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Latest Posts

Ultrasound Isn’t All That Useful In The ER

What Shari Welch Said.

Ultrasound is a neat toy, and I’m all about toys.  I found two opportunities to play with enhance patient care with our ultrasound today on my shift.  But it doesn’t have the bang for the buck that the enthusiasts think it does.   It has very narrow, but real, utility, and does nothing to generate revenue.  It does in some cases enhance patient turnaround, and it certainly enhances patient satisfaction (they love cool toys as much as we do — and extra face time with the doctor to boot!).  But that’s a small return on a machine costing tens of thousands of dollars. Read more »

*This blog post was originally published at Movin' Meat*

Hospital Halloween Pumpkins

… they can get creative with “pump-kin” decorating:

*This blog post was originally published at Dr. Wes*

Mainstream Media Has Blogger Envy

headline_nurse2I never knew that newspapers use to hire nurses. This nurse is working in a big city at the news desk. I wonder if she had to have a journalism degree as well as a nursing license in order to write copy for a media outlet back when nurses wore their cap. There was a time when only journalists wrote the news. Now anyone with a computer, a video camera, and a website can out scoop CNN. Kim from Emergiblog told me that some bloggers and a member of the press got into a debate at BlogWorld09. I wasn’t surprised to hear this because mainstream media thinks that its the only legitimate source for news. Come on mainstream media, we both know what’s really going on here. You have blogger envy.

I’m sorry if I sound cranky, mainstream media, but I’m really tired of all your whining. I know you don’t think that citizen journalists check their facts and that we lack reliable news sources. Some of you have even said that our stories aren’t fair and balanced. Do you really want to go there, mainstream media? I’m talking to you Fox News and MSNBC. You’ve got your nerve to criticize anyone about their scruples. Read more »

*This blog post was originally published at Nurse Ratched's Place*

Is the HON Code Meaningless?

doctor question honcodeHealth on the Net Foundation has been evaluating and rating medical websites for years and it’s sad when we find out there might be some problems and concerns around this highly-respected system.The Bradfield Resident blog published an interesting entry:

…from a review the HONcode guidelines on the Health On the Net Foundation website, it appears that the Australian Dental Association’s site, which currently displays a HONcode seal, does not respect the HONcode principles.

Details of the water fluoridation argument (and safety of mercury in fillings, etc) aside, it is apparent that the current ADA website does not respect a number of the HONcode principles – to an obvious and significant extent – and I imagine this to have been the case for a number of years, if not from the original review in January 2004. This example does not instill confidence in the credibility of the Health On the Net Foundation seal used for medical and health websites. I seek your explanation as to how a site reviewed numerous times with such glaring inconsistencies could be certified. I have not particularly listed examples of the inconsistencies since they appear on almost every page of the ADA website – if you cannot see them, I hold little hope for the HONcode’s reputation at all.

*This blog post was originally published at ScienceRoll*

Rural Emergency Medicine: Stigma & Stereotypes

Lee Falls, SC

I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.”  It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest.  The natural beauty is breathtaking.  Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some found nowhere else.   Fish and game abound.  In fact, our wooded hospital grounds support a flock of at least 30 wild turkey.  And last deer season, the only deer I saw were the three does grazing at the end of the ED driveway one night, spotlighted by two of our paramedics.

We have a lot of wonderful things here, things that are gifts of the rural life.  We have good people, the salt of the earth types who care about personal morality and Southern courtesy.  People who bring you a glass of sweet tea when your car breaks down.  We live with a low crime rate, and minimal illicit drug use compared with more populated areas.  It is a good place to raise children.  It’s also a cool place to practice, where a busy summer shift can bring an acute MI, a near drowning (from inner-tubing on Class IV white water while drunk), a pit viper bite, a bull goring and many other pathologies, more or less interesting.

But, as physicians in a rural area, we pay a price.  Because we have to endure a certain stigma.   Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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