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db's Medical Rants

May 16, 2012

The biggest therapeutic advance in the last 10 yrs – #10yrsblog

A faithful reader writes: What drug or therapy released in the last 10 years has had the greatest positive impact? This question stumped me for several days.  I tried to think of a new drug that I use a great deal.  Most new drugs now have important niches.  I considered rifaxamin for hepatic encephalopathy, ceftaroline [...]

May 15, 2012

What performance measures have wraught

A reader sent this to me anonymously: Healthcare-acquired pneumonia has been ruled out based on the following reasons.  The first is that the patient's respiratory status has not worsened over the past month while he has been on treatment.  Secondly, the patient is afebrile.  Thirdly, the patient has normal WBC count of 8.2 and normal [...]

May 15, 2012

How blogging has helped me academically #10yrsblog

A colleague wrote: Has blogging been an interesting side note to your career as an academic professor in medicine or has it been a more integral part of your own professional development? I was already quite successful in my academic career, but I still believe that blogging has enhanced my effectiveness.  So what has blogging [...]

May 14, 2012

No influences allowed on my blog #10yrsblog

I got asked this question: How can pharma companies work collaboratively with health bloggers? What's needed? On this blog it is not happening.  No pharma, no device companies, no requested guest blogs.  No collaborations! In my opinion, one must take blogging seriously or just forget about having the blog mean anything. I have written extensively [...]

May 13, 2012

What explains blogging longevity? #10yrsblog

I started this blog May 19th, 2002.  Explaining longevity is subjective.  Mostly, I like blogging.  I find it fun to put my ideas into words.  Some have asked me how I get so many ideas.  I read other blogs, some journals, the NY Times Health section and I see patients.  Ideas come from all those [...]

May 11, 2012

Day 1 reflections #sgim2012

Yesterday was a long day.  I spent much time mentoring and talking.  Viewed many posters, both research and clinical vignettes.  Had some meetings, both formal and informal. Participated in a tweetup. Went to a nice Presidential reception.  Back to my room I crashed. Meetings are fun and tiring. While going around the posters, several residents [...]

May 10, 2012

Teaching attending poster #SGIM2012 #meded

During my poster perusal, I saw a couple of excellent posters on teaching attendings.  The best attendings go to the bedside and interact with the patient, doing history or physical components as necessary, and making certain that the patient knows the plan for the day.  The attending has residents and students with them. I discussed [...]

May 10, 2012

#SGIM2012 the night before

Standing in line to check into the hotel – the Disney Dophin and Swan – someone asked me how many meetings I had attended.  I answered 30 or 31.  SGIM has had a great influence on my academic career.  Because of SGIM I have friends all over the country. Today I went to the poster [...]

May 9, 2012

Almost 10 years of blogging – what questions do you have?

In 11 days I will celebrate 10 years of medical blogging.  To celebrate this achievement, I invite readers to "interview" me though questions.  This is your chance to ask me anything – about blogging. Thanks in advance for your questions!

May 9, 2012

When did we stop teaching the basics?

Over the past decade the ACGME has focused on the six competencies:   Patient Care Medical Knowledge Practice Based Learning and Improvement (self improvement) Interpersonal and Communication Skills Professionalism (basis for all physician skills) Systems Based Practice (working with the health care system) Now I do understand that these competencies have some underlying validity.  But [...]