Tuesday, July 19, 2005

Grand Rounds XLIII (43, 1:43,...OK, just the next one in the series)

Let the hosting of the postings begin -- so many posts, so little time! I'd like to group these into a few broad categories -- Trying to be a "Good" Doctor, Medical Business & Monkey Business, Being a Patient, and Extras....

Trying to be a "Good" Doctor

There are only two sorts of doctors: those who practice with their brains, and those who practice with their tongues. (William Osler)
OK, I admit it, I’m a doctor …. so I’m a bit partial to posts that hit close to home. This post by Red State Moron hits all too close to for surgeons as he tries to make sense out of what can be unfathomable -- surgical complications. "You never remember the times when everything went perfectly. It is supposed to go perfectly.”

A discussion of Alternative Treatments is offered by Corpus Callosum, who notes that "I do not think that compassion is "alternative therapy." It is just part of being human." Compassion is a hard thing to come by when dealing with dementia, as Intueri illustrates. And while compassion is important, my esteemed surgical colleague to the East notes that it is important for patients to know a bit more about the folks who may be operating on them -- Inquiring Minds Want to Know.
Medical education is not completed at the medical school: it is only begun. (William H. Welch)
Intueri also shows us how some interns have more to learn than others; the subject of this story sounds like an intern who will generate a goodly number of humorous posts in the next 12 months. And while Protodoctor Neils at The Haversian Canal will learn much in the next few years, he shows he has a good start to his education with I'm not a doctor, but.....
It is extremely difficult for a physician who puts too much trust in what he reads to form a proper decision from what he sees. (Andrew Boorde)
As Orac points out, it’s important to read each published study with hefty dose of salt, as it is the rare study that provides a definitive answer to a clinical question. This is an excellent post, which should be read by physicians, lay people, and especially journal editors.

The politics of medicine are explored in this excellent post by Dr. Tony, who speaks out about the potential for poorly run peer review. Politics of a different sort are on GruntDoc’s mind, who is a bit peeved at the ACEP and it's political agenda.

Medical Business and Monkey Business
A drug is a substance that when injected into a guinea pig produces a scientific paper. (Anonymous)
Starting off on the business side of medicine is a discussion on the Health Business Blog of an innovative pricing plan for a the new drug BiDil. But is this a truly a “new” drug, or simply an Ethnopharmacological phenomenon? Read the thoughts of a new medblogger, CardioBlog for an interesting perspective.

The forward march of technology in medicine is trumpeted in Sumer’s post regarding the practical application of that informatics in radiology practices. Hospital Impact tells us about robots in hospitals -- COOL! -- and Medical Connectivity lets us know about an innovative wireless technology that may be a simpler solution for many hospitals – even cooler!

From InsureBlog comes a summary of several posts regarding HSAs and HRAs, warts and all. This is a good discussion, and the earlier posts are great background for those wading through insurance coverage changes (my group just switched to an HSA). The Health Care Blog wants us to be alerted to the coming of the Medicare Participating Prescription Drug Plans -- and potential associated scams.

As most of you know, Kevin, M.D. has started a new blog, Straightfromthedoc, and today he is shedding some needed light on the issue of hot flashes and HRT. Not to be outdone, Clinical Cases informs us about a novel effort by physicians at Johns Hopkins -- they're blogging! What a concept! Or is it simply clever marketing?

Being a Patient
The student is to collect and evaluate facts. The facts are locked up in the patient. (Abraham Flexner)
Opinionated Bastard (who somehow got the title to his blog before I could claim it) reminds us that medical care isn't all that easy on some folks. Healthy Concerns weighs in with three posts this week -- you choose your favorite, but I enjoyed her discussion about what it is like to come home to the US after a few years and start searching for insurance. Finally, I found out that Beldar had a recent significant run-in with the medical system (hope he’s on the mend).

From the health care delivery side of things, GruntDoc lets us know that sometimes, you can have too much of a good (nor not so good) thing (a photo that must be seen to believed). Dr. Charles weighs in with a look at a tick and potential Lyme disease. Finally, Greg the neurologist blogger has a few "thoughts for food" as it relates to skin conditions.

On the lighter side, Interested Participant shows us what happens when interesting people participate in what we can euphemistically label “innovative” health care. And, despite what the Viagra/Cialis/Levitra crowd says, there apparently can be such a thing as too much sex, according to this report from Parallel Universes.

Interesting Extras

>> Sneezing Po has a few interesting thoughts about teamwork, and how it relates to medical care delivery.

>> What do Charlie and the Chocolate Factory, James and the Giant Peach, and The Twits have in common with shunts used for hydrocephalus? Read MedGadget for the whole story.

>> Finally, at Far From Perfect, we hear about one man's experience on his last night as a paramedic. Thanks to him for his service there and in his new position as a military medic!

Thanks to everyone who took the time to send a link. Next week's Grand Rounds will be hosted by Pharyngula.
Be happy while y'er leevin, for y'er a long time deid. (Scottish Proverb)