Tuesday, October 11, 2005

Grand Rounds, Vol. 2 Issue 3

This week’s PSA (courtesy of drdeborahserani):
National Depression Screening Day was October 6
World Mental Health Day was yesterday, October 10

______________________________________________

“A feller wiser than myself once said, 'Sometimes you eat the bar, and sometimes the bar, he eats you.’” –The Big Lebowski

This week’s Grand Rounds is meditation on symbiotic relationship between law and medicine. I mean, without medicine, what would lawyers do? And without lawyers? Well, probably some aspect of medicine would be worse off than it is now.

Editor’s Picks

Sound Practice.net sets the tone for this week’s Grand Rounds with Under Promise and Over Deliver: Why Patients Sue Doctors. He writes, “I think part of the cause of malpractice is the public's need to believe in their doctors, and their disappointment when bad things happen. The lack of transparency and communication between physicians and patients only adds to the size of the gap that devastates the family when outcomes are poor.”

Insureblog submitted a post about which questions insureds should ask about their premiums; I prefer to link to this slightly older post, which gets us thinking about an ethical (and legal) question: “When one donates money on behalf of a specific person (or cause) is it wrong if that money is diverted to something (or someone) else?”

Interested Participant gets double points for submitting a post that is both on topic AND has a Canadian theme (Happy Thanksgiving. I am listening to k.d. lang’s Hymns of the 49th Parallel in honor of the occasion!): Unsatisfied Canadians heading to the U.S. for surgery because they can get appointments 18-24 months sooner than in their native country. Could they bring some of those low-cost meds with them?

Docket Review

In a lesson many Justices and judges could learn from, DB’s Medical Rants shows how to separate one’s personal philosophies from application of constitutional law. He argues that Oregon’s right to legislate approval of physician assisted suicide should remain a state- and not a federal-level decision, no matter how ethically deplorable he finds the practice to be. The end does not always justify the means.

Newcomer PharmaGossip keeps us posted on the Vioxx trial, with only a wee bit of snarky commentary: “was there some sort of LOTTO draw and good ole Briggs was the winner/loser/hero/patsy (delete as appropriate)?.”

Two writers, Kevin, M.D. and The Mommy Blawger, react to the JAMA’s article on “Implications of Cerebral Palsy Litigation.”

Advisory Memos

RedStateMoron highlights the SorryWorks! coalition and their efforts to mediate the malpractice crisis we’re mired in, but questions whether legislation is the right tool for the problem.

Without calling it “patient rights,” Joan at Oasis of Sanity, has a lot of suggestions for improving patients’ understanding of their situation in “the problem with labs:” “I’m referring to the labs, or laboratory reports, that list a bunch of incomprehensible words and acronyms, along with a bunch of equally incomprehensible numbers, that delineate exactly what was found in a blood sample.”

Barbados Butterfly doesn’t say it can help dodge a lawsuit, but nonetheless points out the difference experience makes in a surgical team’s ability to transact urgent business without alarming the patient:
“Surgical Registrar to Anaesthetic team: How are you going up there?
Junior's interpretation: The surgical reg values my contribution to this operation and wants to exchange greetings.
Senior's interpretation: Something's wrong. Probably some blood loss.”

Tired of illegible, incomplete or absent patient drug records, Over!My!Med!Body! has taken matters into his own hands and created a website where patients can list, track and print out a list of their medications. Med!Body!, please be careful the Good Samaritan in you doesn’t hang you out to dry in the liability department.

What happens when you can get a gallon of milk, one hour photo developing and a rapid strep culture all in one place? Aggravated DocSurg considers the possibilities, big box malpractice suits among them.

Approaching Ripeness

Trent McBride, writing at Catallarchy, takes on individuals who deny AIDS is caused by HIV.

Clinical Cases and Images directs our attention to a video post from Medscape General Medicine that calls medical blogging “anarchy.”

Amicus Briefs

Kim at Emergiblog shares her story of nursing burnout and offers a few tips to others for avoiding it. Further examples are available from ImpactEDNurse, who discusses “deep nursing” and on-the-job techniques for mindfulness, meditation and meaningful caregiving.

The Health Business Blog reconsiders the wisdom of consumer directed care after reading that multiple gestations persist in the IVF business despite the medical, ethical and financial “wisdom” of restricting the number of implanted embryos.

And what about consumer directed prevention? Parallel Universes hopes the plain monetary cost of smoking will serve as a deterrent.

A Difficult Patient writes from experience on Domestic Abuse.

Political Calculations tells us how U.S. blood donations are faring in the wake of hurricane Katrina.

Docaroundtheclock directs us to an article on health care, childbirth specifically, during the Brezhnev era in communist Russia.

Dicta

Orac at Respectful Insolence shows his stripes on the issue of “alternative medicine” in “How to Succeed at Quackery.”

Relatedly, GruntDoc shares tips on how NOT to act in the ER if you’re there to scam some drugs.

Healthy Concerns reflects on gender and reactions to a promised phone call that never comes.

The Cheerful Oncologist delivers a death allegory that is beautiful, and more than a little unsettling.

Res Gestae

doulicia asks that you visit this post at SageFemme to see what legislation and malpractice threaten to take away – at least from women who prefer to birth in the hospital.
_______________________________________

Mea Culpa

To all the excellent bloggers whose posts I omitted this week, please continue writing and submitting. When I volunteered to host, I had no idea I would receive so many submissions, all of them excellent. I tried to present a collection of pieces that resonated with the theme or with each other. That meant not including some stellar posts. If yours was one, I appreciate your sharing it with me. I promise to be similarly empathetic when I’m left off Grand Rounds.

Next Week

Grand Rounds will be hosted by Diabetes Mine.

40 Comments:

Anonymous Tom said...

Great job. Your hard works shows. Thanks for hosting.

5:58 AM  
Blogger Henry Stern, LUTCF said...

.
What a terrific job! And I'm flattered that you found my older post still relevant (I do, too). Depending on the comments I get due to your link, I may even post my own take ;-)

Oh, and Thanx for a new word, too; I'd never heard the term "labor doula" before, and looked it up. Neat!

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Blogger I am a Milliner's Dream, a woman of many "hats"... said...

Great job, doulicia...you make doulas look smart...because we are...I'm proud to be a colleague, in that and in blogging.
Hh

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Blogger ibear M.D. said...

Great job hosting! I think you did a fantastic job.

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Blogger Lars said...

Thank you for being talking about National Depression Screening day. Screening for depression is one of the most effective ways of catching this disabling condition so that it can be effectively treated. But why only 1 day a year? Because it takes too long to administer the screening. So to overcome that, we at AuroraMD automated the screening process, so that it happens automatically in the primary care waiting room with little staff time. Then the results are presented to the doctor in the exam room. See our website http://www.auroramd.com .
Is your doctor screening everyday?

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Anonymous Anonymous said...

Great job! Thank you for your help. I will try and be a little less "snarky", but the Vioxx trial brings out the worst in me!!

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Blogger doulicia said...

Nothing wrong with snarky!

Thanks all for your encouragement and submissions. It was a lot of fun to do Grand Rounds; don't miss the opportunity if you haven't hosted yet!

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Blogger Julie said...

Woo-hoo! You go, girl!

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