Member

I recommend these. They’re terrific. Get ‘em while they last.

XY Scrubs, a premier provider of men’s scrubs and medical work apparel is having a 50% Off Sale on all Men’s Scrubs. Providing eco-friendly, anti- microbial, durable and fashion forward scrubs for Men, XY Scrubs (XYScrubs.com) has established itself as the New Leader in Men’s Scrubs, introducing three unique lines of medical apparel.
…
To take advantage of the 50% off sale enter the promotional code “HALFOFFSCRUBS” at the checkout window.

via Save 50% at XYScrubs.com.

I have some (Full disclosure, I got some gifted to me by their designer/owner, and I like ‘em. A lot.)

This isn’t the part that made me roll my eyes:

FORT WORTH — A juror was arrested Tuesday morning as she attempted to enter a courthouse with a loaded handgun and after deputies saw the weapon during a screening, a Tarrant County official said.The incident occurred about 8:30 a.m. at the south entrance to the Tim Curry Criminal Justice Center.
…

This was:

Authorities did not release any information on why she had a loaded 32-caliber handgun at the courthouse.
via Crime Time: Juror arrested for trying to enter Fort Worth courthouse with loaded gun.

A .32? Why?

My brother (the Aerospace Genius) is branching out into race engineering consulting.

Think Fast Engineering is his effort, and if you want to go fast, you’re looking for the right fellow. (If you are rolling your eyes in a ‘what’s he done’ mode, have a look at his ‘about page‘, and then pick your jaw up from your chest).

I’m biased, but aside from my Dad he’s the best engineering brain I know. (Dad’s not for hire).

“Speed is money: how fast do you want to go?”

Okay, it’s got an Fword in it, so if you’re prone to the vapors, skip this one.

The rest of you, laugh, and enjoy.

What he said…

Query: Why hadn’t they notified me upon arrival — or even before arrival when I was aboard the plane? They knew what plane I was on. Why have me go through a long fruitless wait at the airport? If you have such a powerful information system, why not use it to the benefit of your patrons? Especially your so-called “priority” customers.Indeed, why can’t all customers gain access to the baggage information system on their computers or iPhones? Sounds like that would be better service and possibly save money for those companies, too.

via Not Running a Hospital: Carrying a lot of baggage.

Dear Readers,

It has been my pleasure over the last 4 years to blog on HCC-related topics and exchange ideas with many of you. I have learned a ton from everyone.

This is my last post and I anticipate retiring the blog by the end of the month.

via HCC Blog » hccblog.

Another good blogger taps out. Too bad.

Awful.

FORT WORTH — When Dr. Benjamin Siu saw patients at Cook Children’s Medical Center, visits began and ended with hugs, handshakes and prayers.

In between, “Dr. Siu would patiently go through what he had seen in the tests. He wouldn’t bombard you with mumbo jumbo,” said David Faulk, whose son Jonathan, now 3, was born with three chambers in his heart.

Dr. Siu, a pediatric cardiologist, died Jan. 3 after falling off his bicycle as he rode near South Z. Boaz Park in far southwest Fort Worth. He was 51.

via Benjamin Siu, doctor at Cook Children’s Medical Center, dies at 51 | Obituaries | News f….

So: the 2011 winner of the worst quackery award is: battlefield acupuncture. This bizarre practice, invented just 10 years ago, offers a trifecta of ills:

It offers no medical benefit and carries a real risk of harm for some patients.

The U.S. government is wasting tens of millions of dollars per year on it, and plans to increase its spending next year.

The patients are wounded combat veterans who have no choice about where to get treatment.

In battlefield acupuncture, the “doctor” (no competent doctor would do this) sticks needles into the patient’s ear to relieve pain.

via The Worst Quackery of 2011: Battlefield Acupuncture – Forbes.

Incredible. And infuriating.

(Found on Twitter, but I cannot recall who tweeted it).

Wow. Short, and sweet, and painful.

…peddling the same tired phenomenon of magical thinking regarding the diagnostic miracle of highly sensitive troponins…

via Emergency Medicine Literature of Note: Yet Another Highly Sensitive Troponin – In JAMA.

Nice! Go and read.

via @nickgenes on that Twitter thing…

This article and its graph (from the NEJM), and its interesting, informative but probably useless graph, was referenced today on twitter, via the Washington Post’s Wonkblog,

Recently, the Centers for Medicaid and Medicare Services announced a scheduled cut in Medicare physician fees of 27.4% for 2012. This cut stems from the sustainable growth rate (SGR) formula used by the physician-payment system. …
To illustrate the level of inequity in this system, we broke down the national spending for Medicare physician services by state and by specialty and determined which states and specialties have contributed most to the SGR deficit between 2002, when the program was last balanced, and 2009. Although SGR spending targets are set on a national level, we computed state targets by applying the SGR’s national target growth rate to each state’s per capita expenditure, using 2002 as the base year. Our analysis is an approximation, because, unlike the SGR, we do not adjust for differential fee changes. …

We compared the state targets for the years 2003 to 2009 to actual state expenditures and added the annual difference between these figures to get a cumulative difference between the state’s spending and the SGR target. This cumulative difference was then divided by the 2002 per capita expenditure to determine the percentage growth since 2002.

via The Sources of the SGR “Hole” — NEJM.

