What I love about being an anesthesiologist

Posted on 20. Oct, 2014 by in Physician, Surgery

I wear a lot of hats in my job.  Though I’m a physician who specializes in the practice of anesthesiology, I don’t spend all day every day at the head of an operating room table. Many days I spend in an administrative leadership role or conducting research studies.  These functions support the best interests of […]

Continue Reading →

The long, tragic odyssey of a HMO patient  

Posted on 20. Oct, 2014 by in heart, Physician

Every so often you have a patient in your practice that you sort of know, but really don’t. You’ve seen the name somewhere, but your mind draws a blank when asked about him. You may even have a vague idea of what he looks like, but if he were to bump into you on the […]

Continue Reading →

Ebola: Who’s looking out for the nurses?

Posted on 20. Oct, 2014 by in conditions, Hospital, Infectious disease

Being a nurse is a risky job.  Needle-stick injuries, violence, back injuries, and infectious disease are all potential threats.  But until recently, nursing was not usually viewed, like police work, or commercial fishing, as a life-endangering career choice. Those who risk their lives for their work go into it knowing the risks, and receive intensive […]

Continue Reading →

Nancy Snyderman shows indifference for her role as a medical communicator

Posted on 20. Oct, 2014 by in conditions, Infectious disease

I wish Dr. Nancy Snyderman the best of health. I’m happy that she remains free from the deadly Ebola virus, and hopefully it will stay that way. It must have been extremely difficult for her to be under quarantine, especially since she was feeling healthy. It’s simple: When you feel good, you want to be […]

Continue Reading →

Working in an ER in Liberia: A physician shares his story

Posted on 20. Oct, 2014 by in emergency, Infectious disease, Physician

In June 2014, the first patient with Ebola arrived at Liberia’s county hospital, Redemption. As tensions grew around the city of Monrovia, administrators at JFK Hospital began to devise plans for handling patients with suspected Ebola. Officials from the CDC then came and gave us lectures. They discussed prevention of spreading and what our plans […]

Continue Reading →

8 tips to survive the marathon of a physician career

Posted on 20. Oct, 2014 by in Physician, Primary care

Many physicians are discouraged by the state of medical practice in 2014. Maintaining job satisfaction and well-being for the duration of a decades-long medical career can be as daunting as completing an uphill marathon. In addition to keeping up with the explosion of medical knowledge and maintaining certification in your specialty, what concrete practices can […]

Continue Reading →

To medical students and residents: It really does get better

Posted on 20. Oct, 2014 by in Medical school, Physician, Residency

I recently attended my 10-year medical school reunion class party, and I have to admit, I had a great time. From the beginning, my class was special. We had 104 amazing people who were truly inspired to make a difference. Continue reading … Your patients are rating you online: How to respond. Manage your online […]

Continue Reading →

Why doctors are afraid of their patients

Posted on 20. Oct, 2014 by in Physician, Primary care

We all start out as idealistic medical students, downright puppy-like in our devotion to our patients, eagerly bounding to their rescue and spending hours listening to their concerns. Somewhere along the way, we start shutting down, seeing patients as demanding and feeling as if we’re always fighting them off. Continue reading … Your patients are rating […]

Continue Reading →

Delirium in the elderly: pharmacologic management is a last resort

Posted on 20. Oct, 2014 by in hospital medicine, Neurology, Psychiatry

From a paper in American Family Physician via Hospital Medicine Virtual Journal Club:

Treatment of delirium should focus on identifying and managing the causative medical conditions, providing supportive care, preventing complications, and reinforcing…

Continue Reading →

Top stories in health and medicine, October 20, 2014

Posted on 20. Oct, 2014 by in Infectious disease, News

From MedPage Today: Ebola: Politicos Mull Travel Restrictions; Docs Say No. As Ebola continues to dominate the headlines, one hotly debated question is whether the U.S. should ban travelers from the West Africa nations where the disease is raging, as a preventive measure. Ebola: Do the Dogs Have It? Bentley, the dog of Ebola patient Nina […]

Continue Reading →

The pain scale: Rating your pain needs context

Posted on 19. Oct, 2014 by in Pain Management, patient

Pain is one of the few things in life universally common to all races, all ages, virtually all people for the history of time.   Though it is always with us, it is also the most difficult of human feelings to describe or even talk about. Doctors in an attempt to understand the degree to which […]

Continue Reading →

Improve patient behavior with virtual assistants

Posted on 19. Oct, 2014 by in Diabetes, endocrinology, Mobile health, Tech

Few will argue that the overall health of Americans has deteriorated in the past quarter century.  Diabetes or prediabetes afflicts nearly 120 million people. Roughly two of three Americans are either overweight or obese. Pharmaceutical companies focus on drug discovery as a solution.  Thousands of apps for smart phones are being developed to change our […]

Continue Reading →

A retired cardiologist goes back to work. Paperwork greets him.

Posted on 19. Oct, 2014 by in Hospital, Physician

On July 1, 2014, I retired after 35 years in practice. Or at least so it seemed. Before and after retirement, my cardiology group asked if I might be interested in part-time work. At first I said no. Due to my retirement, a physician’s poor health, and one partner’s departure due to chronic complaints of […]

Continue Reading →

Enterovirus 68: Why you shouldn’t panic

Posted on 19. Oct, 2014 by in conditions, Infectious disease, Pediatrics

With all the news about enterovirus 68 sending hundreds of children to hospitals, it’s easy to panic when you hear about a case in your neighborhood — or, even worse, if your child starts coughing. But please, don’t panic. Continue reading … Your patients are rating you online: How to respond. Manage your online reputation: A […]

Continue Reading →

Should we use antipsychotics to treat ADHD?

