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Impeding progress

July 20, 2011 by

Dr. Edwin Leap (he of the excellently written and quite frequently updated EdwinLeap.com has started a second blog, to which he seeks submissions.

I think from the title of his new effort,  Impeding progress, you can get a feel for what he’s after.

Interesting idea, and while it’ll give all of a place to vent our spleens, I find blogs that are all negative rants to be cringeworthy after a while. I’m sure Dr. Leap (whom I met at ACEP this year, and he didn’t know me from Adam), will do a good editorial job.

So, go hither and submit your case of impeding progress!


Filed Under: Announcements, MedBloggers

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

May 31, 2011 by

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.


Filed Under: Medical

My first medical checklist

May 11, 2011 by

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.

 

 


Filed Under: Amusements, Emergency, Medical

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

May 3, 2011 by

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.


Filed Under: Medical

Patient emits potentially harmful gas; hazmat called to Ann Arbor hospital | Detroit Free Press | freep.com

May 1, 2011 by

Absent other information, the referred to ‘rodent poison’ is probably a superwarfarin. It’s like regular people-coumadin, but superconcentrated. It kills rodentia by causing them to bleed to death.

Which makes the ‘gas effect’ seem really odd, but possibly explainable.

A patient who apparently ingested rodent poison and is emitting potentially harmful gasses has created a hazardous material situation at St. Joseph Mercy Hospital in Ann Arbor.

The man is isolated in his room in the medical intensive care unit on the hospital’s sixth floor, 5301 McAuley at East Huron River Drive, hospital spokeswoman Lauren Jones said this afternoon.

via Patient emits potentially harmful gas; hazmat called to Ann Arbor hospital | Detroit Free Press | freep.com.

Two thoughts: 1) I sincerely hope this patient recovers, and 2) if this is just upper GI bleed smell someones’ going to have rotten egg smell on their face.

I looked up superwarfarins, found a couple of interesting case reports, but none that talk about abnormal gases.

(For the uninitiated, the smell of digested blood is amazingly awful. It’ll make experienced, hard ED staff retch). I can understand why the smell would set off alarms, except that it’s not that uncommon, so it shouldn’t be a surprise.

It’ll be interesting to see what come of this.

Lighting matches in the hospital is a nono, by the way.


Filed Under: Amusements, Medical

Movin’ Meat: Medical Malpractice Self-Insurance — Is it right for your group?

April 15, 2011 by

ShadowFax is doing all EP’s a favor by explaining one of the more frustrating, and opaque areas of Emergency Medicine, group insurance. His group self-insures (apparently), and he knows way way too much about it:

One of the more painful elements of running a group practice is the ritual abasement before the god-like executives at the insurance company annual malpractice insurance re-bid. It’s kind of like a visit to the dentist: guaranteed to be uncomfortable and with the potential for a very unhappy surprise. Also, it leaves your face numb and drooling. The only thing that matches it in pain is writing the check every quarter, year after year, and then looking back at your actual, you know, losses, and seeing that you have paid for insurance way way more than you ever lost in liability claims. It’s got the all visceral satisfaction of lighting a pile of money on fire.

via Movin’ Meat: Medical Malpractice Self-Insurance — Is it right for your group?.

He’s got another, just as informative follow-on post, and the promise of at least one more. Frankly, it’s a primer for groups who are considering this (and AFIK, mine isn’t).


Filed Under: Emergency, MedBloggers

My anti-doc-muzzling rant was linked

April 7, 2011 by

This one.

By Dr. Helen (without a comment) and by Don Surber with a very nice comment. It’s astounding to me how commenters everywhere are on board with suppression of speech. And sad.

Nice to be noticed, though.


Filed Under: MedBloggers

Officials investigate first Tarrant County measles cases in 17 years | Mom2MomDFW.com

April 5, 2011 by

Health officials are investigating two confirmed cases of measles, the first in Tarrant County in 17 years.

via Officials investigate first Tarrant County measles cases in 17 years | Mom2MomDFW.com.

Goody. I was tested years ago and was a vaccine responder, but still.


Filed Under: Medical

Yahoo! News: US News breaks out the best hospitals by 1 Mil Metro areas

March 29, 2011 by

To take a bite out of their guesswork, U.S. News tapped its latest annual evaluation of the nation’s nearly 5,000 hospitals and, for the first time ever, ranked the best ones in the 52 U.S. metropolitan areas with 1 million or more residents. Today’s release of those rankings represents the largest expansion of U.S. News Best Hospitals since the annual rankings began more than two decades ago.

via Yahoo!.

Interesting.

Update: Hmm, that article over-spoke. Here’s more what’s happening, from the WSJ: they’re just getting less support, not running away.

 


Filed Under: Medical

Google Drops Health Project – GLG News

March 29, 2011 by

Summary
Google Health being dropped is a setback for Electronic Medical Records EMRS in three ways: 1 Widespread adoption through cloud access; 2 Time-to-market and payback; and 3 Cross-industry collaboration.

via Google Drops Health Project – GLG News.

My summary: Google couldn’t find any way to make money doing this, so they bowed out.

I think that’s a completely rational decision for them to make. Unfortunate for the world, but that’s business.


Filed Under: Medical

Aggravated DocSurg: Waiting & watching for Jon

March 26, 2011 by

We were invincible. Packed into Jon’s pale yellow Olds Cutlass, the car I’d always wanted, careening down the road between our high school and its “sister” all-girls school, we’d sing along with whatever was playing on the oversized speakers garishly mounted in the back. More exactly, we’d usually be screaming along with the music, which was loud enough to rouse more than a few nearby drivers from their afternoon daydreams.

