From the monthly archives:

September 2007

How to stick it to unhelpful consultants

September 30, 2007

An ER doc strikes back.

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Who’s the patient?

September 30, 2007

Getting hooked at WhiteCoat Rants. Worth a chuckle.

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Don’t alter prescriptions

September 30, 2007

Especially if you have Parkinson’s.

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Medgadget vs Sermo

September 30, 2007

Turning up the heat?

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Neurosurgeon: "People think we make millions of dollars, but that’s not true"

September 29, 2007

More on critical physician shortages due in part to rising malpractice rates.

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Pelvic exams in the ER

September 29, 2007

How useful are they really?
For such a useless procedure, there is an unreasonable amount of emphasis placed on its performance by our consultants, probably a vestigial remnant from the olden days when CT scans, ultrasounds, and antibiotics were not as powerful or widely available.

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A typical ER shift

September 29, 2007

You’d be surprised at how little time is spent on actual medical emergencies.

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The 5-hour CT scan

September 29, 2007

A woman was forgotten in a CT scanner. Scary thing is, this wasn’t the first time this happened:
A physician who works at the practice and knew of the incident said it’s not the first time such a thing has happened. “People have been left in the office after hours, when something like that happens [...]

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Leaving your mark

September 28, 2007

Sid Schwab on naming anatomy:
When it takes some effort — maybe a microscope or some really careful dissection — to discover something, it seems reasonable that your name gets attached. Islets of Langerhans. Ampulla of Vater. Sphincter of Oddi. Valves of Heister. Crypts of Morgani (he got “columns,” too.) But where’s the cutoff? I don’t [...]

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Cover your ass, defensive medicine

September 28, 2007

Chris Rangel on how defensive medicine has changed the practice of medicine:
The practice of emergency medicine (among other high risk specialties) has become so regimented and infused with defensive medicine tactics that many ER docs are not even aware of how this has changed the way they think. It seemed as if this ER physician [...]

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Chantix: Pfizer’s golden goose?

September 27, 2007

With the miserable failures of Exubera and torcetrapib, Pfizer is throwing some marketing muscle behind Chantix - an anti-smoking medication that actually works and is quite useful. A look at the recent DTC ad for the product.

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"I order a lot of CT scans"

September 27, 2007

An ER doc confesses:
I shouldn’t let this kind of thing bother me. Why should I care what the techs and nurses think? Let them walk a mile in my shoes. They’re not held accountable if they miss a head bleed or PE or small bowel obstruction or neck fracture. I am.

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A for-profit DO school is about to open

September 27, 2007

Bizarre and could be start of a disturbing trend. What kind of corners will be cut in the name of profit?
Critics say a for-profit school will be beholden to investors and will scrimp on educational mission. Supporters assert that Rocky Vista must meet the same accreditation standards of other osteopathic schools. They also say [...]

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Mmm . . . purple urine

September 27, 2007

What a fascinating cause of this phenomenon:
Purple discoloration can occur in alkaline urine as a result of the degradation of indoxyl sulfate (indican), a metabolite of dietary tryptophan, into indigo (which is blue) and indirubin (which is red) by bacteria such as Providencia stuartii, Klebsiella pneumoniae, P. aeruginosa, Escherichia coli, and enterococcus species.

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The patient-hitting cardiologist

September 27, 2007

He has resigned from the hospital, but gives his side of the story:
He said the patient was “a drug addict coming off of opiates, completely in withdrawal (and was) restrained as he should have been by protocol by five technicians. I was only the sixth person, never hitting anybody.”

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