President Obama has stressed the importance of “bending the cost curve” in order to put the brakes on galloping health care expenses that total 2.5 trillion dollars a year and are increasing at 6% a year. The fastest way to do this is shockingly simple: carefully explain to patients the known risks and benefits of procedures. Read more »
Sam Nouv runs a little donut shop about a mile from my house.
When John was in the hospital, that’s where I bought the donuts for the nurses.
After immigrating to the U.S. from Cambodia in 1987, Sam started working at the shop and by 1990 he owned it (Update via Steve in comments: When he was 13, his parents were murdered by the Khmer Rouge. He spent several years in a displacement camp in Vietnam before finally being sent to the States as part of an entire plane load of orphans).
With the exception of a few holidays, Sam is in the store every morning at 3:30 am and works until 6:00 pm.
Seven days a week.
His wife, Lori, works with him, but she wasn’t there on that Wednesday morning in October.
Thank God. Read more »
*This blog post was originally published at Emergiblog*
I thought of not telling this story at all. Recently when it was in the news here it seemed wise to rather bury it altogether. But it is something I experienced and, after all, this blog is about my experiences, so…
Six years in a department gives you enough time to do a few things that can be legendary (like this story). This was one that most at the time thought was one. However, at the time it impacted me on a different level.
The surgery department had a fairly intensive academic session every Tuesday. The highlight was a discussion delivered by one of the registrars on some or other topic. He was required to reference the absolutely newest literature and the standard was very high. It was a big deal. Most guys spent a few months putting their talks together. Read more »
*This blog post was originally published at other things amanzi*
In a recent issue of Wilderness & Environmental Medicine (Volume 20, Number 2, 2009), Anne-Michelle Ruha and Steven Curry have written an article entitled “Recombinant Factor VIIa for Treatment of Gastrointestinal Hemorrhage Following Rattlesnake Envenomation.” This is a “case report,” meaning that this is a description of a particular medical event, rather than a study.
To open the piece, the authors observe that North American rattlesnakes possess venom with properties that can cause severe physiological effects, such as low platelet count and, on occasion. bleeding. In this report, we learn about a 44 year old man who was bitten on the index finger by an unidentified (unknown for this case) species of rattlesnake. The victim developed massive gastrointestinal bleeding that was treated eventually with a product known as recombinant factor VIIa. His initial clinical presentation included an altered level of consciousness, profoundly low blood pressure (shock), sweating, and vomiting of bright red blood. Read more »
This post, Man Dies Of Internal Bleeding After Rattlesnake Bites His Finger, was originally published on Healthine.com by Paul Auerbach, M.D..
There hasn’t been much discussion about serious tort reform in the current healthcare reform debate. That’s probably because most policy experts don’t believe it will make a significant dent in healthcare costs. I happen to believe that tort reform would be a huge boon for healthcare (just ask Ob/Gyns in Texas) and save a lot in defensive medicine practices and unnecessary testing, but even if I’m wrong and it wouldn’t result in cost-savings, there’s another issue at play: access to primary care physicians.
We all agree that we’re in the midst of a major shortage in primary care physicians. Many different solutions have been proposed – everything from “let the nurses do it” to forgiving medical school loans to physicians who choose primary care as a career. However, solving the PCP shortage isn’t just about recruitment, it’s about retention. And with up to a half of PCPs saying that practice conditions are so unbearable they’re planning to quit in the next 2 years – Houston, we have a problem. Read more »
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…
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…
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…
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…
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…
