Unity Farm Journal – 4th week of October, 2014

Posted on 23. Oct, 2014 by in Uncategorized

While I was in China at the beginning of the week, Kathy maintained the farm and all its activities.   To prepare for Monday’s night’s frost, she picked all the mushrooms from our Shitake logs.   Subtypes Miss Happiness, Native Harvest, a…

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Dispatch from China

Posted on 22. Oct, 2014 by in Uncategorized

On Monday and Tuesday I met with government, industry, and academic stakeholders  in Qingdao and Shenzhen China to discuss healthcare technology,  patient empowerment, and process improvement in the rapidly expanding Chinese healthcare system…

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InformaticsMD in Podcast by Neil Versel

Posted on 21. Oct, 2014 by in healthcare IT risk, healthcare IT safety, Neil Versel, podcast

Neil Versel is a journalist specializing in health IT, mobile health, patient safety, quality of care and the business of healthcare.  He is a prolific writer of the web site Meaningful HIT News and others (http://www.informationweek.com/author-bi…

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Judy Faulkner and EPIC, Show us your EHR screens

Posted on 21. Oct, 2014 by in Dallas News, Ebola virus, EPIC, healthcare IT risk, Robert Wilonsky, Texas Health Presbyterian Hospital

At “Congressional committee releases timeline detailing how Presbyterian treated Ebola patient Thomas Eric Duncan”, Dallas News, Oct. 17, 2014 there is a link that provides acccess to documents released by the U.S. House of Representatives’ Energy and …

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Multi-dose flu shot has only 25 mcg of mercury – most commercial fish contain 23 mcg of mercury per 8 ounces of fish

Posted on 21. Oct, 2014 by in Vaccines

Multi-dose flu shot has only 25 mcg of mercury – most commercial fish contain 23 mcg of mercury per 8 ounces of fish http://buff.ly/11CTRPwAre multi-dose vials less expensive?Economics are a bit complicated due to wastage with multiple vials:Single ve…

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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 […]

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Grumpy People Get the Details Right — Science of Us

Posted on 20. Oct, 2014 by in Amusements

Think back to the last time you had to navigate a customer-service situation. Perhaps you were trying to make a doctor’s appointment when few convenient times were available, or you may have been speaking with a credit-card rep in an effort to get a onetime waiver on a late payment charge. Maybe you were speaking […]

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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 […]

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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 […]

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How to Pick the Right Bedtime – select a wake up time, count back 7 hours and add 10 minutes to fall asleep

Posted on 20. Oct, 2014 by in sleep

Given the importance of a good night’s sleep, how do you pick the best possible bedtime? WSJ’s Heidi Mitchell and Stanford University’s Dr. Rafael Pelayo discuss with Tanya Rivero.Related:What Makes A Great Bedtime? | Craig Canapari, MD http://bit.ly/1…

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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 […]

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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 […]

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Primecuts: This Week In The Journals

Posted on 20. Oct, 2014 by in PrimeCuts

By Anish Parikh, MD

Peer Reviewed

This week, the Ebola virus outbreak continues to dominate the news both here and abroad. The number of newly-diagnosed patients in West Africa continues to rise, particularly in Guinea, Liberia, and Sierra Leone, while Nigeria and Senegal have gone nearly four weeks without any new cases. International aid workers infected with Ebola continue to be transported out of affected areas back to their home countries, however as a consequence of this, new cases are now starting to arise…

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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 […]

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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 […]

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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 […]

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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…

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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 […]

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Wikipedia and Facebook for Clinical Documentation

Posted on 20. Oct, 2014 by in Uncategorized

Over the past several years I’ve written about the inadequate state of clinical documentation, which is largely unchanged since the days of Osler, (except for a bit more structure introduced by Larry Weed in the 1970s) and was created for billing/leg…

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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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…

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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…

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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. […]

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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…

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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…

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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…

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