Blog | Monday, June 15, 2009

Grand Rounds at ACP Internist


Welcome to Grand Rounds at ACP Internist, a newspaper serving internal medicine. We're paying tribute to the daily newspaper. Read on for the latest headlines, opinions, features and even the funnies.

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Headline News

Rx for health care: good medicine
By See First Blog
Evan Falchuk joins the chorus of comments that have arisen about Atul Gawande, MD's, influential New Yorker article on the U.S. health care system. Unfortunately, most readers are missing the most important point, "that we need to put good medicine back at the center of health care."

For health care reform, keep it simple
By Colorado Health Insurance Insider
Sen. Ted Kennedy's health care reform bill includes good ideas but attempts to do too much.



Opinions
For best care, doctors must keep the whole patient in mind
By Not My Second Opinion
A family medicine doctor provides clarity for a confused patient whose dizziness led her to see several specialists--and get several diagnoses. To prevent such situations and fix our broken healthcare system, doctors need to start treating the whole patient.

Even evidence-based medicine has its exceptions
By The Jobbing Doctor
Of course, doctors should practice evidence-based medicine. But they should know when it's time to break the rules, as well, a 30-year veteran writes.

Predicting the shape of health care reform
By ACP Advocate
Potential consensus legislation could include higher Medicare payments for primary care physicians but might be "too little, too late."

When it comes to diabetes, misinformation abounds
By Six Until Me
Kerri Sparling writes about some of the most common diabetes misconceptions and stereotypes she's encountered in the 22 years since her diagnosis.

Letter to the editor
Duncan Cross responds to a Wall Street Journal editorial that holds patients responsible for health care costs by suggesting the members of its editorial board either have perfect health or a virulent strain of contagious rectocephaly.



Medicine
Insight into asthma
By Allergy Notes
Allergy Notes highlights some intriguing research on how Leukotriene B(4)-BLT1 axis may contribute to airway remodeling in asthma.

Some evidence isn't ready for practice
By Laika's Medliblog
There is a lot of talk in medical circles about bridging the gap between evidence and practice, but even the gold standard randomized controlled trial doesn't always give useful answers.




Finance

Factor patients into the health care cost equation
By Marianas Eye
David Khorram discusses the ways in which patients' behavior can drive up health care costs.

Slow and steady might win the health care reform race
By HealthBlawg
Health care reformers may be biting off more than they can chew. The Massachusetts approach of addressing one thing at a time--access, cost and quality--might be worth considering at the national level.



International
Don't blame Canada
By Canadian Medicine
Some commentators have pointed to Canada's health care problems as an excuse to avoid further federal involvement in the U.S. health care system. But this argument is no more than fearmongering, Canadian Medicine writes.



Health and Lifestyle
If changing a habit is hard, try 1/2 instead
By How to Cope With Pain
Sometimes tackling a habit is too hard. Make incremental changes instead for healthier choices about diet, exercise or smoking cessation.



Women's Health
Gynecology rules, but birth process is more boredom than miracle
By Vagus Surgicalis
A New York Times piece on maternal mortality prompts an Australian medical student to reflect on his recent OB/GYN rotation.

Lessons learned from a bittersweet birth
By Beyond the Short Coat
A medical student recounts his very first delivery--of a baby destined to die from severe holoprosencephaly--and his subsequent interaction with the patient's family.

Addicted to ultrasounds
By Reality Rounds
A NICU nurse wittily recalls her obsession with weekly ultrasounds while pregnant--until a wise medical director puts her in her place.



Sports
Arthroscopy results no better than pretend surgery
By The Fitness Fixer
Knee surgery is done, recommended, repeated and taught, but the evidence base shows it is more often not needed. A study shows that having arthroscopy is no more effective than having fake surgery.

Your mattress, your health, your choice
By The Back Pain Blog
PubMed archives shed light on sleep studies that examine whether quality mattresses help back pain.

Hip replacement technique may benefit 'young actives'
By InsureBlog
Henry Stern talks to orthopedic surgeon Robert Roman about the pros and cons of the Birmingham approach.



Technology
Tricky diagnosis? Consult Dr. Google
By Clinical Cases and Images
Ever wonder how you can use Google Squared to create an automatic differential diagnosis list? Find out on the latest post.

Cloud computing for automated patient reminders
By Medicine and Technology
Systems can gather medical information and alert clinicians and patients if a problem is detected. These types of automated reminders are not difficult to generate with the right algorithms that are driven by evidence-based practice guidelines. Will electronic health records lead to improved patient outcomes?



Weekender
Catch more than a sunburn at these beaches
By Medicine for the Outdoors
California and Illinois beaches have particularly high levels of bacteria and swimmers may want to check online water quality reports before diving in.

Add footwear to the list of essential protection
By Teen Health 411
It's a good idea to keep your shoes on this summer in the locker room or at the pool, where viruses and fungi often lurk.



Family
Not a DIY project: curing depressed teens
By Doc Gurley
Paying for professional help, in the form of cognitive-behavorial therapy, is worth the money for the parents of depressed teens, according to new research.

From caregiver to 'care-taker'
By In Sickness and In Health
When a serious illness strikes, the role of caretaker often falls to the patient's significant other. But what happens when the caregiving partner gets sick?

Curing bad behavior in the hospital family
By Florencedotcom
In an effort to improve patient safety, the Joint Commission is targeting disruptive behavior, yet another area where health care can take a cue from the aviation industry.

Your career
Saying no to new business
By Novel Patient
It takes some hunting to find an internist who wants a new patient with multiple complex chronic illnesses, according to this first-person investigation.

Be honest about your experience (or lack)
By Suture for a Living
When a patient asks how many procedures a physician has performed--or even if they don't ask--telling the truth is the right thing to do.

Entertainment
Nurse Jackie Disappoints
By Digital Doorway
Our "TV critic," Keith Carlson, RN, offers his reaction to the premier of Nurse Jackie, a new Showtime "dramedy" that showcases a drug-diverting, fib-telling, take-no-prisoners nurse who does little to advance the image of nurses in the public eye.

Jenny McCarthy feuds with science
By Dr. Val
Dr. Val suggests a boycott of Oprah and provides evidence-based rebuttals to Jenny McCarthy's anti-vaccination propaganda.



The Funny Pages

Cartoon Caption Contest
Each month, ACP Internist lets readers create their own cartoon captions and vote for the winner. Submit all entries by June 18. Pen the winning caption and win a $50 gift certificate good toward any American College of Physicians product, program or service. (We have a gift shop and non-clinical books for the lay reader.)

Medical News of the Obvious
Every Monday, ACP Internist skewers studies that shouldn't have needed to be done. Read more every Monday at Medical News of the Obvious.

"Bob at the Carnival"
Bob the Male Nurse Action Figure goes to the carnival, a part of the continuing photographic adventures of Bob the Nurse.



The Final Page
We hope you enjoyed our newspaper. Now that you're finished, don't forget to recycle.