Today's thought

It is the boast of modern man, To do at most the least he can. Piet Hein

Share...

Share |

Other seas to surf...

Medicine

KevinMD  |  THCB  |  EMR and HIPPA  |  A Country Doctor Writes  |  Dr Mintz  |  Clinical Cases  |  Dr Charles  |  33 Charts  |  Care and Cost  |  Science-Based Medicine  |   Musings of a Dinosaur  |   Seattle Mama Doc  | 


Politics

Ezra Klein  |  Steve Benen  |  Matt Yglesias  |  Think Progress   |  Wonk Room   |  Glenn Greenwald  |  The Incidental Economist  |  Big Sky Ideas


 Photography
 MDPB
Science and Behavior

The Frontal Cortex   |  Neuurologica  |  Overcoming Bias  |  Dan Ariely  |


 Math 
StatisticalSkier   |  Flowing Data  |  Stat Modeling 
Humanities 
 World Wide Words
 Humor

xkcd 


 Miscellany

A list apart 

Who's on-line

0 registered users and 29 anonymous guests on-line.

You are an anonymous guest. You can register here.

Mea sententia...

Nov 22, 2014

The innovator's prayer

Words of wisdom…


Categories: Philosophy and ethics

Nov 15, 2014

Workplace Wellness Programs: sense or nonsense?

Workplace wellness and chronic disease management programs (now encouraged by the ACA) are quite common, but being a $6 billion dollar industry doesn't make them useful. Recent personal experience with one such program has led me to look more closely at the topic.

 

Categories: Medicine

Nov 08, 2014

Two very different cultures in medicine

Was the surgeon a princess, complaining about a pea under her mattress? Or am I a sheeple, accepting a woefully inadequate system? What do you think?

 

Categories: Medicine

Nov 01, 2014

The admission ticket

Why does the ‘chief complaint’ make me think about  pancakes and fig newtons? The chief complaint may just be an admission ticket.

Categories: Medicine

Oct 29, 2014

Is the patient always right?

Patient satisfaction has become a prominent goal in health care. Is this a good thing?

 

Categories: Medicine

Oct 22, 2014

The ice-pick headache

Categories: Medicine

Oct 15, 2014

Why I decided against pediatrics

I love children. I won’t claim to ‘understand’ them, but I am comfortable with them, and happy to work in their universe rather than asking them to be part of mine. I find them easy to work with. The ED nurses occasionally referred to me as the “child whisperer.” I am often asked by friends and colleagues why I did not become a pediatrician. 

 

Categories: Medicine

Oct 08, 2014

She thinks I'm real

As a child, I looked forward to the infrequent family outings that involved a restaurant. As the eldest of three, it gave me a chance to strut my stuff in front of my sisters: I was allowed to order without much interference, so it was a rare opportunity to have a cheeseburger, fries and the most chocolate item available for dessert. 

 

Categories: Medicine

Oct 01, 2014

When the improbable becomes inevitable

“Just keep doing tests. Eventually you are bound to find something.”  She was right, of course. But not in the way she meant.

 

Categories: Medicine

Sep 29, 2014

Infested...

After decades of hiking, camping, canoeing, kayaking and swimming in various back country environments, it finally happened. I have been colonized. Beaver fever, also known as giardiasis, caused by the protozoan Giardia lamblia.  Enjoying my metronidazole.

 


Sep 22, 2014

Stranger in a strange land

I find myself a stranger in a strange land, or (more prosaically) a square peg being forced into a round hole.

 

Categories: Medicine

Sep 15, 2014

Incrementalism and the status quo

I was recently told that ‘the problem’ underlying my often strained relationship with the institution where I work is that I am a revolutionary working in an institution committed to incrementalism.

 

Categories: Management

Sep 08, 2014

Quality goals and flipped priorities

What would you think if you received this message from management: “You can ignore chlamydia…it is not one of the quality goals for this year.” Or if you were told at a meeting to discuss a mandated quality initiative: “All you have to do to get credit for BMI screening is just click the box that says you will talk about it at the next visit.” (Both true stories.)

Categories: Medicine

Sep 05, 2014

Thanks for forty four...

Forty four good years, with more to come.  I’ll honor it with some words we started with…

 


Sep 01, 2014

Thoughts for Labor Day

I don’t consider myself a laborer, though I surely work very hard. I work because I love to.

 

 


Aug 29, 2014

Problems are not the problem

Having problems is not a problem.

Believing or pretending there are no problems, and then punishing or marginalizing those who want to fix the problems - THAT is a problem.



 

Categories: Management

Aug 22, 2014

Thoughts about the medical history

‘Taking a history’ is one of the first clinical tasks medical students are taught. The logic behind this is inescapable: without the history, attempts at diagnosis and treatment are doomed to failure. We start our training with the history, when we present patients for discussion with other doctors (in training or later, in practice) we start with the history. And except in rare emergencies, we start every patient interaction with the history.  The history: it always starts there but it doesn’t end there.


Categories: Medicine

Aug 15, 2014

Insomnia cure, Lysistrata style

The appointment was for his annual physical, and to review his well controlled hypertension and gout. After we had addressed these issues, I asked if there was anything else he was concerned about.


Categories: Medicine

Aug 08, 2014

Questions patients should be asked

In a previous post I talked about some important questions I ask myself in my attempt to avoid missing the correct diagnosis.

 


Categories: Medicine

Aug 01, 2014

Don't 'due-due' on patients

I have a serious problem with the ubiquitous use of 'due' when talking with patients about what their medical options are. This came up recently when I was given a list of my patients who were ‘due’ for certain services, required if my institution is to receive a financial quality incentive. Typically, ‘due’ shows up in EHR alerts (the diabetic patient is 'due' for their A1c or microalbumin) and quality programs (patients are 'due' for a mammogram every 2 years, a DXA at 65, a pneumovax at 65, even well child visits at set intervals). Clinicians see it and hear it so often, it becomes part of our internal thought process. But it is wrong and harmful. 

 

Categories: Medicine
Page 1 / 16 (1 - 20 of 303 Total) Next Page Last Page