October 5th, 2011 by Lucy Hornstein, M.D. in Opinion
Tags: Board Certification, Differences, Family Practice, General Practice, Internal Medicine, Internship, Medical, Primary Care, Residency, Training
3 Comments »
I get mail, this from a healthy 20-something reader who’s just moved to a new city:
What’s the difference between doctors listed as Family Practice, Internal Medicine, and General Practice? Also, what are some things I should consider (that I might not already be considering) when finding a primary care physician?
That’s a bit of a loaded question, not because of any bias of mine (perish the thought!) but because each of those terms is used in different ways, by different people, at different times, for different purposes. So here’s the rundown on each of them in turn.
Family Practice
What it’s supposed to mean: Designates a physician who has completed a three-year postgraduate training program in Family Medicine, trained to provide primary care to patients of all ages, presenting with conditions of any organ system, including care of acute conditions and ongoing management of chronic diseases.
What doctors hope people think it means: Read more »
*This blog post was originally published at Musings of a Dinosaur*
October 5th, 2011 by Felasfa Wodajo, M.D. in Opinion, Research
Tags: Apple, Commentary, Communication, Featured, Intraoperative Images, iPad, iPhone, Journal of Surgical Radiology, Measurement, Mobile, Mobile Health, O.R., Operating Room, Sensors, Size, Small, Surgery, Surgery Videoconferencing, Visualization, Wireless Networking
1 Comment »
As we discussed in the first of this two part series, mobile devices are already entering the world of the surgeon. Currently, it is mostly downloadable apps that promise to help surgeons with the informational portions of their tasks, such as tracking the cases they have done, e.g. Surgichart or helping in the consent process, e.g. Surgery Risk
While apps that are dedicated to the technical aspects of surgery, such as the excellent AO Surgery Reference, are becoming available, in the future we will see the iPad (or its brethren) actually in the operating room. Why ? Because the iPad has many characteristics that make it a great an advanced surgical instrument.
First is its small size. Every modern operating room has stacks of electronic equipment hanging from the ceiling or in large cabinets for patient monitoring and controlling in-field devices. Since the iPad already supports a bevy of standard wireless communication protocols, many of these large boxes’ functions could likely be off-loaded to an iPad with clever engineering. One immediate advantage would be that Read more »
*This blog post was originally published at iMedicalApps*
October 4th, 2011 by MotherJonesRN in Opinion
Tags: Advanced Degree, American Red Cross, Atlanta, Chautauqua School of Nursing, Clara Barton, Emergiblog, Equals, HealthLeadersMedia.com, Intelligence, Kim McAllister, Kim Sharkey, Leadership Role, Nursing, Physicians, Profession, Respect, Saint Joseph’s Hospital
1 Comment »
Here is Clara Barton, posing with a new class of graduate nurses who received their nursing education through a correspondence course offered by the Chautauqua School of Nursing. Did you know that some of Clara Barton’s contemporaries did not view her as a legitimate nursing leader because she supported alternative ways of getting a nursing education? It’s kind of ironic that many nursing leaders back then didn’t view the founder of the American Red Cross as an equal. Some things never change.
It’s an old discussion. Are nurses with an advanced degree better nurses? Do they make better leaders and does getting a degree elevate the profession? My blog mother, Kim McAllister, from Emergiblog brought my attention to an article that appears at HealthLeadersMedia.com. The article contains Read more »
*This blog post was originally published at Nurse Ratched's Place*
October 3rd, 2011 by DrWes in Health Policy, Opinion
Tags: Approved, Bleeding, Dabigatran, denied medications, Diabetes Hypertension, Government Regulation, Health Care Reform, non-rheumatic atrial fibrillation, non-valvular atrial flutter, Patients, Pradaxa, Responsibility, Rules, Stroke Risk, Warfarin
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I had a patient with non-valvular atrial flutter denied dabigatran (Pradaxa®) by their insurer recently. The patient had diabetes, hypertension and has had a heck of a time maintaining therapeutic blood thinning levels (prothrombin times).
But those are the rules, you see. Only patients with non-rheumatic atrial fibrillation can get dabigatran, I was told. Dabigatran was never approved for atrial flutter, only atrial fibrillation. Never mind the stroke risk in non-rheumatic atrial flutter, like atrial fibrillation, has been found to be significant.
For my patient, dabigatran would have been the perfect solution.
But increasingly I’m finding the patient is not mine, they’re Read more »
*This blog post was originally published at Dr. Wes*
October 2nd, 2011 by John Mandrola, M.D. in Opinion
Tags: AF, AF Ablation, Angioplasty, Atrial Fibrillation, Cardiology, Dangerous, Downsides, Evidence, Experience, History, Ineffective Treatment, Interventional Cardiology, Interventional Radiology, JAMA, Jerome Groopman, Journal of the American Medical Association, Multaq, Palliative Care, Pamela Hartzband, Prolonged Life, Proof, Struggles
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You have probably read that experience makes for better doctors.
And of course this would be true–in the obvious ways, like with the hand-eye coordination required to do complex procedures, or more importantly, with the judgment of when to do them.
There’s no news here: everyone knows you want a doctor that’s been out of training awhile, but not so long that they have become weary, close-minded or physically diminished. Just the right amount of experience please.
But there’s also potential downsides and struggles that come with experience. Tonight I would like to dwell on three ways in which experience is causing me angst.
But first, as background…
It was the very esteemed physician-turned-authors, Dr. Groopman and his wife, Dr. Hartzland, who wrote this thought-provoking WSJ essay–on how hidden influences may sway our medical decisions–that got me thinking about how I have evolved as a doctor. They were writing from the perspective of the patient. But in the exam room, there are two parties: patient and doctor.
# 1) The sobering view that experience brings: Read more »
*This blog post was originally published at Dr John M*
