Posts tagged as:

residency

Learn how to conduct a family meeting by using a structured approach

November 16, 2009

by Alex Smith, MD
On my last day of ward attending, I handed out an EKG that resembled the Dow Jones industrial average over the last 10 years (not pictured). The normal pattern of an EKG was completely disrupted: ST segments were markedly elevated, P waves were hidden, and beats were grouped in odd patterns. My [...]

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Surgeons don’t receive enough training when resident work-hours are capped

November 13, 2009

by Crystal Phend, MedPage Today Senior Staff Writer
Limiting surgical residents’ work hours has compromised both surgical education and patient safety, according to an analysis concluding that an 80-hour work week isn’t enough.
The maximum 80-work week imposed in the U.S. for residents is too little to provide mastery in surgery, Gretchen Purcell Jackson, MD, PhD, [...]

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Is the hospital July phenomenon a myth?

November 10, 2009

“Don’t go to the hospital in July.”
That’s the prevailing public perception, since that’s when new resident-physicians begin their hospital training. And indeed, there have been studies from Australia and England showing a higher rate of death and adverse events during this time.
But what about in the United States?
Recent data isn’t so conclusive. A piece [...]

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How emotional stress affects physician training

October 21, 2009

Much has been made of fatigue increasing the number of medical errors doctors make.
But what about other factors, like emotional stress?
That’s a little-reported issue that Pauline Chen addresses in her recent New York Times column. In residency, some doctors-in-training have to care for small children, among other life issues. As Dr. Chen notes, [...]

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How to reduce the risk of medical errors from patient hand-offs

September 25, 2009

One of the consequences of capping resident work-hours is increasing the frequency of patient hand-offs.
In a recent column in The New York Times, surgeon Pauline Chen cites a somewhat frightening statistic that during a course of a typical 5-day hospitalization, patients “are passed between doctors an average of 15 times.”
And residents sign over patients several [...]

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Do resident work-hour restrictions increase surgical complications?

September 8, 2009

by Chris Emery, Contributing Writer, MedPage Today
Reductions in resident physician work-hours at teaching hospitals in 2003 were associated with an increase in complications related to surgery to repair hip fractures, a new study found.
The rates of pneumonia, hematoma, renal complications, and blood transfusions associated with hip surgery rose disproportionally at teaching hospitals compared to [...]

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How to make industry influence transparent in continuing medical education

August 25, 2009

by Larry Husten, Ph.D.
A recent hearing of the Senate Aging Committee on continuing medical education (CME) should scare anyone who might need to see a doctor in the next few years. But you don’t need to be a Washington policy wonk to discover that there’s a huge problem with CME.
Just walk into the lobby of [...]

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Should patients care how many times a doctor has performed chorionic villus sampling?

July 7, 2009

When it comes to procedures, experience counts.
In a recent op-ed in the WSJ, maternal-fetal medicine fellow Adam Wolfberg talks about the potential complications of chorionic villus sampling (CVS) (via Suture for a Living). Used to assess the risk of Down Syndrome in the fetus, it involves inserting a 3 1/2 inch needle into the [...]

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Do doctors set themselves up for physician burnout?

July 7, 2009

It’s no surprise that doctors are prone to burnout, especially during residency training.
But, according to a study cited by Pauline Chen in a recent New York Times column, it’s part of the doctor-in-training culture. In fact, residents “from seven different specialties and found that they set themselves up for burnout by accepting, even embracing, [...]

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Why would a doctor stop seeing patients?

June 30, 2009

It’s no secret that training a doctor takes a tremendous amount of time and money, both from the physician and the government, who subsidizes a substantial amount of the cost of training.
So, in the midst of a physician shortage, internist Toni Brayer wonders about doctors who simply decide to stop seeing patients.
After talking to a [...]

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ACP: Embracing a culture of cost-effective health care

June 25, 2009

The following is part of a series of original guest columns by the American College of Physicians.
by Steven Weinberger, MD, FACP
In his column in the June 1 issue of The New Yorker, Dr. Atul Gawande used the example of McAllen, Texas, to illustrate the widely disparate spending on health care around the country. This oft [...]

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10 President Obama posts you may have missed

June 20, 2009

With entries dating back to 2004, here are 10 classic blog posts on President Obama:
1. How the primary care doctor shortage threatens Obama’s health reform plan
2. The Obama health care summit, and did the President offer any clues to the upcoming health reform effort?
3. Is Physicians for a National Health Program the biggest threat to [...]

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5 top medical comments, June 14th 2009

June 14, 2009

Here are some of the more interesting comments readers have left recently.
1. Carla Kakutani on how Massachusetts’ health reform won’t relieve ER overcrowding:
Insurance does not equal access (although it’s better than nothing). Nothing changes until every stakeholder recognizes they have to control costs and allow a rebuilding of primary care in the US. That includes [...]

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Poll: Is further reducing resident work hours worth the cost?

June 8, 2009

The Institute of Medicine is recommending “rapid implementation” of its proposed plan to further restrict medical residents’ work hours. The plan includes a 5-hour nap during extended shifts, a strict 16-hour cap on shifts without naps, reduced workload, and more days off.
But at what price?
It seems like common sense that better rested doctors make fewer [...]

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How to get doctors to embrace health care reform

June 2, 2009

Doctors still wield tremendous influence in the health care debate, since they still have the confidence of most patients.
If Congress and the Obama administration can convince doctors to support health care reform, it can be, as the ACP’s Bob Doherty notes, “decisive in determining if the public will be behind the effort, because voters are [...]

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Grading medical students, pass-fail or letter grades?

May 30, 2009

Medical schools have traditionally used letter grades for their students, but to decrease the competitive atmosphere between these prospective doctors, some of gone with a simple pass-fail system.
Does it matter?
A recent study suggests the answer is no. When comparing two groups, one who was graded “A-F” and the other pass-fail, there was no difference [...]

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