Learning from the detectives

The best detectives obsess, not willing to give up on finding the answer. They keep searching until the answer becomes crystal clear.

The danger of admission diagnoses (ht @medicalaxioms)

If we hope to decrease diagnostic errors, we must emphasize not labeling patients with a diagnosis until we have sufficient certainty.

Health care IT and the airline industry

We clearly should look to the airlines and how they use technology for airplanes.  To not do so puts our patients at risk.

Why do we still use oral furosemide?

Recently we had another patient taking 80 mg of Lasix twice daily – and he had gained 50 pounds. IV furosemide worked beautifully.

What is community acquired pneumonia?

So I accuse the system that was trying to improve quality as actually causing diagnostic errors and inappropriate treatments.

We should do a better job teaching “red flags”

Over the years, I have written about the short head and long tail. You can use the search function to find several posts since then.

Antibiotic resistance – should we blame primary care or ICU physicians?

Most organisms already have developed resistance to penicillin, amoxicillin and first generation cephalosporins.

Is Internal Medicine MOC necessary?

I truly believe that we are well represented on the ABIM board by thoughtful, ethical physicians, many of whom I know.

Interpreting the new sore throat article

I hope we can find a company (or more than one) who would develop a point-of-care test for Fusobacterium necrophorum.

An observation on the MOC debates

I have both publicly and privately criticized the former MOC process. Along with my colleagues we urged major changes in the process.