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Crowd-Sourcing For Medical Diagnoses

The Times ran an intriguing experiment on its Well blog yesterday: a medical problem-solving contest. The challenge, based on the story of a real girl who lives near Philadelphia, drew 1379 posted comments and closed this morning with publication of the answer.

Dr. Lisa Sanders, who moderated the piece, says today that the first submitted correct response came from a California physician; the second came from a Minnesota woman who is not a physician. Evidently she recognized the condition’s manifestations from her experience working with people who have it.

The public contest – and even the concept of using the word “contest” – to solve a real person’s medical condition interests me a lot. This kind of puzzle is, as far as I know, unprecedented apart from the somewhat removed domains of doctors’ journals and on-line platforms intended for physicians, medical school problem-based learning cases, clinical pathological conferences (CPC’s) and fictional TV shows. Read more »

*This blog post was originally published at Medical Lessons*

The Globe’s Health Champions

Newsweek published an interesting and interactive infographic showing the rankings of countries based on different parameters such as quality of life, education, and health. Regarding the healthcare system, guess which country is in the first place?

Here’s the top 10:

1. Japan
2. Switzerland
3. Sweden
4. Spain
5. Italy
6. Australia
7. Singapore
8. Norway
9. New Zealand
10. The Netherlands

*This blog post was originally published at ScienceRoll*

What Makes A Conversation “Psychotherapy?”

Years ago I had a student who repeatedly asked me how psychotherapy works. “How is it different than a conversation?”

When I think of psychotherapy, I think in terms of the talking itself as being the aspect that helps — and yes, of course it can be used in conjunction with medications. I think of it as being structured — in terms of time and place and frequency — and being all about the patient. And whether or not it’s actually discussed, some of what works is about the relationship — most people don’t get better talking to someone they despise, and the warmth, empathy, feeling listened to and cared for, well, they’re all important. And I also think of it as being a process over time. These are all parts of my definition, however, and they may not be parts of yours. Read more »

*This blog post was originally published at Shrink Rap*

Reflections On Nursing Education

The discussion regarding the entry level for nursing has been ongoing for decades. I have articles written in the 1940s extolling the virtues of the BSN long before the first ADN program opened in 1952.

Every now and then, someone broaches the topic of making the BSN the entry level and BAM! the flames that ensue make the health care reform debate look like Mr. Roger’s Neighborhood.

Why the rancor?

Well, if one states that the BSN should be the entry level for a registered nurse, then it follows there must be a reason why an ADN should not.

That does not sit well with ADN graduates. Read more »

*This blog post was originally published at Emergiblog*

Rural Emergency Medicine: Stigma & Stereotypes


Lee Falls, SC

I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.”  It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest.  The natural beauty is breathtaking.  Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some found nowhere else.   Fish and game abound.  In fact, our wooded hospital grounds support a flock of at least 30 wild turkey.  And last deer season, the only deer I saw were the three does grazing at the end of the ED driveway one night, spotlighted by two of our paramedics.

We have a lot of wonderful things here, things that are gifts of the rural life.  We have good people, the salt of the earth types who care about personal morality and Southern courtesy.  People who bring you a glass of sweet tea when your car breaks down.  We live with a low crime rate, and minimal illicit drug use compared with more populated areas.  It is a good place to raise children.  It’s also a cool place to practice, where a busy summer shift can bring an acute MI, a near drowning (from inner-tubing on Class IV white water while drunk), a pit viper bite, a bull goring and many other pathologies, more or less interesting.

But, as physicians in a rural area, we pay a price.  Because we have to endure a certain stigma.   Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

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…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

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…

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Latest Book Reviews

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…

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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…

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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…

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