October 30th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Tips, Opinion, Research, True Stories
Tags: Biological Aging, Dr. Lucy Hornstein, Getting Older, Good Sleep Habits, Healthy Aging, Medical Residency, Medical Residents, Medical School, Musings of a Dinosaur, puberty, Signs of Aging, Teen Health, Young Adults
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I heard a 23-year-old woman complain: “I must be getting old when 11:00 at night is late.” It got me thinking.
It turns out that the explanation for why teens are natural night owls has recently been elucidated. They can’t help it — they just don’t get tired until way later in the evening. Then, of course, their bodies want to stay asleep well into the next morning in order to feel sufficiently rested. Since most of them are stuck with the artificial structure of school hours, they’re screwed — and condemned to suffer constant fatigue from cumulative sleep deprivation. Old news.
Then I started wondering about the back end of this phenomenon. Even though our American “youth culture” attributes great coolness to late-night happenings, since this pubertal sleep shift is biological, there must come a point at which their pineal glands go back to releasing melatonin at a more reasonable hour. Does 10 years sound about right? I remember not being nearly as enamored of the “all-nighter” by the time medical school rolled around, as opposed to college, where staying up all night was a regular occurrence. Certainly by residency (ages 26 to 30), it was a killer. Read more »
*This blog post was originally published at Musings of a Dinosaur*
October 30th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Opinion
Tags: 33 Charts, Doctors and Social Media, Dr. Bryan Vartabedian, Social Media In Medicine
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Recently I was speaking to some physicians about social media. As we discussed the evolution of public social platforms and physician-specific networks the question came up: “How many social networks can a doctor have?” In other words, if a doctor dedicates time to Facebook and Twitter, will he or she then also spend time on Sermo, iMedExchange, or Doximity? This is an important question if you’re in the business of attracting doctors to a specific network.
As part of the attention crash, we’re facing the reality of human bandwith. We can only socialize in so many places. I always tell physicians starting out to pick their social spaces carefully. You can only dedicate so much time to social. For me, my attention is spent here on 33 charts and on Twitter. I’ve been tempted to get into podcasting, video and other media, but time is a limited commodity. Read more »
*This blog post was originally published at 33 Charts*
October 28th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, Opinion
Tags: Company Doctors, Doctor Referrals, Dr. John Mandrola, General Medicine, Healthcare reform, Major Hospital Networks, Medical Specialists, Physician Consolidation, Physician Referral, Private Medical Practice, Profit-Driven Healthcare
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As a specialist, one of the saddest truisms about practicing medicine in the private world has always been how little one’s clinical skills determines referrals. Unfortunately, as our present healthcare climate pushes “providers” to consolidate along the lines of major hospital networks this injustice will only worsen.
A decade or so ago when I started private practice it was obvious that referrals came to me because of my association with an established group. This association was essential, as one could have been the next Michael Jordan of electrophysiology, but referrals would still have gone along historic lines, to the favored group. It would have taken a Herculean effort, over years, to encroach upon such long-established referral patterns, etched over the bonds of rituals like Wednesday afternoon golf matches and dinner clubs.
Thus, few specialists start independently. You join an established group, do good work, form relationships and eventually, your quality becomes known. As it should be: Do good work and doctors will trust you with their patients. But yet, even the highest caliber specialists may fall prey to the easily accessible, affable (but unknown and untested) “new guy.” For enhancing referrals, availability and affability trump [actual] skills at least 90 percent of the time. Read more »
*This blog post was originally published at Dr John M*
October 28th, 2010 by DrRob in Better Health Network, Opinion, True Stories
Tags: Being a Primary Care Doctor, Big Picture Benefit of Primary Care, Caring for the Whole Family, Dr. Rob Lamberts, Family Doctor, Family Medicine, General Medicine, Internal Medicine, Life's Lessons, Long-Term Relationship, Musings of a Distractible Mind, Patient-Doctor Relationship, PCP, Personal Relationships, Physician Value, Primary Care Physician
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Her eyes were bloodshot. She responded to my casual greeting of “How are you?” with a sigh. “How am I? I’m alive, I can tell you that much for sure.” She went on to describe a situation with her adult son who’s in a bad marriage and has struggled with addiction. She sighed again: “I feel weak. I don’t know if I can deal with this one. I’ve had so many hard things in my life already. When will it stop?”
“Many hard things” — yes, I agree with that assessment. She’s been my patient for more than a decade, and I’ve had a front row seat to her life. Her husband died a few years ago (while in his 40′s) of a longstanding chronic disease. Her daughter also has this disease, and has been slowly declining over time. I’ve watched her bear that burden, and have actually shared some in that load, being the doctor for the whole family.
I’ve also taken care of her parents, who had their own psychological problems. They were difficult patients for me to manage, and they had died long enough ago that I had forgotten that difficult chapter of her life. I’ve helped her with her emotional struggle from all of this. It was hard, but she hung on as best as she could. I know. I was there when it was happening.
To me, this is the biggest benefit of primary care. Yes, it’s nice to have a doctor who knows what’s going on with all of your other doctors. It’s good to have a doctor you are comfortable talking with about anything. It’s good to have someone without a financial stake in doing surgery, performing procedures, or ordering tests. But the unique benefit a long-term relationship with a primary care physician (PCP) is the amazing big picture view they have. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
October 28th, 2010 by Felasfa Wodajo, M.D. in Better Health Network, Health Tips, News, Opinion, Research
Tags: Bedbugs, Dermatology, Dr. Felasfa Wodajo, Health Tips for Travelers, iMedicalApps, Infectious Disease, Infestation, Insect Bites, International Travel, iPhone App, Logical Images, New York, Organism-Borne Skin Diseases, Parasite Contamination, Parasitic Insects, Public Health, Skin Lesions, Skinsight, UK Guardian
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Bedbugs are back. For many people, this is only slightly curious, since their understanding of bedbugs stops at the second half of the bedtime admonition: “Sleep tight, don’t let the bedbugs bite.” But, for those others who have experienced a home bedbug infestation, it is a modern nightmare.
The tiny critters can hide in any furniture crevice or fabric fold and come out only in the wee hours of the night in search of their favorite food: human blood. Their bites cause intense itching which can last days to weeks and they can remain dormant and hide for months.
The cause of the recent resurgence is unknown. It does not seem to be paying any great regard to socioeconomic status nor to cleanliness. In metropolitan New York, it seems to have caused a minor panic, with families having to temporarily move out of their homes for toxic fumigation and thousands of dollars of clothes and artifacts being disposed of for fear of contamination. For a chilling recounting, check out this article in the UK Guardian: “How bedbugs invaded New York.”
Since so many skin afflictions are related to insect bites, the folks at Logical Images have just released Bedbugs ‘n Things, an iPhone app that describes the most common perpetrators of insect bites, identification by the appearance of the bite marks and recommended treatment. For bedbugs in particular, it goes further and gives a thorough set of guidelines for concerned traveler so they avoid bringing home uninvited travelers inside their luggage or clothes. Read more »
*This blog post was originally published at iMedicalApps*
