Having a blog allows one to “brag” about ones publications. A colleague and I just had a paper published in the American Journal of Medicine - Academic General Internal Medicine: Past, Present, Future.
I would love to hear comments for anyone dedicated enough to read the article.
Retired Doc is on a roll (although I wish he would change his font and spacing - very difficult to read).
More things I did not become an internist to do
is a follow-up to:
‘Why I did not become an internist’
which was stimulated by a letter to the Annals of Internal Medicine 10 years ago:
The [...]
Readers of this blog should know my feelings about this issue. The ACP has stepped up to the plate. U.S. Primary Care Near Collapse, Physicians Warn
Primary care could fall apart in the United States without immediate reforms, the American College of Physicians said on Monday.
“Primary care is on the verge of collapse,” said [...]
Due to too much travelling, too many restaurant dinners, and a variety of other personal defects, I decided a few weeks ago that I needed to lose several pounds. Fortunately, I do lose weight quickly, and have made great progress over the past 3 weeks. My weight loss diet is one that I [...]
Actually Medicare does. Perhaps the incentives are insufficient. Obviously, money is not the only driving force as physicians decide the type and location of their practice. Some physicians will choose underserved areas for personal (perhaps even altruistic) reasons; others will avoid such practice sites regardless of income.
This is not a uniquely US [...]
Several years ago at Grand Rounds (our local version not the blog version), I debated a colleague on the issue of screening and treating h pylori in dyspeptic patients. The debate was spirited and focused on several issues. Key issues involved prevention of gastric cancer and relief of symptoms.
A recent article [...]
Retired doc wrote about this concept recently - American Medical News article on “relationships” leaves retired doc confused.
At its core, relationship-centered care calls on physicians and patients to have longstanding compassion relationships with each other.” So, we or someone is to call on patients to have compassion for the doctor? Our job is to [...]
In Article, Doctors Back Ban on Gifts From Drug Makers
The gifts, drugs and classes that makers of pharmaceuticals and medical devices routinely give doctors undermine medical care, hurt patients and should be banned, a group of influential doctors say in today’s issue of The Journal of the American Medical Association.
Medical schools and teaching hospitals should [...]
Interns’ Hours Shorter, and That’s Good for Patients
This essay, from a new intern, unfortunately reflects the naivete of new interns.
But how much should patients have to suffer, and should they be subjected to increased risks as a result of residents’ long hours? The line in the sand keeps shifting.
“Every patient deserves an awake and alert [...]
A recurring, perhaps annoying, topic for my ranting involves time. We, unlike any other professionals, are not paid according to time, but rather according to the “type” of encounter.
The problem, as I see it, is that those who have designed the encounter types have lumped widely disparate encounters into one or two buckets. [...]
My recent post on science and pseudoscience has sparked a health debate. I only wish that the purveyors of these “alternative” ideas would engage in truly scientific debate.
Medical science has advanced dramatically since my medical graduation (1975). Each year we learn more and improve our treatment and diagnostic options. Some advocates of [...]
Two of my favorite medical bloggers have called out pseudoscience.
More on alternative medicine
and
A verbal spanking from Jacob
Both physicians argue (correctly) that we have an obligation to demand a scientific approach to any propsed treatment. They both reject any theory which has no clear rationale.
They have covered this issue better than I [...]
I have several TV series which I watch religiously (I love my DVR). Of those shows (which I may reveal in future posts), the best is Battlestar Galactica. If you know nothing about this show, please read this overview - ACROSS THE UNIVERSE
I was chatting at dinner the other night with some friends. Two of the men had stopped taking statins recently. The conversation, while clearly anecdotal, has stimulated my thinking.
One quit because of tendon problems. He had Achilles’ tendon pain. Now I have searched for a link between statins and tendon problems, [...]
I found the ruling much more important than a ruling concerning physician assisted suicide. What I find in the ruling is a respect for physician decision making concerning narcotics. Of course, like most rulings, we see what we want to see.
Fraught Issue, but Narrow Ruling in Oregon Suicide Case
The Supreme Court’s ruling was, [...]
