Archives for May 2011

The Radical Notion That Doctors Are People, Too | Psychology Today

Dr. Au is hear from…

Becoming a doctor requires hard work and sacrifice, but a system that expects their doctors to be committed to their jobs to the exclusion of all else is flawed. And maybe there’s quite simply nothing wrong with young doctors at all, rather something wrong with the historical culture of medicine, such that the idea of doctors as human beings can inspire so much debate.

via The Radical Notion That Doctors Are People, Too | Psychology Today.

Good article.

Humanity frees cattle, buffalo from cloven-hoofed plague • The Register

The second disease ever defeated by man.

The OIE was able to declare yesterday that “the 198 countries with rinderpest-susceptible animals had been declared free of the disease”.OIE director general Bernard Vallat said: “Today we witness a historical event as rinderpest is the first animal disease ever to be eradicated by humankind.”

via Humanity frees cattle, buffalo from cloven-hoofed plague • The Register.

The other: smallpox.

This is good news.

Oprah signs off and doctors everywhere rejoice « Dr. Jen Gunter

I’ve never watched Oprah outside The Color Purple, so she didn’t directly affect my life. Apparently it’s good for my BP I didn’t:

But for the purposes of this blog, we will say she is gone. And doctors everywhere are rejoicing. Why? Because Oprah is the Supreme Empress of medical woo, disseminating the greatest combination of medical mumbo jumbo and snake oil the world has ever seen.

via Oprah signs off and doctors everywhere rejoice « Dr. Jen Gunter.

I did get a chuckle out of a twitterer who asked ‘on her last show, does Martin Lawrence step out of his Oprah suit’?


Doctors and dentists tell patients, “all your review are belong to us”

We (especially doctors themselves) like to think docs are smart. While all are very well educated in medicine, it doesn’t mean they’re actually smart at much else. Docs are well know to lose gobs of money in stupid ‘investements’ like Avacado farms and ostrich ranches (and yes, there are those with the chicken ranch problems, as well).

Here’s a dumb thing some docs are adopting I hope goes away quickly, as it’s actually not in the best interest of medicine:

When I walked into the offices of Dr. Ken Cirka, I was looking for cleaner teeth, not material for an Ars Technica story. I needed a new dentist, and Yelp says Dr. Cirka is one of the best in the Philadelphia area. The receptionist handed me a clipboard with forms to fill out. After the usual patient information form, there was a “mutual privacy agreement” that asked me to transfer ownership of any public commentary I might write in the future to Dr. Cirka. Surprised and a little outraged by this, I got into a lengthy discussion with Dr. Cirka’s office manager that ended in me refusing to sign and her showing me the door.

The agreement is based on a template supplied by an organization called Medical Justice, and similar agreements have been popping up in doctors’ offices across the country. And although Medical Justice and Dr. Cirka both claim otherwise, it seems pretty obvious that the agreements are designed to help medical professionals censor their patients’ reviews.

via Doctors and dentists tell patients, “all your review are belong to us”.

Read the article to get a good flavor of the problem, but here’s the moral objuection I think eviscerates their doing this (from the article):


When Ars asked Schultz about medical professionals who ask their patients to sign these agreements, he was scathing. “It’s completely unethical for doctors to force their patients to sign away their rights in order to get medical care,” he said. He pointed out that patients seeking treatment can be particularly vulnerable to coercion. Patients might be in acute pain or facing a life-threatening illness. Such patients are in no position to haggle over the minutia of copyright law.

Do good work, take charge of complaints, and live well.


Navy Fights Mickey Mouse for SEALs Trademark –

Update 5/26/11: that didn’t take long (via the LA Times):

Faced with a public relations firestorm, Walt Disney Co. said it had withdrawn its application to trademark the moniker “SEAL Team 6” for use on games, snow globes and TV shows.

Kerfuffle over, though I’d bet someone at Disney has had a bad week.


Well, it was a pretty mickey mouse move….

SEAL Team 6 isn’t going down without a fight.

The Navy is challenging Disney’s attempt to trademark the name of the elite squad responsible for taking out the world’s most wanted terrorist.