Posted on 19. Oct, 2014 by in conditions, Pediatrics, Psychiatry

Polypharmacy, or use of multiple psychiatric drugs, for treatment of attention deficit hyperactivity disorder (ADHD) is on the rise. A recent study compared treatment with basic therapy (stimulants plus parent training) with augmented therapy (those two plus risperidone, an atypical antipsychotic). The study concluded that treatment with risperidone was superior. When children show dramatic improvements in behavior on […]

Continue Reading →

The Medical Futurist: Weekly Introduction

Posted on 19. Oct, 2014 by in medicine

Working as a speaker and consultant with medical technology, pharmaceutical and web companies; as well as universities and governments worldwide, my mission as The Medical Futurist is to make sure…

Visit my blog to read the whole article and other…

Continue Reading →

Comparison of anticoagulation strategies for acute VTE

Posted on 19. Oct, 2014 by in cardiovascular, hematology, Pharmacology

There are now multiple strategies available. They were compared in a recent systematic review and meta-analysis:

Objective To summarize and compare the efficacy and safety outcomes associated with 8 anticoagulation options (unfractionated heparin [U…

Continue Reading →

Improve how we learn in medicine

Posted on 19. Oct, 2014 by in Education, Medical school

This New York Times article stimulated thoughts about teaching internal medicine: “Better Ways to Learn“: In the new book, “How We Learn: The Surprising Truth About When, Where, and Why It Happens” (Random House), Benedict Carey, a science reporter for The New York Times, challenges the notion that a high test score equals true learning. […]

Continue Reading →

Ebola Virus Outbreak Goes Viral!

Posted on 19. Oct, 2014 by in General Whistleblowing

While I haven’t devoted significant space on this blog to the news media, it is not because I do not have strong opinions on the current state of journalism.  Indeed, I could write an entire blog on the subject, and many have.News acquisition an…

Continue Reading →

Cocaine related Aortic Dissection

Posted on 18. Oct, 2014 by in cardiovascular, toxicology

From the International Registry of Acute Aortic Dissection:

Methods

Our study analyzed 3584 patients enrolled in the International Registry of Acute Aortic Dissection from 1996 to 2012. We divided the population on the basis of documented cocaine use…

Continue Reading →

The Practical Guide to the Future of Medicine

Posted on 17. Oct, 2014 by in medicine

I wrote a book “The Guide to the Future of Medicine: Technology AND The Human Touch” to prepare everyone for the coming waves of change, to be a guide for the future of medicine that anyone can use….

Visit my blog to read the whole article and o…

Continue Reading →

The cardiometabolic risks attributable to chronic inflammtory diseases

Posted on 17. Oct, 2014 by in cardiovascular

From Circulation:

Background—This study sought to evaluate whether risks of diabetes mellitus and cardiovascular disease are elevated across a range of organ-specific and multisystem chronic inflammatory disorders.

Methods and Results—A matched c…

Continue Reading →

I totally just touched my new book: Collected Journalism, out next week!

Posted on 17. Oct, 2014 by in book, onanism

Excitement. My new book is out next week. It’s a collection of journalism, essays, academic papers, government reports (woo!) and other stuff. It’s called “I think you’ll find it’s a bit more complicated than that”. …

Continue Reading →

Memories… part 3

Posted on 17. Oct, 2014 by in Uncategorized

Dr. Tallahatchie went home. Because he was unable to use stairs for several weeks, and his apartment building didn’t have an elevator, he needed to find a place to stay that was on the first floor.Which, as it turned out, was my apartment.So, 3 of us w…

Continue Reading →

The top 50 science stars of Twitter according to AAAS/Science. What does it mean?

Posted on 16. Oct, 2014 by in Twitter

It’s nice to be on the list of The top 50 science stars of Twitter according to AAAS/Science. However, the list is based on somewhat arbitrary criteria and is meant to provoke discussion rather than to be taken seriously. What is valuable, however, are…

Continue Reading →

New word: "maieutikos"

Posted on 16. Oct, 2014 by in Uncategorized

Among the joys of teaching Lean process improvement with people like the Lean Institute Africa’s Norman Faull are the unexpected language lessons. Today at a Best Care Always workshop in Johannesburg, Norman posted the slide seen above.Maieutikos?I’ll …

Continue Reading →

When Doctors and Nurses Work Together

Posted on 16. Oct, 2014 by in Doctor and Patient, Doctors, Featured, Malpractice, Nursing and Nurses, Pauline Chen, Suits and Litigation (Civil)

A group of doctors and nurses at Yale-New Haven Hospital has been quietly working to change the culture of “defensive medicine” that so many have come to accept as inevitable.

Continue Reading →

Augmented Reality Mirror in Telemedicine

Posted on 16. Oct, 2014 by in Augmented Reality, medicine, technology

A great article was published about how augmented reality mirrors will take telepresence to a new level. They have invented a system that utilizes a camera and a flat panel display that will provide…

Visit my blog to read the whole article and othe…

Continue Reading →

Brand name versus generic statins

Posted on 16. Oct, 2014 by in cardiovascular, endocrinology

Generic statins had a slight edge in this study, likely due to better adherence:

Measurements: Adherence to statin therapy (measured as the proportion of days covered [PDC] up to 1 year) and a composite outcome comprising hospitalization for an acute …

Continue Reading →

Unity Farm Journal – Third Week of October 2014

Posted on 16. Oct, 2014 by in Uncategorized

Apple Season continues.   This weekend we crushed 152 pounds of apples yielding 8 gallons (2.2 gallons per bushel), down a little from our last crush which yielded 2.4 gallons per bushel, likely because Baldwin apples are less juicy than McIntosh….

Continue Reading →