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Drug Marketing During The Holidays Targets Night Shift Workers

…And all through the town not a creature was stirring except for some struggling to stay awake throughout the night shift….

So reads a newspaper ad for a federally-controlled substance in prescription drug form that is marketed for ES caused by SWD or OSA.

Don’t know what that means?

Come on.  Where have you been?

Like ED for erectile dysfunction, PE for premature ejaculation, and GERD for gastrointestinal reflux disorder, these are the new marketing names for conditions that drug companies want to sell you drugs for.

ES = excessive sleepiness

SWD = shift work disorder

OSA = obstructive sleep apnea

The drug company’s online ads feature a fireman, a police officer, a construction worker.  I am very sensitive to Read more »

*This blog post was originally published at Health News Review*

Tired Health Care Workers And Patient Safety: Tips To Avoid Fatigue

Health care facilities should take five steps to ensure staff aren’t becoming sleep fatigued, according to a Sentinel Event Alert from The Joint Commission.

Shift length and work schedules impact job performance, and in health care, that means patient safety, the alert stated. A study of 393 nurses over more than 5,300 shifts showed that nurses who work shifts of 12.5 hours or longer are three times more likely to make an error in patient care.

Furthermore, residents who work traditional schedules with recurrent 24-hour shifts:
–make 36 percent more serious preventable adverse events than individuals who work fewer than 16 consecutive hours,
–make five times as many serious diagnostic errors,
–have twice as many Read more »

*This blog post was originally published at ACP Hospitalist*

The Tired Medical Blogger

Ever feel like you’re kind of stuck and you need a change? I was there last week. With the upcoming Thanksgiving week, life was adding more stress that was difficult to handle. For weeks now, I felt like I was taking all my efforts and playing catch up. Don’t get me wrong. I’m very happy where I’m at right now professionally and personally. I was just tired.

“Social Media Fatigue” is a dirty little secret that the early adopters never write about – especially those in health care social media. That’s why I was surprised when a few months ago, my good friend, Seattle Mama Doc wrote the post “Online Sabbitical.”

I’m taking an online sabbatical this month. Consider this an act of both self-reflection and self-awareness but also an act of self-preservation. As any blogger knows, blogging every few days, taking photographs daily, approving and responding to comments 24 hours a day (7 days a week), while authoring content in your head every few paces, is an entirely consuming experience. Blogging has completely changed my life. And this job is an utter privilege… But I’ve been consuming media, blogging, and authoring content without reprieve since November 11, 2009.

Now, my blogging frequency and my podcast frequency have Read more »

*This blog post was originally published at Family Medicine Rocks Blog*

The Changing Priorities Of A New Generation Of Physicians

Doctors are, famously, workaholics. That’s just the way it’s been forever, at least as far back as my memory goes. You work crazy hours in residency, you graduate and work like a dog to establish your practice or to become a partner in your practice, and then you live out your career working long hours because there just aren’t enough hours in the day to do everything that needs to be done. I remember, growing up in the ’80s, that my friends whose parents were doctors were latchkey kids whose dad (usually the dad, then) was never at home when we were hanging out in the rec room playing Atari.

Yeah, Atari. Look it up, kids.

Not much had changed by the time I went to medical school. There was recognition of the fact that burnout was an issue — that divorces, alcohol abuse and suicides were more common among physicians than in other professions. The unspoken implication was that being a doctor was difficult and stressful, which increased the risk of these consequences of an over-burdened professional life. These stresses were accepted as part of the turf, as a necessary part of “being a doctor.” It wasn’t optional, and indeed, most physician teachers that addressed the matter chose to sublimate it into a mark of nobility. Being a physician was a calling and a duty, and a physician must gladly subordinate his or her own happiness and well-being to the service of their flock.

But things have changed, or at least a slow shift is in progress. Read more »

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

Can Decision Fatigue Lead To Medical Errors?

Do you suffer from decision fatigue when you are sick or anxious or overwhelmed by bad health news?  Does your doctor make less well-reasoned decisions about the 10th patient she sees before lunch?  How about the surgeon during his second operation of the day?  How about the radiologist reading the last mammogram in a daily batch of 60?

A provocative article by John Tierney in Sunday’s NYTimes Magazine adds a new layer of complexity to the body of knowledge collecting around decision-making processes.  Considerable news reporting has focused on how cognitive biases influence our judgment and how many of us experience the abundance of choices available to us as a burden rather than a privilege.  This article adds to that understanding: Our decision-making abilities appear to be powerfully affected by the demands of repeated decision making as they interact with depleted blood glucose levels. That fatigue mounts over a day of making decisions and as blood glucose levels fall between meals. In response, we tend to either make increasingly impulsive decisions without considering the consequences or to make no decisions at all. Tierney describes a study analyzing 1,100 parole decisions by judges over the course of a year:  “Prisoners who appeared early in the morning received parole about 70 percent of the time, while those who appeared late in the day were paroled less than 10 percent of the time.”

The effects reported in the article were Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

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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