January 4th, 2012 by RyanDuBosar in News
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A rural hospital on the verge of closing because of problems retaining its rotating door of physicians offered two months of leave for missionary work to keep a more stable roster. It worked, according to a profile written by the Associated Press.
All employees at Ashland Health Center in Kansas, from maintenance staff to the doctors, get two months off to do missionary work in other countries or other volunteering duties for the community. The move has attracted socially minded physicians and their families, many of whom had backgrounds in missionary work already and wanted an environment to keep doing it. The recruitment was developed with support of the Via Christi medical residency program in Wichita, which is sponsored in turn by the University of Kansas School of Medicine.
It’s not the only effort underway in Kansas. Read more »
*This blog post was originally published at ACP Hospitalist*
January 3rd, 2012 by AmyGivlerMD in Health Tips
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When I was in medical school on my dermatology rotation, we joked that all skin treatments boil down to three decrees: If it’s wet, dry it. If it’s dry, wet it. And if in doubt, use steroids.
Some other time I’ll discuss the “drying” of skin, or the use of steroids (which are not, by the way, the kind of steroids taken illegally by athletes!) Today I’ll cover how to keep the skin “wet” – and some principles of moisturizing.
Skin is our first line of defense against disease. Bacteria, viruses, parasites – dangers lurk everywhere. But our epidermis (the outer layer of our skin) blocks them almost always. When people have inflamed skin, the epidermis becomes disrupted and infectious particles can enter their body.
The key to keeping the epidermis intact is keeping it moist. Now, I’m talking about moisture just below the surface of the skin (within the epidermis), so the outside surface doesn’t feel wet. There are molecules within the epidermis that Read more »
*This blog post was originally published at Making Sense of Medicine*
January 3rd, 2012 by DrWes in Opinion, True Stories
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The call never should have been made.
It broke every proscribed rule.
After all, I was not on call. Thanks to the wonders of computer technology, it was very clear that I was being covered by my colleague. And yet, despite this, it came.
“Dr. Fisher, I’m so sorry for calling you at home, but I received a call from Ms. X, the wife of your patient Mr. Y. who said she really needed to speak to you about her husband… she seemed quite concerned and insisted I call you…. I told her I’d see if I could reach you at home… I’m so sorry, but it sounded urgent… I have her number, could I connect you?” Read more »
*This blog post was originally published at Dr. Wes*
January 3rd, 2012 by Lucy Hornstein, M.D. in Opinion
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Why is it easier to talk about quality of life with patients who are dying? Why don’t we factor these considerations into the decision-making for patients with conditions that aren’t fatal?
The presence of a terminal illness serves to focus everyone’s attentions. Widespread cancer metastases? Concerns about tight blood glucose control fade away. End-stage liver disease? Blood pressure control doesn’t matter so much any more. Bony pain from prostate cancer? Narcotic and sleeping pill addiction doesn’t even occur to anyone. I find it far more problematic to deal with patients with debilitating but non-fatal conditions when treatment options are perceived as limited because of co-existing diseases that produce so-called contraindications to certain medications.
I have a patient in his mid-70s with severe pain from osteoarthritis. Several fractures and a couple of unsuccessful joint replacement surgeries haven’t helped matters. Several years ago he found that a little drug called Vioxx worked extremely well for him, reducing his pain considerably and allowing him to do pretty much watever he wanted. As we all know, however, that drug was pulled from the market because of an unacceptable increased risk of heart attacks and other untoward cardiovascular events. Interestingly, Read more »
*This blog post was originally published at Musings of a Dinosaur*
January 3rd, 2012 by Nicholas Genes, M.D., Ph.D. in Opinion
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I’ve been using my iPad in the ED, with my white coat’s sewn-in iPad-sized pocket, for some time now — mostly for patient and resident education, and to look up dosages or rashes. Hitting up my Evernote database or Dropbox documents is also useful. Occasionally I’ll use my iPhone, for its LED light (when the otoscope can’t reach to where I need to see) or rarely, its camera (in compliance with my hospital and department photo policy, naturally).
Our ED’s EHR isn’t quite accessible enough via iPad for me to quickly check results or place orders at the bedside — right now it’s just too cumbersome. But there’s been progress — enough so that I start to wonder about the flip side: instead of reviewing iOS medical apps and pining for an optimized EHR experience on the iPad, what if there are features of the iPad that could limit the utility of medical apps?
Well, there are some product design issues, like impact resistance and bacterial colonization, that have been discussed. But the operating system, iOS 5, has some quirks, too. Some have received a lot of attention. Some are maddening in their capriciousness. Read more »
*This blog post was originally published at Blogborygmi*
