Grand Rounds Volume 7 Number 27


I'm honored to be hosting Grand Rounds for the fourth time. This is not the GR theme today, but I did want to mention that it's Doctor's Day tomorrow in the United States. Doctor's Day was first observed on March 30, 1933. Eudora Brown Almond, wife of Dr. Charles Almond, decided to set aside a day to honor physicians.

The red carnation is commonly used as the symbolic flower for National Doctors Day. In 1990, law was passed designating March 30 as "National Doctors Day." Big shout out to all my physician colleagues out there!

These are the best 31 posts that the medical blogosphere has to offer this week. In my editors picks, I wanted to highlight what I thought were the most interesting posts of the week. There is also a short excerpt from each of my picks this week. 

My Pics Of The Week

Anessa, a 2nd year osteopathic medical student, from the d.o.ctor blog writes the post "Mary" in which she learns more than medicine at a recent visit to a nursing home and rehabilitation center. Here's a quote....

I had been assigned to help out with the Bingo game. This was not a job to be taken lightly. Bingo is serious business at that particular nursing home. Some residents had lucky chairs, and if they found someone else mistakenly sitting in their spot, well all hell would break loose. I'm talking outright name-calling, hair-pulling, face-slapping scenes straight out of a Jerry Springer episode. Fortunately, those were rare occurrences. 

Linda Pourmassina, Internal Medicine Physician, from the Pulsus blog writes "Unspoken Gratitude: A Lesson For Me From An Unexpected Source." I can so relate to this story... 

Sometimes appreciation can feel sparse in a field that is built on trying to fix problems. Sometimes a kind word from a patient can lift us up during a challenging day. I have had many patients who have done just that. But on this particular day, this patient’s silence was the most touching and heartfelt expression of gratitude.

Kimberly, a medical student, from the Future Of Family Medicine Blog writes about the "Hazing Of Family Medicine." Does it happen? You bet it does. Read on....

Every one of us who practices family medicine has had to defend our chosen profession against a myriad of antagonists. [W]e are sometimes told that we are too smart to pursue family medicine. Other topics range from salary comparisons between specialties to scope of practice. I’ve been told on many occasions that I should specialize for many different reasons but am rarely commended for choosing primary care. Luckily, most of us are unphased by such comments. However, I believe that there are students who are pulled from primary care because of what I like to call the hazing process. 

Jay Lee, Family Physician, from the California Academy of Family Physicians blog writes "#FMRevolution = Family Medicine Revolution" which is a rallying post for Family Physicians and other primary care providers to change the current US health care delivery system...

I would also argue one of the main reasons why folks are so darned uncomfortable is that the vector of our health care delivery system has begun to shift away from fragmented, volume-based to integrated, value-based care. My question for you, dear colleague, is: "Will you choose to sit on the sidelines or will you compete in the game?" 


The Rest Of The Medical Blogosphere's Best Posts Of The Week

Kevin Pho from KevinMD writes "Guiding Patients Online Is A New Physician Responsibility For The Digital Age." Physicians not only need to know about online resources, they need to engage patients in exploring the information found on these resources.

Ramona Bates from Suture For A Living writes "Following Instructions." Medication instructions are sometimes subject to interpretation.

Julie Rosen from the Bedside Manner Blog writes the post "Offline vs. Online Patient Conversations" stating that physicians should ask their patients how extensively they use the internet to facilitate better communication. The post reports two surveys stating that patients are going to the internet for health information.

Sarah Beth from SarahBethRN writes "Social Medical And Privacy In Healthcare" stating that in social media, finding the balance between protecting patient privacy but still trying to connect with patients - this will be the challenge moving forward.

Zoe Brain from the AE Brain blog writes the post "They Mean Well (Part 1)" talking about the complex nature of gender and sexual identity and the emotional complications of intersex surgery. I also invite you to read the comment sections of parts 1 & 2 as well.

Dr Ves from the Clinical Cases and Images: Casesblog writes "86% Of Australian Doctors Report High Rates Of Job Satisfaction." You'll be surprised on the reasons why. Also check out how the writer incorporates twitter comments into the blog post.

Doug Peredina from The Road To Hellth blog writes the post "Motivation and Healthcare Performance - Part 2" in which he explores self-determination theory, which is the the psychology behind pay-for-performance programs, and why this thinking doesn't really work in the health care industry.

