September 11th, 2011 by RyanDuBosar in Research
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Nearly three-quarters of survey respondents said they look up information online in front of a patient sometimes or often, and another 11% said they do when absolutely needed. Only 13% deliberately avoid it.
ACP Internist polled its readers in relation to its story on computers in medicine, in which it focused on whether doctors should look up information in front of a patient. From this, 362 readers responded in August that: Read more »
*This blog post was originally published at ACP Internist*
September 8th, 2011 by Edwin Leap, M.D. in Opinion
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I think a lot about the slow, certain dissolution of medicine as we know it. Mental health issues crowd emergency departments, as few mental health clinics are available. Psychiatrists are in short supply. Drug abuse overwhelms the medical system, with either patients seeking pills or patients families hoping to get them off of pills.
Persons with little interest in their own health continue to smoke and drink, use Meth and eat poorly. Disability claims are skyrocketing as younger and younger individuals confabulate their misery in hopes of attaining a check, paid for by someone else.
The poor, with genuine medical problems, have increasing difficulty finding care as jobs, and insurance, fade away. Politicians, eager to be re-elected, eager to be loved, promise Read more »
*This blog post was originally published at edwinleap.com*
August 28th, 2011 by RyanDuBosar in Better Health Network
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Four out of five doctors agree that they don’t need scans to make the right diagnosis.
It’s an old-fashioned concept frequently discussed among ACP members, but the history and physical combined with basic tests is way more important to diagnosis than ordering scans and advanced tests. A recent research letter in the Archives of Internal Medicine makes the case.
In the letter, Israeli researchers described a prospective study of 442 consecutive patients admitted from the emergency department in 53 days.
A senior resident examined all patients within 24 hours of admission (mean=14), including a history, physical, and review of ancillary test findings done at the emergency department, such as blood and urine tests, electrocardiography, and chest radiography. The resident also reviewed additional tests such as Read more »
*This blog post was originally published at ACP Hospitalist*
August 11th, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
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The American College of Graduate Medical Education has enacted further restrictions on resident work hours. No more than 80 hours per week of work for resident physicians, averaged over one month. And no more than 16 hours of continuous work for first year residents (24 after that), which includes patient care, academic lectures, etc.
Whenever they do this sort of thing, everyone seems excited that it will make everyone safer. After all, residents won’t be working as much, so they’ll be more rested and make much better decisions. It’s all ‘win-win,’ as physicians in training and patients alike are safer.
I guess. The problem of course is that after training, work hours aren’t restricted. There is no set limit on the amount of work a physician can be expected to do, especially in small solo practices, or practices in busy community hospitals.
I understand the imperative to let them rest. I understand that fatigue leads to mistakes. I get it! But does the ACGME get it? Read more »
*This blog post was originally published at edwinleap.com*
July 27th, 2011 by Elaine Schattner, M.D. in News, Opinion
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Recently the Times ran a leading story on a new med school admission process, with multiple, mini-interviews, like speed dating. The idea is to assess applicants’ social, communication and ethical thinking (?) skills:
…It is called the multiple mini interview, or M.M.I., and its use is spreading. At least eight medical schools in the United States — including those at Stanford, the University of California, Los Angeles, and the University of Cincinnati — and 13 in Canada are using it.
At Virginia Tech Carilion, 26 candidates showed up on a Saturday in March and stood with their backs to the doors of 26 small rooms. When a bell sounded, the applicants spun around and read a sheet of paper taped to the door that described an ethical conundrum. Two minutes later, the bell sounded again and the applicants charged into the small rooms and found an interviewer waiting. A chorus of cheerful greetings rang out, and the doors shut. The candidates had eight minutes to discuss that room’s situation. Then they moved to the next room, the next surprise conundrum…
This sounds great, at first glance. Read more »
*This blog post was originally published at Medical Lessons*