On May 3, just two days after Usama bin Laden was killed in a raid on the Al Qaeda leader’s Pakistan compound, Disney filed trademark applications to use the name “SEAL Team 6” on everything from entertainment, toys, video games, clothing, footwear — even Christmas ornaments and snow globes.

via Navy Fights Mickey Mouse for SEALs Trademark –

I’m thinking even a corporate behemoth like Disney has to see the light at the end of this tunnel. (“Is that a laser designator on my desk?”)

Many congrats to Bob

Bob’s my son, and today most of the family got to witness his swearing into the Texas Bar by the Chief Justice of the Supreme Court (along with about 400 new colleagues). It was a good, brief ceremony, and as we didn’t get to see him graduate from Law School this was our Graduation event for him.

Afterward we had a nice lunch, and I beat the odds by driving home without my mother in law giving me driving tips.

Life is good!

CDC EPR | Social Media | Preparedness 101: Zombie Apocalypse – Blog

This is a very catchy way for the CDC to get more people thinking about emergency preparedness: get ready for the Zombies, and you’ll have most of the other disasters covered.

There are all kinds of emergencies out there that we can prepare for. Take a zombie apocalypse for example. That’s right, I said z-o-m-b-i-e a-p-o-c-a-l-y-p-s-e. You may laugh now, but when it happens you’ll be happy you read this, and hey, maybe you’ll even learn a thing or two about how to prepare for a real emergency.

via CDC EPR | Social Media | Preparedness 101: Zombie Apocalypse – Blog.

And I really like their graphic:

City of Dallas tested on civics: fails overwhelmingly.

If you needed to find an example of government action designed to make citizenry cynical and disillusioned look no further than this story, from WFAA:

DALLAS — Dallas will keep $2,000 found by a teenager in a parking lot last February.

The money will go into the city’s general fund — not back to Plano high school student Ashley Donaldson, who found the cash in an envelope at the Pavillion Shopping Center in North Dallas.

(The video.)

This after being told she’d get it if nobody claimed it. I found this story on Hot Air, who described it as wall-punching material. They were correct.

So, how much is $2,000 to the city of Dallas? (Hint, their 2010-11 budget is $2,795,393,655 (it’s in the 2011 .pdf file) Two Billion with a B.) 2000/2795393655=  7.15×10-7, or, 0.000000715%

So, you can see they need the money. Certainly means more to the City of Dallas than a 15 year old girl.

My first medical checklist

Laugh if you want, this helps my life, at least at work.

For months after starting my current gig, I would sometimes get to work with everything in all my pockets, and sometimes not.

I’d forget my ID, or my pen, or my phone, or my…well, there you go.

Then my OCD started to kick in, and, a Mental Checklist was born.
I now have to get 6 things, and set them on the table or I screw it up every time.

  • ID
  • stethoscope
  • my phone
  • work phone
  • pen
  • sharp stick (I’ve written about this before, but cannot find it. You should search an ER blog for the word ‘knife’ and then wonder why you bothered).

Last week I apparently went against the checklist, and halfway through the shift realized I’d lost my ID. Of course, after about a combined half-hour of fruitless search I gave up, and found it in my bag on the way out. Geez.

Yeah, it sounds stupid. But if it’s stupid and it works, it’s not stupid.



Employment rocks

It’s a bad economy and a poor employment situation, especially for lawyers. It has been for a couple of years, but for my son the drought has broken, at least temporarily. A job! In law! And in Fort Worth.

The job does not pay a ton of money, and since law firms aren’t stupid it’s for a ‘trial period’ (pardon the pun), but it’ll get him some experience, some income, and get him some contacts in their world. So, winning!

Kudos to Bob!

Medical Apps? There’s a Doc for That

When emergency physician Harvey Castro asked a nurse to start a dopamine dose for a hypotensive patient one day, he watched the nurse leave the room, find the book that could guide her to the titratable dose, look in the index and then flip through until she found what she needed. Castro wondered, Isn’t there a more efficient way?

via Medical Apps? There’s a Doc for That.

A fellow DFW doc who’s done well in the Medical App world ( Deep Pocket Series ).

Dr. Castro was nice enough to let me play with some of his apps about a year ago, and while I never found a big use for them (my practice style, no knock on him) they were well done and approachable for me.

Kudos to Dr. Castro!