Henry Stern from the Insureblog writes "Birthin' And Such" stating that the United States spends over $50 Billion a year on child birth related expenses? But, what does that really buy us? Good points made here.

Elaine Schattner from the Medical Lessons blog writes "Crowd-Sourcing A Medical Puzzle" where she states that a prominent website posted a medical mystery and asked their readers to come up with the already known answer. "Why we don’t have this sort of crowd sourcing for tough, unsolved medical cases?," she writes. Good question.

Fisher Qua from the Healthiest States Blog writes "Health Care Isn't Fair." Did you know that the US healthcare system is setup to be unfair? This post explores this and what now need to happen.

Beth Renzulli from the Happy Internist blog writes "the dying game" where the writer goes to a local senior center and explores the end of life through this creative exercise. An interesting way to sort through these type of issues.

Mary Pat Whaley from the Manage My Practice blog writes the entertaining piece "A Perfect Day In Your Medical Practice: The Efficient And Well-Run Medical Office." If all these bullet points happen at her office, I'm going to work there.

David Harlow from HealthBlawg: Health Care Law Blog writes "Who Owns Patient Data? (The Walgreens Edition)." Can "de-identifying" health information be repackaged to "re-identify" patient records? Hmmmm...

ACP Internist Blog submitted "Office-Based Doctors Are Economic Powerhouses." Did you know that the economic impact of office based docs compare to the hospital industry and is more than nursing homes and home health?

ACP Hospitalist blog submitted "Life At Grady: Control" A poignant post by a physician about a patient encounter.

Jennifer Middleton from The Singing Pen Of Doctor Jen blog writes "Exceptions To The Rule" stating that quality medicine should go beyond whether you have good quality numbers on reports.

Melissa Arca from "Confessions Of A Dr. Mom" writes "Crashing Down" in which she remembers a story, before she as a mom herself, as a pediatric resident in the ICU. 

Pat Jonas from the Dr Synonymous blog writes "Family Medicine: End Of Lice To End Of Life, We're There. What Do You Think?" A keen insight into a day in the life of a family doc. Man, I can relate to this post.

Jacqueline from Laika's MedLibLog writes "A New Safe Blood Test To Diagnose Down Syndrome" describes a promising new method to screen for Down syndrome, possibly moving on from the amniocentesis and chorionic villus sampling. 

Chris from HokieMD Weblog writes "Hospital Time." Did you know that time inside hospitals moves faster than it does outside? This medical student shares examples of why that is.

Steve Wilkins from the Mind The Gap blog writes "Patient Satisfaction And Doctor Requests - What's The Score?" Are physicians afraid that saying no will impact their patient satisfaction scores?

Mark from the Live In Underserved Medicine blog writes "The Social Contract" which outlines and analyzes societal expectations of physicians, physicians expectations out of society, and how they interrelate.

Jeffrey Seguritan from the Nuts For Healthcare blog writes "When Primary Care Says No To Insurance" which outlines a retainer based primary care model which the author states is an "evolution" of the patient centered medical home concept. Interesting.

E-Patient Dave from writes about "The Salzburg Statement On Shared Decision Making" urging patients and clinicians 'to work together to be co-producers of health.'

Paul Auerbach from Healthline writes "Whooping Cough & Immunizations." Good practical information and tips.

Ed Pullen from writes the post "Rickets" which is a great review of this almost forgotten about disease.

Dean Brandon from Pediatric Dentistry wrote "Apollo 13, A 'Successful Failure'" and applies the lessons learned there to his orthodontic practice. 

Ryka Galbraith from the Expat Doctor Mom blog writes "Top Three Reasons Diets Fail."

I also invite you to check out the entire "Family Medicine Rocks" website, which is new for me. I was formerly blogging at The Doctor Anonymous site until recently. There is also a podcast associated with this new site. Thanks again to Dr. Nick Genes, Grand Rounds Founder, for the opportunity to host again.

It's always a lot of fun to put this together. I hope you have fun reading all these great posts. If you're not already, please follow @GrandRounds on twitter, and also "Like" the Grand Rounds Facebook page. Next week, Grand Rounds will be hosted over at Emergiblog. Enjoy!