Supreme Court Backs Oregon Assisted-Suicide Law
Readers may remember that while I would personally oppose the law, I respected the right of the people to pass such a law. I clearly believe that the Federal Government should not interfere in this matter. The Supreme Court agrees.
The Supreme Court on Tuesday let stand Oregon’s physician-assisted [...]
Most physician readers understand the yearly battle on physician payment. The current obscure convoluted formula has calculated that we should receive a significant pay decrease this year. Each year we play a political game with Congress over payment. We (all physicians) want a change in the reimbursement formula. Congress uses this as [...]
There are no facts, only interpretations. - Nietzsche
Trial and Error
Many of us consider science the most reliable, accountable way of explaining how the world works. We trust it. Should we? John Ioannidis, an epidemiologist, recently concluded that most articles published by biomedical journals are flat-out wrong. The sources of error, he found, are numerous: [...]
On Not Wanting to Know What Hurts You
IT’S sick, the way Americans think about illness.
A disease like diabetes gallops practically out of control, with estimates that 21 million Americans have it and 45 million more could develop it. Yet relatively few people worry about it or alter their behavior to postpone or possibly prevent its [...]
I have blogged on this issue before. Unfortunately, the problem probably gets worse rather than better. Let’s Get Serious About Relieving Chronic Pain
Now the federal government, and especially the Drug Enforcement Administration, is working overtime to make it even harder for doctors to manage serious pain, including that of dying patients trying to [...]
Fears raised over diuretic drugs
Doctors are being urged to monitor people to whom they prescribe diuretics after a study linked the drugs to low sodium and potassium levels.
A review of 32,000 adults found 20% of those on the drugs for high blood pressure and heart conditions had low levels of these key minerals.
Only a third [...]
GruntDoc (host of next week’s Grand Rounds) is an ER physician. Thus, we should not be surprised to see this rant - National Report Card on the State of Emergency Medicine.
The point of this exercise is, as I understand it, to bring public (read: lawmaker) attention to the state of your emergency departments. I [...]
Bacteria Grab a Windpipe and Hold It Hostage
Most physicians have already figured out the diagnosis from the title of the article. We always worry about this diagnosis.
This article is really a thank you note to an excellent physician who made all the right decisions. This rant is my way of thanking the author [...]
Imagine the classic theme by Ennio Morricone.
The Good
The pharmaceutical industry has invested in new drug development, and has major successes. We continue to see new exciting approaches to treatment. Due to the pharmaceutical industry, HIV has become a chronic disease, CHF patients have a better life expectancy, many cancers are cured.
The Bad
Because pharmaceutical [...]
News sources had very little further coverage on Cheney. I do respect his privacy, but as a blogging MD, I must guess. I think I got it right yesterday. Here is an expanded Washington Post article - Cheney Released After Hospital Visit
Both conditions are often treated with nonsteroidal anti-inflammatory drugs, the family [...]
On the road, little time to blog until tomorow - but good news, today is Grand Rounds.
VIce President Dick Cheney Taken to Hospital After Complaining of Shortness of Breath
Vice President Dick Cheney was taken to George Washington Hospital early Monday experiencing shortness of breath, a spokeswoman said.
Lea Anne McBride said that doctors found his EKG unchanged and determined he was retaining fluid because of medication he was taking because of a [...]
Those familar with my teaching know that I get most excited when discussing acid base or electrolyte problems. Thus, this story immediately caught my eye.
FDA Approves Astellas’ VAPRISOL(R) For The Treatment Of Euvolemic Hyponatremia
First arginine vasopressin (AVP) antagonist approved for the management of potentially life-threatening sodium/water imbalance
DEERFIELD, Ill., Dec. 30 /PRNewswire/ — [...]
For those with Archives of Internal Medicine subscriptions - Residency Training in the Modern Era: The Pipe Dream of Less Time to Learn More, Care Better, and Be More Professional
This editorial addresses three observational studies on the changes in work hours requirements that internal medicine programs adopted in 2003. I have blogged often [...]
