August 23rd, 2011 by Michael Kirsch, M.D. in Health Policy, Opinion
Tags: Charges, Customer Service, D.C., Emergency Department, Emergency Medical Care Bills, Explanation of Benefits, Health Insurance, In-network, Injury, Washington
1 Comment »
A few months back, while we were on vacation in Washington, D.C., my 17-year-old son Noah sustained an injury at 1:00 a.m. I was asleep, but this is usually a few hours earlier than he typically retires. In our hotel room’s bathroom, he dropped a glass and then managed to step in the wrong place. A sharp shard sliced through the soft skin between his great and second toes. Blood was spurting wildly and he woke me up with a shout. He was spooked.
We gastroenterologists are experienced at stanching bleeding, although I was uncertain how to do so without some kind of scope in my hand. I reflected on my ACLS training, which is a comprehensive 2 hour course that my partners and I take every 2 years. In between those sessions, I neither think about nor practice any advanced life saving procedures. It doesn’t seem rational that a community gastroenterologist should be schooled in temporary pacemakers, when most of us haven’t interpreted an EKG in decades.
I still remember the fundamentals of life support, the famed A, B, Cs, standing for airway, breathing and circulation. I decided to apply this to the hemorrhage at hand.
Airway: the windpipe was open and functioning
Breathing: the kid was breathing
Circulation: BINGO!
After going through this brief but critical checklist, I now knew where to focus. Read more »
*This blog post was originally published at MD Whistleblower*
August 23rd, 2011 by Berci in Opinion
Tags: Crick, DNA, Double Helix, Iconic Image, Quora, Science, Watson
No Comments »
There is a very interesting thread on Quora. Users want to find the most iconic scientific image ever. It might sound like an easy job but it’s truly not. My vote is for the Watson-Crick DNA double helix photo. What is yours?
*This blog post was originally published at ScienceRoll*
August 23rd, 2011 by Elaine Schattner, M.D. in Opinion, Research
Tags: Academic Medicine, Alternative Medicine, Cancer Treatment, Communication, Disclosure, Dr. Andrew Lowy, Grey's Anatomy, Hipec, Hot Chemotherapy, hyperthermic intraperitoneal chemotherapy, Informed Consent, Medical News, New York Times, USC San Diego
No Comments »
There’s so much weird and exciting cancer news this week, it’s hard to keep up!
Double-kudos to Andrew Pollack on his front-page and careful coverage in the New York Times of the hyperthermic intraperitoneal chemotherapy (Hipec) technique that’s being used at some name-brand health care facilities to treat colon cancer.
First, he spares no detail in the Times describing the seemingly primitive, crude method:
….For hours on a recent morning at the University of California, San Diego, Dr. Andrew Lowy painstakingly performed the therapy on a patient.
After slicing the man’s belly wide open, Read more »
*This blog post was originally published at Medical Lessons*
August 23rd, 2011 by KerriSparling in Opinion
Tags: A1C, Accu-Check One, Agamatrix Meter, Animas, Blood Sugar, Dexcom, Diabetes, Freestyle meter, Glucose Meters, One Touch, PWD
No Comments »
I have several One Touch meters, a Freestyle one, and a Dexcom continuous glucose monitor that I consult on a regular basis. (Not usually at the same time, but I have been doing multiple checks recently. More on that below.) I also have an Agamatrix meter and an Accu-chek one, somewhere in the diabetes cupboard in the bathroom, only without any strips that aren’t expired.
And I have a lot of anxiety when it comes to glucose meters. The variability of these machines makes me crazy in the head, and it caused me a lot of grief when I was pregnant, because my blood sugar goal range at that point was so tight and so specific, and any variability was huge for me. (I shared some samples of wonky results in this post.)
In the last few weeks, I’ve been doing some experimenting with my meters, Read more »
*This blog post was originally published at Six Until Me.*
August 22nd, 2011 by Dinah Miller, M.D. in Opinion
Tags: Doctor's appointment, New Patients, Patient Obligations, Private Practice, Prospective Patients, Psychiatry, Psychology, schedule, Scheduling Conflicts, Shrink, Therapy, Weekly Appointment
No Comments »
I’ve been at it a long time, and one thing (of many things) that I still have not gotten down is scheduling. I seem to have a method to my own madness, but somehow I imagine it’s not how other people do this. I’ve heard other shrinks say, “I’m booked for the next 4 weeks” or say they aren’t taking any new patients. Some people put a “no new patients” message on their answering machine. Wait, so no appointments for 4 weeks? What if a patient calls and needs to be seen very soon? Like this week? If you can’t wait, go to the ER? I thought the point of having a private doc was that you didn’t have to go to the ER unless something couldn’t be handled safely as an outpatient. And if you tell the world that you don’t take new patients, then don’t people stop referring to you? It seems to me that patients will come in and announce, “I’m doing better and want to come less often,” “I’m moving,” “I’m done,” or they will cancel an appointment, not call back, and not be heard from again for weeks or months. Sometimes it all happens on very short notice and life can be very unpredictable.
In my pre-shrink days, I thought that psychiatry worked such that patients came every week (or twice a week, or whatever) and had their own slots. Tuesday at 1, that’s me! So a psychiatrist had every slot full with patients this way, and could be “full,” until a patient finished and stopped coming, and then another soul was let in to the Tuesday at 1 slot. Gosh that would be nice, but it doesn’t seem to work that way. Read more »
*This blog post was originally published at Shrink Rap*
A few months back, while we were on vacation in Washington, D.C., my 17-year-old son Noah sustained an injury at 1:00 a.m. I was asleep, but this is usually a few hours earlier than he typically retires. In our hotel room’s bathroom, he dropped a glass and then managed to step in the wrong place. A sharp shard sliced through the soft skin between his great and second toes. Blood was spurting wildly and he woke me up with a shout. He was spooked.