Here are the graphs, and my attempts at explanation, and the questions I have:  Read the rest of this entry »

Pretty neat.

Zdogg and Dr. Harry have the Christmas spirit. Sorta.

There comes a time…when we heed a certain call—when the world must come together as one.

This is NOT one of those times.

But it is the Holidays, so we should probably take a moment to think of those less fortunate than ourselves. People who go hungry while others feast. People without a single shred of hope remaining. I’m talking about healthcare workers taking call during the Holidays.

via Feed The Wards (Do They Know It’s Christmas Time?).

Follow the link and enjoy their latest video. The chorus is very good. They aren’t Bad Lip Reading quality with their chorus, but not bad…

(Yeah, jealousy, I wish I had this kind of creativity. Or any, really.)

I got a nice email form someone who stumbled across this Humble Blog, and had the following questions; my replies follow. Those who have something constructive to add, please do so in the comments.

1. I’m most interested in EM. Given that I have no prior military service/experience, am I basically going to have to do a GMO tour to get this specialty?

Well, it depends on a lot of factors. Your branch of service is probably the biggest determinant (AF is best, Navy is historically worst at going from Internship straight to residency without a GMO tour), but there are several reasons you might not want to go straight to residency.

Honestly, residency is easy compared with being a GMO, at least the first year of a GMO tour. I finished a Basic Surgery Internship, and went to the fleet as a Battalion Surgeon (honorary doc title). I could spit out the Ddx of hypersplenism but had no idea how to treat musculoskeletal back pain, an ankle sprain, or PFPS. I’ll get into the rest of this later.

2. Did you do a GMO tour? If so, how was it?

Yes, GMO for 4 years. Fortunately for me it was between conflicts. To plagarize some guy, it was the best of times, it was the worst of times. Seriously, if I could have my GMO job 1/2 time and my real job 1/2 time I’d be a very happy person, and a happy doc.

3. What made you ultimately decide to stay in military post-active duty or leave for private practice?

I wasn’t a career type, and I knew I wanted to work in the real world. At the time new EM grads were going to boats, and while they’d be very useful there were there a shooting war, it would be a punishment tour otherwise.

4. What kind of leadership opportunities did you have in military medicine that you feel would have been impossible/unlikely in civilian medicine?

I got to lead, really lead, some excellent Navy Corpsmen, I got to advocate for some Marines and Sailors who needed it, and I got to go places nobody gets to these days. (2 trips to Iwo Jima, try booking that on Kayak).

5. Would you have decided to still do HPSP if the scholarship amount was significantly smaller? (ie, <50% what it is).

It was that then, I did it because I wanted to serve and it served by desires and interests. In general, if you’re considering HPSP just to pay the bills you won’t be a happy camper, and you’re signing on the line for a lot of years.

6. Is it possible to find out how many GMOs the Navy needs? (Currently, there are rumors that the Navy is going to change the GMO program).

No idea. But, don’t consider GMO time punishment, or time lost, it’s just something different, and I still think of (parts of it) fondly. The bonus of being a GMO and re-applying to a military residency? Time in Service is weighted on your app. So, if you want to be a brain surgeon but were bottom of your class, after a few GMO tours you’d most likely be in (YMMV).

Best of luck with your decision, and please let me know how it goes!

Aah, the French:

The idea of putting maggots into open flesh may sound repulsive, but such a therapy might be a quick way to clean wounds, a new study from France suggests.

via Maggots Clean Wounds Faster Than Surgeons | Wound Healing | LiveScience.

I kid. I think this is a good idea, and it’s natures’ way of saying ‘cleanup on aisle three’. Patients not infrequently will be brought to the ED with awful, non-healing wounds infested with maggots.

We typically kill them off, more because a) the staff is completely grossed out and b) if you’re living at home and have maggots in your wounds, let’s just say your personal hygiene is deeply suspect. Rank, in fact. Needs a decon level bad.

However, there is a legitimate role for biological wound cleaning; I have a WWII surgical book with a chapter in it on growing your own sterile maggots. It’s not an ER thing, but it’s yet another tool in the armamentarium of bad wounds.

You. Don’t. Say.

Thanks to a $374,000 taxpayer-funded grant, we now know that inhaling lemon and lavender scents doesn’t do a lot for our ability to heal a wound. With $666,000 in federal research money, scientists examined whether distant prayer could heal AIDS. It could not.

The National Center for Complementary and Alternative Medicine, or NCCAM, also helped pay scientists to study whether squirting brewed coffee into someone’s intestines can help treat pancreatic cancer (a $406,000 grant) and whether massage makes people with advanced cancer feel better ($1.25 million). The coffee enemas did not help. The massage did.

…

“Some of these treatments were just distinctly made up out of people’s imaginations,” said Dr. Wallace Sampson, clinical professor emeritus of medicine at Stanford University. “We don’t take public money and invest it in projects that are just made up out of people’s imaginations.”

via Studying alternative medicine with federal dollars – latimes.com.

For those who are curious about homeopathy: