generation of nurses.Nursing RelaxationAlmost always, nurses and doctors are always stressed, and it is not easy to relax even someone told them to. What to do? Take the awesome advice of Mother Jones as she discovers the wonders of needles. I will surely try this one of these days!And to complete our relaxation and rejuvenation process, try the healing benefits of Reiki, too! The mantra is this: Just for today, do not anger Just for today, do not worryOther ConcernsHistory and Cheek Biting - sarcastic and witty post from Max E Nurse.Electromagnetic Fields and Preemies - is there a link? Not true. Not true. Nurse Sandy tells why.Sleeping Pill Risks - another great post from TherapyDoc. I agree more with the alternatives like exercise and avoiding caffeinated drinks.Brain Advice - that organ needs some form of exercise, too!Water Woes - yes, water. The precious liquid. Student nurse Faith ranted a mouthful and it's worth reading. I experienced this one time, too.Heal Your Prostate - a natural recipe for men having troubles.Web 2.0 + Medicine - is a marriage possible? Or will it end up in divorce?_______________That's it for this round! I hope you get to read all the posts. They're all informative and eye-opening. It was great hosting Change of Shift! Special thanks to Kim for making this possible.The next edition will be hosted on May 29th over at Miss-Elaine-ious RN. Be sure to send your choice posts to her. (Source: .PARALLEL UNIVERSES.)

The punisher and the “coast guard cocktail”

Polite Dissent — Thu, 15 May 2008 04:00:00 +0100

scene from Punisher: Force of Nature (By Swierczynski and Lacombe) The “Coast Guard Cocktail” is a sea-sickness remedy of legendary fame. Like many legends, it’s not entirely clear how much is truth, and how much is myth. I’ve seen many references to the cocktail, but I’ve never met anyone who’s actually taken it. Was it actually dispensed, or at least condoned, by the Coast Guard, or is the name supposed to be a slur against them (as in “they need sea-sickness pills”)? The medicine behind the cocktail is sound, if a bit excessive. Two separate pills make up the treatment. The first is promethazine, better known in the U.S. by the brand name Phenergan. It is an excellent medicine at quelling nausea and is indicated for prevention of motion sickness — unfortunately, it is also extremely sedating. The second pill in the cocktail, ephedrine, a stimulant, is taken to counteract the sedation caused by the Phenergan. It is the same medication that until recently was the active ingredient in many energy drinks and diet pills. It can cause nervousness and irritability, and at high doses there are concerns about elevated blood pressure and abnormal heart rhythms. I’m always leery when a pill is prescribed to the combat side effects caused by another medication. That can easily lead to drug after drug prescribed, and before you know it, you’re on twelve pills for a simple problem. Plus, even with the ephedrine, I suspect the Phenergan is still going to be sedating. That may be all right for passengers who can sleep the day away, but I wouldn’t want any professional on it when they’re supposed to be on duty (or – like the Punisher — supposed to be shooting people). Phenergan is available by prescription only (at least in the U.S.), and the legality of ephedrine varies by locale. The “over-the–counter stuff” the Punisher refers to is likely either Dramamine (dimenhydrinate) or Bonine (meclizine). Both are good at motion-sickness, though not quite as good as Phenergan. Both are also sedating, but again, not as sedating as Phenergan (particularly meclizine, which is less sedating than Dramamine). Extra credit to writer Duane Swierczynski for having himself listed as the doctor on the Punisher’s prescription bottles. Tags: comics medicine punisher motion sickness phenergan ephedrine duane swierczynski (Source: Polite Dissent)

Links for 2008-05-15

Family Medicine Notes — Thu, 15 May 2008 04:00:00 +0100

Results for '+series:"national ambulatory medical care survey series", -availability:restricted' National Ambulatory Medical Survey (Source: Family Medicine Notes)

Medblog power 8

Kevin, M.D. - Medical Weblog — Thu, 15 May 2008 03:47:40 +0100

MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.

Fast break up

Tundra Medicine Dreams — Thu, 15 May 2008 02:03:00 +0100

(Source: Tundra Medicine Dreams)

What is a kuspuk?

Tundra Medicine Dreams — Wed, 14 May 2008 22:30:00 +0100

(Source: Tundra Medicine Dreams)

"isn't it time we had a health system run by doctors?"

Kevin, M.D. - Medical Weblog — Wed, 14 May 2008 19:45:39 +0100

Ezra Klein makes some sense in analyzing a potentially politically feasible approach to reform. (Source: Kevin, M.D. - Medical Weblog)

Cathole

Kevin, M.D. - Medical Weblog — Wed, 14 May 2008 19:00:05 +0100

(via The Happy Hospitalist) (Source: Kevin, M.D. - Medical Weblog)

The bias against physicians leading health it

Kevin, M.D. - Medical Weblog — Wed, 14 May 2008 19:00:03 +0100

Health Care Renewal: "I believe this and related stereotypes about physicians are a driver and an enabler (either through genuine belief or through disingenuous opportunism) of much that ails medicine today through the interference of non-medical outsiders. The fundamental message is that physicians are children who cannot do anything more than medicine, and require 'a village' of paternalistic non-medical outsiders to manage their affairs." (Source: Kevin, M.D. - Medical Weblog)

MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.

One click

Kevin, M.D. - Medical Weblog — Wed, 14 May 2008 18:00:01 +0100

Cool ad. (Source: Kevin, M.D. - Medical Weblog)

99233

Kevin, M.D. - Medical Weblog — Wed, 14 May 2008 18:00:00 +0100

Coding clinic continues. (Source: Kevin, M.D. - Medical Weblog)

What do emergency physicians do?

