Archives for July 21, 2008

MedBlogs Grand Rounds 4:44 The 200th Edition!

I’m Honored to be the first Sixth Time Host, but more importantly to be the host of the 200th Edition of MedBlogs Grand RoundsDr. Nick Genes deserves all the credit for starting (and maintaining) this wandering collection of links to the best of the MedBlogosphere (thanks, Nick!).

There were more than 40 submissions this week, and here they are in the order they were received, (with my ER Doc attention span review in parenthesis at the end of the link):

The Happy Hospitalist submits an excellent diagnostic sign of malingering, the Sleeping Husband Sign (must read for acute care docs and nurses).

Highlight Health says people lie about their fruits and vegetable intake (no!) in  Did You Eat Your Fruits and Vegetables Today? (I’d have the same reporting bias, unless coffee and beer are considered grains).

Vitum Medicinus describes how his medical school tries to convince students to become family doctors…and how they really end up
doing just the opposite in The failed mandate of our family practise course (surprise: medical students didn’t get into med school by being dumb or easily influenced).

Wait Time blogs about the upside of efficient time management: having time to spend with patients in Finding Time (this says a lot about his compassion, and makes the point that being efficient doesn’t mean heartless; it’s the opposite).

Dr. Val interviewed reporter (and Texan) Bob Schieffer about his cancer in A Survivor’s Story (Dr. Val is a good interviewer, and has some amazing access).

Amanzimtoti write about visiting Americans from an NGO (ugly Americans) in Third world aid (Bad behavior should be punished, by pointing it out).

Other Things Amanzi (yes, the last two are related) relates an arresting story from the ICU: captive (that’s some determination).

Diabetes Mine interviews an inspiring diabetes educator: The Diabetes Educator We All Should See (nice interview by one of the medblog worlds’ brightest lights).

Colorado Health Insurance Insider covers a push by ACOG and the AMA to label home births as unsafe: Shame On You ACOG and AMA (seconded here).

Dr. Tienchin Ho also has something to say about this ACOG statement in HBACM Statement on Home Births (also thinks the ACOG got it wrong; new blog is focused on good birth information, home and hospital).

Dr. Shock begins a series on the Patient-Doctor relationship with Empathy (quite good).

Insure Blog has nothing nice to say about shoddy reporting in Disturbing Carrier News (read it all to see the happy ending).

FreshMD introduces me to a new term in Tonsilloliths a.k.a. throat poo (another great term for the ED).

Suture for a Living reviews , well, Major and Lethal Complications of Liposuction (Fortunately, I don’t need it this week…).

Odysseys of George finds and cures a rare cause of upper GI bleeding: A Rare Bleeder or is it really? (with pictures!).

How to Cope with Pain wonders Are You Mindful 24/7? (something I wonder about in the ED chronic pain patients…)

In Sickness and In Health finds she can vacation in My Own Private Idaho (I like happy endings in stories).

Health Business Blog on The Medicare monster (which Will eat us alive, as no politician is going to push Means Testing until we’re past broke).

Canadian Medicine reports in the over-regulation isn’t just a US thing with It’s a wrap for dangerous donairs after health warning — and good riddance, I say (I don’t want one).

HealthLines’ Health Connects wishes Nelson Mandela a Happy 90th Birthday (do I want to be 90?  No, I want to be this age twice around…).

Unique but Not Alone write about a conversation with her daughter: But we’re not like that Mom… (I’m impressed she can write about this talk at all…).

HealthLine’s The Fitness Fixer wants to set the record straight about Three Common Swimming and SCUBA Myths in the News Again (nothing about waiting after eating before swimming…).

Covert Rationing submits Fun With Randomized Trials, and Breasts (the comma is unnecessary, as is any comment from me).

Medical Jokes alerts us to an acupuncture technique guaranteed to stop, well, any problem: Roman Acupuncture (not much repeat business).

Neuroanthropology introduces us to Bench and couch: genetics and psychiatry (I read it, and I think I understand, but I hope it’s not on the test).

Notes of an Anesthesioboist on the self-describing Why The O.R. is NOT a “Meat Market,” Grey’s Anatomy Notwithstanding; and, Looking a Patient in the Mouth: What’s That About? (good intro to one aspect of the pre-anesthesia eval, and some really interesting pictures…).

Doc Gurley on steroids for atypical infections in Body’s Too Eager… (good post, but her prestigious award under her picture got my attention).

Anatomy on the Beach has some Thoughts of a Generalist (and I think the blogger is correct).

HealthLine’s Teen Health 411 (lotta HealthLine bloggers out there) says correctly Youth Need More Exercise (though I think statins in the teens is too much).

