These days, there is a lot of talk about expanding scopes of practice for the group of folks who used to be called physician extenders and then midlevel providers and more recently non-physician providers, many of whom are now getting degrees with the title “doctor” incorporated. While it seems to vary, these folks may include nurses, physician assistants (one day to be called physician associates perhaps), pharmacists, and more.   Lots ...

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Brought to you by MedPage Today. 1. More Evidence Fecal Transplant Clears C. Diff. Fecal transplant for Clostridium difficile infection is a safe and effective treatment and can alter patients' fecal microbiota to resemble that of donors over time. 2. CT Lung Screens Catch Most Cancers. The National Lung Screening Trial found that CT scans were highly sensitive in detecting lung cancer in ...

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A radiologist reflects on indeterminate findings Radiologists care about their patients, even though most diagnostic radiologists don't meet and greet their patients the same way direct-care clinicians do. Some people have the erroneous perspective that radiologists and pathologists don’t care about the welfare of their patients. It is possible for us to understand that view if we look at radiologists and pathologists as isolated workers who work in ...

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Female feticide: The ethical issues of ultrasound in India and China The use of ultrasound has had a large impact on health care in resource poor countries. This article details some of the research that has been done overseas to look at the impact on bedside ultrasound by caregivers to deliver more appropriate care for injured and ill patients in Africa, Asia and Mexico. Using an ultrasound to determine how dehydrated a child ...

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Ordering tests just to reassure patients doesnt work Every primary care doctor has been faced with this situation. A patient reports vague symptoms and is very worried that they are a sign of a catastrophic illness. The symptoms aren't even slightly suggestive of the disease the patient is worried about, but the patient's neighbor's brother-in-law was just diagnosed with the same disease, and so the patient is pretty sure that ...

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"What's the most important finding on this chest x-ray?" There he was, standing before 5 ICU residents, each peering at a chest film on displayed on the over-sized computer screen. "Um, the pleural effusion?" whimpered a third-year resident. "No!" barked the attending. The others, standing dumbfounded in front of the computer display, searching for another finding but finding none, stood silently. "Come on, folks!  Look!" And try as they may, no one saw it. "The name, folks, ...

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I’m sure that many of you have read the New York Times post  titled "Job Prospects are Dimming for Radiology Trainees." I don’t know about you, but this article made me feel more than ever that in order to choose the right specialty, you have to predict the future of the field. Don’t choose a field that’s going to be heavily affected ...

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Mrs. Smith (not her real name) fidgeted in her chair in my examination room as I scanned the radiology report she had given me. She had visited the emergency room the previous evening with severe abdominal pain that had eventually been diagnosed as gastritis, or swelling of the stomach lining due to a virus. During her evaluation, the ER physician had ordered a CT scan of her abdomen and pelvis. ...

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I can remember making rounds with a seasoned surgical attending in medical school.  In typical fashion, surgical rounds were a lot like the military.  The “General” (attending physician) at the front, always commanding respect (and often fear) followed by the chief resident, junior residents, interns and finally medical students.  Cases were presented, statuses were updated and plans were formulated.  Then came the barrage of medical fact questions–mostly directed at the ...

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Tell me to what you pay attention and I will tell you who you are. -Jose Ortega y Gasset The senior resident hauled our little band of medical students down to the radiology file room. As he dug through the heavy manila x-ray jacket searching for films, he told us the patient’s story. “This 63-year-old lady was really sick when she came in. Heart attack a couple of years ago. New trouble ...

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