The ER is the portal of entry to our hospitals now, for better and for worse. On the plus side, this means that most patients being admitted to general medical and surgical services have a workup at least started and are triaged appropriately to their destination. A good ER evaluation should answer the following questions: 1. What’s the nature of the illness? Are we dealing with the heart, the brain, or an abdominal organ? ...

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The organizations that rate hospitals and doctors have proliferated as the internet has become mainstream over the past 5 years. I'm sure you have seen some of these: U.S. World & News Report, Consumer Reports Health, Health Grades, Leapfrog, Hospital Compare, Americas Best Doctors and 100 Best Hospitals. My local magazine lists the "top doctors" along with full page paid ads and promos that are very compelling. The questions is, do ...

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Originally published in MedPage Today by John Gever, MedPage Today Senior Editor Four out of five surgeons agree: Laparoscopic procedures cause substantial discomfort and pain for the surgeons who perform them. More than 80% of surgeons completing an online questionnaire reported pain or stiffness in the hands, neck, back, or legs after performing minimally invasive surgeries, according to Adrian Park, MD, of the ...

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The cell-phone is a wonderful device. Even I, somewhat Luddite about certain technologies, find it delightfully useful for things like calling my wife when I lose the grocery list, calling my wife for directions and calling my wife to remind me of what I was supposed to be doing. I’m not really a fan of texting, though my wife and oldest son seem to communicate that way quite effectively. It’s ...

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According to a recent editorial from Emergency Medicine News, emergency residency programs are doing a poor job preparing their emergency residents for the real world. The authors note that a typical, large urban academic emergency department comprise less than 5 percent of U.S. ERs, and that "residency programs train physicians in some of the most inefficient EDs in the land. Relative value units of emergency medicine work per hour in ...

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New regulations to reduce wait times for medical care in California are due to take effect next year. Under the proposal, primary care doctors employed by HMOs are required to see patients within 10 days of the appointment request, and specialists must see patients within 15 days. Telephone calls must be returned within 30 minutes and patients needing urgent care have to be seen within 48 hours. But will these mandates actually ...

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The New York Times recently featured a disturbing expose of serious medical errors associated with the newest forms of high tech radiation treatment, entitled, Radiation Offers New Cures, and Ways to Do Harm. The piece is an example of excellent medical journalism, compelling stories of two individuals who sustained truly horrifying injuries as the result of treatment errors framed a detailed investigation of similar errors that have occurred in New ...

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Marleine Bastien is the founder and executive director of Fanm Ayisyen Nan Miyami--Haitian Women of Miami--www.fanm.org, which advocates for the rights of Haitian women. She is also a congressional candidate for U.S. House District 17, representing Little Haiti and other neighborhoods in Miami. Erin N. Marcus spoke with Bastien on Jan. 22 about the Haiti earthquake. What has FANM been doing since the earthquake? As soon as we heard about it, ...

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More graduating doctors are making family and personal life a priority, and opting for part-time work. But when primary care doctors are needed more than ever, is that contributing to the shortage? That's a question that Dr. Gwenn asks over at Better Health. In pediatrics specifically, more "are now opting for part time work right out of the gate, just after training or during, in their 30s. And, that more men ...

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Early in my training as a glider pilot my instructor showed me an excellent but simple analogy for ensuring my safe performance as a pilot. I have always remembered this lesson, which he called the ‘accident slope’, and have tried to apply it to my method of practicing medicine, as well as the other ‘dangerous’ activities for which I have an affinity. “Accidents and mistakes are seldom the result of one ...

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