HealthLine’s Medicine for the Outdoors (the esteemed Dr. Paul Aurebach) alerts us to MRSA Madness and Tomato Update (good info on MRSA; I disagree on wound cultures, and our food supply is laughably vulnerable.  Where are those Rajneeshees, anyway?).

The Back Pain Blog answers the age-old question Sciatica and the Epidural: Are You a Candidate? (good info for those who are considering it).

Life. Not Terribly Ordinary went to dinner, and it didn’t go well.  Awkward much? (very).

Rural Doctoring submitted several (she’s on a tear these days) but this one fit: What is Transparency? (only Flea knows for sure…).

The Cockroach Catcher advises how to get out of trouble: Try Illness First, then Children (it didn’t work; read it anyway).

Clinical Cases has found a way to use Google Trends for Research (with videos, even).

Allergy Notes has found a potential screening tool for asthma: Portable Exhaled Nitric Oxide Meter as a Screening Tool for Asthma (at 52% sensitive and $4200 it’s going to be a tough sell).

Dr. Penna has an intro to Molecular Orthopaedics – What is it (orthopedists are getting smarter…).

HealthLine’s Tech Medicine has a  Review of Epocrates on the iPhone (does anyone own Palm stock anymore?  If so, why?).

HealthLine’s Fruit of the Womb has a comment string highlighting that Amniocentesis is Not Without Risk (good and bad outcomes within).

and Last but not Least,

Emergiblog thinks MedBloggers should have their own conferences, and outlines her thoughts  in A League of Our Own? (I’m in).

If you’ve read this far either I accidentally missed your submission (sorry, attach it in the comments) or you’re in desperate need of an actual life.

Or, you’re reading to see this: Next Weeks’ edition will be found at Edwin Leaps’.

Thanks for coming!

Update: Kim from Emergiblog has found an illustration of my grand round skills:

funny pictures

Heh.  Thanks, Kim!


The MedGadget guys have the courage of their blogging convictions, and have started a new site focused on medical politics:

MedPolitics is a blogging platform and a social network maintained for and by US physicians. Our primary focus is on the politics of healthcare. If you are an American doctor who feels strongly about the challenges our profession is facing, consider to join our community.


Yes, if you’re a physician, and are interested in blogging there, join up!


I’m on the fence about joining, and not because of Dr. Ostrovsky or any of the MedGadget folks, it’s just that I have so little to fill this blog I don’t know if I should dilute what little output I have now.  Time will tell.


Best of luck to MedPolitics!

Medicare Saver

I got an email last week asking me to have a look at, and maybe blog about, the following:

Hi, I am part of the team of local independent medical and technology
professionals that have just created an online Medicare Part D tool to help
even the playing field for seniors and independent physicians and
pharmacists.  Having created this baby we realized we have no idea how to
let people know about it.  So I was wondering if you might write a review
of us in your blog.The concept is simple.  The client simply enters their
location and drugs and we search for lower cost medications and list the
plans available to them with detailed pricing and restriction information.
It is free, confidential, and takes about 5-10 minutes.  The site is

I’m all for things that help people make better decisions, so I’ve had a somewhat quick look around, and I generally like it (my gripe’s at the end).

It’s a very professionally done site, navigation couldn’t be easier.  It starts by asking your Zip code, and explains that “Medicare calculates your coverage by your location”, which drives the rest of the decisions inherent in the program.

When you get to step two, entering the medications, there’s the inherent problem with medication name entering: multiple non-sensical names for medications.  For instance, type in ‘metoprolol’ and the following appears:


I’m a doctor and I had to study the choices to make the choice I wanted.  This isn’t a slam on the Medicare saver people, it’s just one example of how this isn’t super-simple (and I don’t know how to make it more simple).

Where I think this site is very useful is the graphical presentation of Part D plans in your area, recommending the least expensive at the top:


And, I can compare all 56 plans, should I want to.  It’ll then ask some questions to check your eligibility, and spit out an answer (I’m not eligible).

This is a good site for a lot of Medicare-covered people, and I’d recommend it as a starting place for discussions about medications with their doctors, and to shop Part D plans.

The MedicareSaver people want to tailor this product for physician practices and pharmacies (they need income too), so if you’re one of those, have a look.

My gripe: the professionally done, entirely understandable talking head at the top of every page cannot be shut off.  It’s not optional.  I really hate audio that plays automatically when I open any web page, and think if you’re going to do that you have to put in a mechanism to turn it off.  I emailed the site builder and mentioned this, and was told this is a deliberate decision based on some Seniors having relatively diminished sight.  Okay, but it still needs a way to shut it off.

That’s not enough to have me pan the whole product: it’s good, and I’d recommend it for the Medicare eligible.

(I have no financial or other entanglement in this product, I just think it’d be useful).

WhiteCoat Rants has a birthday

Woo Hoo – I Made It! « WhiteCoat Rants