My Son passed the Texas Bar

I had little doubt as he’d already passed the Florida Bar, but today he got his Texas results.

We’re as proud of him as we can be. Now, about that legal job you have waiting for him…

My Fresno Trip

Short version: went well.

Longer version: I got there yesterday, early enough to spend a couple of hours with a good friend, and completely accidentally ran into two of my residency buddies.

It’s an interesting phenomenon, and this was just like when I bumped into another at ACEP: it’s like talking to someone you last saw two days ago. It was nice to catch up with one, and I had a brief chat with the other (working a shift). I’ve known a lot of people, but it’s these residency colleagues that I have that really comfortable vibe with. I need to see them more than every 9 years. They’re good people.

Then a dinner with the faculty who trained me (and one new faculty who’s very cool), catching up on their families, the changes in the residency, just small talk. I haven’t enjoyed small talk that much in a long time. While it’s a different connection with the staff, we still have three years in common as they did their best to teach me something.

Then a fitful nights’ sleep after the obligatory final fiddling with the slides. An easy drive to the new (to me) beautiful campus for UCSF-Fresno, which is a giant improvement over the old one in the VMC/UMC building I trained in. (After I left they closed it, maybe in my honor, maybe not).

The talk: I talked about charting ER patients (for docs) in EPIC, which I know fairly well, a general overview of Scribes, then how we do things in my ED. I used the new Prezi presenter, and it worked very well, I like it and will use if from now on over Powerpoint. That said, I have to remember to write my talk in a really poor monitor resolution. My EPIC screenshot slides looked perfect on my monitor, but when turned down to something the projector would deal with they were mush. Very dissatisfying. (Not Prezi’s fault, mine). Did I mention I like Prezi?

The audience was roughly 30 people, mostly residents with some staff and some ER nurses to hear what I had to say about Scribes and how we do things. I had an hour and a half to talk, and about 30 minutes worth of slides. Fortunately there were a lot of questions, so I wasn’t left with a lot of time to kill.

When I talk about how we do things (from the doc perspective) in our ER it always gets attention, mostly because we have a system that flows well, is mutually supportive, and it works to the time and flow advantage of the patients and the docs. All of what we do depends on excellent nursing and hospital staff support, so this isn’t a doc only thing… I think there are parts of what we do that would be adaptable to a residency program ED, and some that aren’t.

I gave my unsolicited advice to the upcoming graduates (lease or rent for a year, don’t buy), and my talk ended well. Nobody booed.

Then a nice tour of the ED, a meeting with some honchos about scribes, and it was time to come home. Fun for me, very ego-flattering to be asked to go back to your residency and talk, and I enjoyed it.

Maybe in another 10 years…

SF’s 477 most frequent HUMS high utilizers of medical servicesDoc Gurley

A really really good piece by Doc Gurley. Read it and appreciate how much work goes into just identifying their HUMSers.

The most costly user of publicly financed emergency health services in San Francisco – a “frequent flyer” in emergency room parlance – is 49, Caucasian, schizophrenic, and addicted. He has been listed in at least two concurrent city systems as homeless either continuously or episodically for 16.6 years. He’s a frequent caller of ambulances…

via SF’s 477 most frequent HUMS high utilizers of medical servicesDoc Gurley.

Fresno Trip

I’m off to Fresno tomorrow, to give a chat about EPIC (our EMR), Scribes and how we see patients with all three in my ED. I’m talking to the residency that mistakenly kept me long enough to graduate, and it’ll be interesting to see their new ED (which I was told would be ready for my last residency year, joke’s on me), and the faculty that remains.

I have been given an hour and a half. I can easily talk all day about seeing patients with EPIC, an hour on scribes and hours and hours about our cascading acuity shift system, so it’s been fun writing a talk to hit the major points without going over. I think I’ve hit the right balance, but time will literally tell.

I’m still debating renting a car vs. the hotel shuttle and a couple of taxi rides. I like the freedom of having my own wheels, but as I’m there for right at 27 hours (many of which will be spent sleeping) it seems kind of a waste. Still debating.

Couldn’t be a better time to be flying, right? This week I will not gripe about everyone going through the TSA’s enhanced interrogation.

(I wonder if any of the Fresno EM residents twitter, that would be interesting…)