Kevin, M.D. - Medical Weblog — Wed, 14 May 2008 17:00:02 +0100

Here's a taste. (Source: Kevin, M.D. - Medical Weblog)

The public's confusion

Kevin, M.D. - Medical Weblog — Wed, 14 May 2008 17:00:01 +0100

This makes some sense as to why reform is so difficult in America:Lake is not interested in explaining reform; her goal is to market reform. And how do you market a product? By appealing to prejudices, and playing on the ignorance of your audience. If they think a yellow box make it a friendlier product, then put it in a yellow box. (Source: Kevin, M.D. - Medical Weblog)

Cigarette smoke ruminations

Prudence and Madness — Wed, 14 May 2008 16:22:56 +0100

I thought of this post while I was smoking a precious cigarette at the back of the clinic when there was a lull in the onslaught of patients for the day. It felt good to be having that moment, no matter how brief it was. I kind of miss being with myself, mulling over things, from the most mundane to the weirdest shit. There are times when I wanted to speed up the days and the nights, so I might come to those most anticipated times, skipping over the stale ones. It is as if there are just so many things to do and I want it all finished in a snap and see the results…so that I could move to doing some more things, others that are still lined up in the pipeline of work/tasks to be done. Who could get bored with the number of things worth doing and with the number of experiences yet to be encountered? How can anyone say that there isn’t much to do, when there are a million things to learn, to discover, to see, to play with, to fix, to burn, to destroy, to build, to create? I, myself, get lost thinking of how awesome it would be to do most of what can be done in a lifetime. But, at times, I wish that I could simply stop time and just stay there, with my burning cigarette, all things suspended and stand still, simply looking up at the dark, forbidding sky, as the smoke rises up to claim it. A space in time to remember all that is good and true. Skip those not so good times and play only the mirthful ones like what you do with your favorite movie, like The Matrix or Underworld. Ah, what a joy! However, even if I try to inhale the moment, savoring it, the moment I do, it’s gone. Perhaps, perhaps, I was looking up too much. (Source: Prudence and Madness)

MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.

Ifluoroscope

Kevin, M.D. - Medical Weblog — Wed, 14 May 2008 16:00:01 +0100

Pretty funny. (via Dr. Wes) (Source: Kevin, M.D. - Medical Weblog)

Amazon kindle and radiology

Kevin, M.D. - Medical Weblog — Wed, 14 May 2008 16:00:01 +0100

How's the screen for viewing plain films?The results? Not too shabby. Although it wouldn't fly for diagnostic purposes, the lace-like pattern of sarcoid in the distal phalanx can still be seen well enough for educational purposes. Of the two dithering modes, I think I prefer the Atkinson algorithm. Also, I have found that an image looks a lot better when it is sized large enough to completely fill the Kindle screen. (Source: Kevin, M.D. - Medical Weblog)

What i’ve been doing today - 2008-05-14

Baggas' Blog — Wed, 14 May 2008 15:59:59 +0100

I’ve finally achieved my century of eBay feedback - currently 104 not out with a blue star, though I really need to stay away from eBay… # looking at the Federal budget - our family loses a fair bit on this one. First time I can remember actually being worse off after a budget # (Source: Baggas' Blog)

Grace 4 u2

The Doctor Is In — Wed, 14 May 2008 15:15:22 +0100

This is a re-post from several years ago, to quell the restless masses until time permits me to write something afresh. After seemingly endless weeks recently of watching Tom Cruise air-box, jump on chairs, pontificate on depression, and talk about the idiocy of Scientology, it’s definitely refreshing — yea, one might even say a veritable antidepressant — to have some sanity expressed by another celebrity who appears to have a more rational cerebrum (although, granted, not as much of a pretty boy). Swiftly and with Style (HT: In the Agora) finds an intriguing quote from Bono, of U2 fame, in his book Bono in Conversation: It’s a mind-blowing concept that the God who created the Universe might be looking for company, a real relationship with people, but the thing that keeps me on my knees is the difference between Grace and Karma. . . .You see, at the center of all religions is the idea of Karma. You know, what you put out comes back to you: an eye for an eye, a tooth for a tooth, or in physics—in physical laws—every action is met by an equal or an opposite one. It’s clear to me that Karma is at the very heart of the Universe. I’m absolutely sure of it. And yet, along comes this idea called Grace to upend all that “as you reap, so will you sow” stuff. Grace defies reason and logic. Love interrupts, if you like, the consequences of your actions, which in my case is very good news indeed, because I’ve done a lot of stupid stuff. . . . I’d be in big trouble if Karma was going to finally be my judge. I’d be in deep sh-t. It doesn’t excuse my mistakes, but I’m holding out for Grace. I’m holding out that Jesus took my sins onto the Cross, because I know who I am, and I hope I don’t have to depend on my own religiosity. I love the idea that God says: Look, you cretins, there are certain results to the way we are, to selfishness, and there’s mortality as part of your very sinful nature, and let’s face it, you’re not living a very good life, are you? There are consequences to actions. The point of the death of Christ is that Christ took on the sins of the world, so that what we put out did not come back to us, and that our sinful nature does not reap the obvious death. That’s the point. It should keep us humbled… It’s not our own good works that get us through the gates of Heaven. It’s a little scary when Karma and Christ get mentioned in the same breath — from a rock star never seen without his wrap-around shades and so-cool demeanor — in a literary aside laced with the appropriate profanities, moreover — and it’s one of the clearest expressions of how the world works you’ve heard in months. God’s a very funny guy sometimes, and uses rather peculiar mouthpieces — which gives me great hope indeed. (more…) (Source: The Doctor Is In)