We were on our way to……take a typing class.

via Aggravated DocSurg: Waiting & watching for Jon..

It goes sideways after that.

Excellent post.


Filed Under: MedBloggers

Dr. Wes: The Wren

March 19, 2011 by

Dr. Wes: The Wren.

A beautifully done blog post. Recommended.


Filed Under: MedBloggers

A laryngectomy shakes this physician to the core

March 16, 2011 by

As an infectious diseases physician with a special interest in head and neck infections, I had extensive experience in otolaryngological illnesses. However, when I was exposed to new, different, and challenging experiences as a neck cancer patient, I had to deal with these as a patient — not as a physician. I endured the consequences of radiation, repeated surgeries, and prolonged hospitalizations. I confronted medical errors in my care, discrimination following loss of my vocal cords, and the hardships of regaining my ability to speak.

via A laryngectomy shakes this physician to the core.

I could not be that brave.

Definitely worth the read.


Filed Under: Medical

Why I don’t blog much anymore, and why I won’t stop

March 15, 2011 by

I don’t, and it’s not because I don’t appreciate the eleven of you. I do, it’s just that life, and blogging, evolve.

Here are my thoughts on why I don’t blog much anymore:

Technology changes. I Twitter more now than I blog. (@gruntdoc if you’re interested). What I twitter is occasionally snarky and completely useless and nonmemorable, so it’s not blogging, it’s just (sorta)-social media in action. Facebook is where people keep track of each other, and I’m engaging there, somewhat. I still prefer blogs.

My role in my Emergency Medicine group has changed. I’m now one of three ‘officers’ (I’m the Secretary, and no I don’t file or take dictation), but with a little more responsibility comes the awareness that people higher up than me are interested in what I think, and vice-versa. I’d hate for anyone to believe my blog is representative of my thinking (it’s not, the blog is better). Low expectations are better than high, in some circles.

I’ve said it. Frankly I’ve written 20 blog posts that I get halfway through and realize “I’ve said this before”, and that’s that. I’ll only rant about the same thing (excluding parasites) about three times, then it’s Done. Repetition isn’t fun to read on blogs, and I’ve spared you. Welcome. (Many bloggers have had this realization and had the decency to quit. Color me indecent).

I’m established. Yeah: stale, but present. There’s one continuous medblog I know of older than mine, and with that comes a sense of being, of not having to write to get attention. To be fair, stale isn’t what I aim for, but it’s what you get when you don’t push, and I’m not pushing. No argument. Also, not an excuse.

Parasites. There are ever-changing ways to screw docs, they’ll find them, and I’m less and less interested in handing them a blog post they can use against me. And, as I hate them, not worth the effort to rail at them. Doing so diminishes me, and certainly doesn’t elevate them. So, heck with that.

Commenting on the work of others is probably my best input/output option. Yeah, it’s sometimes lazy, but I think sometimes i have an interesting take on the blog/news of the moment. (YMMV).

A ton of my blog-peers, and blog-children, have packed it in. Nobody’s claimed blog-grandchild, and I understand that. It’s the blog version of an old-folks home sometimes, with the whipper-snappers causing problems and getting on the porch. No offense, but I haven’t added a blog to the blog-roll in probably a year. I don’t think blogging is dead, but it’s entirely possible it’s passed me by. Time will tell.

Shifting hobbies. I like projectile-oriented things, spend a lot of time (and the same dollars) on this hobby, and fearit’s not something people on this blog really dig. I don’t want to go all-shooting, but it’d be hard to stop if I started. So, restraint. For now.

Snootiness. Yes, me. I feel I’m setting a disapproving example in not blogging when others blog. About politics,  especially. Political hackery turns the seemingly most-eloquent, genius med blogger into a raving idiot, and not in a good way (either way). The disconnect between politics and the gentle practice of medicine is vast, and I choose to lead by Not Playing. True, I’ve lead in a direction nobody is interested in following, but I feel that it’s still worth the lack of effort. Someday my genius will be recognized. I hope.

Aging. As I become more mature I’m letting things go I didn’t before. The realization that some things are temporary, and those that aren’t don’t usually matter have made me (a little) more tolerant of folderol and foolishness. And get off my lawn.

Why I don’t plan to stop:

I’m a blogger. Yeah, not an auspicious beginning, but an actual description of an organism. (Or, to be fair in describing a blogger, an onansim, but I digress). That likes to blog.

I’m too lazy to quit. I’ve goofed on this before, but really, why quit (more than) now?  The world will miss me when I’m gone (I mutter this to myself continuously).

Blind squirrels, etc. Nuts are my especitalty…

I like all eleven of you.

Thanks for coming around now and again. I promise you…nothing, but when the Spirit moves, I shall keep blogging.

 

 


Filed Under: MedBloggers

Texas budget crunch could delay M.D. program in Fort Worth | Texas Legislature | News fr…

March 4, 2011 by

AUSTIN — A proposal to add an M.D. program to the medical school in Fort Worth could be delayed because of state budget woes, lawmakers and local officials said Thursday.The possible setback for the M.D. school — which would be at the University of North Texas Health Science Center at Fort Worth — was just part of the grim news that confronted scores of Tarrant County officials as they spread out in the state Capitol to lobby for local priorities.

via Texas budget crunch could delay M.D. program in Fort Worth | Texas Legislature | News fr….

Interesting.


Filed Under: Medical
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