Grand Rounds Vol 7 # 47

I think I learned my lesson this time.  The first two times I hosted Grand Rounds many of the posts seemed to come from happy bloggers.  I think the lesson this time is don’t be a host when all the news is bad.  Maybe it’s the drought and heat wave in much of the U.S.  Or maybe using the words of Bill Clinton “It’s the economy, Stupid.”  For whatever the reason this week’s Grand Rounds is dominated by rants and whines from bloggers around the globe.  Many of them are right on though, and it has been a bit tough to find good news lately with the debt ceiling fiasco, the subsequent market instability, and the prospects of our first double-dip recession since I was a family practice resident (1980-82).  In order to end on a happy note I took it on myself to find some positive blog posts, so after reading the first section consider sticking around for a bit of positive energy from what I managed to find from some bloggers having a good day.  To try to have some fun with emotions I decided to try to draw a sketch to give you an idea of the mood of the writer:

Dr Bates gets first position since she is hosting Grand Rounds next week.  She breaks the trend too in not being upset or angry.  She writes at Suture for a Living wondering How old is too old for cosmetic surgery?  Her answer?  Well she really answers with number of questions in her post: Ageism and Plastic Surgery.  Maybe the most profound part of her post come from the comments of bioethicist Carl Elliott who comments on a recent NY Times article: “Everyone agrees that one root of the problem is toxic social pressures. The problem is that giving in to these pressures just reinforces them. The more cosmetic surgery older people get, the more social pressure that other older people feel to get the surgery themselves. (And articles like this just make the problem worse.)  Also, does anyone really think that cosmetic surgery actually makes these people look younger? What it really does is make them look as if they’ve had work done. And having work done is not so much a marker of youth as it is of money.”  I think he is pretty much on target.

Undoubtedly Doug Perednia and I do not agree on whom we vote for or a lot else from a political standpoint, but I do believe he is right in his overall conclusion:  Our political leaders lack the courage to make the types of changes needed to reduce healthcare spending and address deficit spending.  Do I agree with all of his conclusions?  No.  Do I think reading his post: No Recovery? It’s the Uncertainty Stupid. About Healthcare on The Road to Hellth blog makes many valid points and is worth the read?  You bet.

At his blog Septicemia, Prenab goes on a self-labeled rant about the proposal of the British Medical Journal to have a blanket ban on articles by authors with potential industrial conflicts of interest.  This has been a hot topic recently as the FDA has taken heat for proposing to allowg input from the pharmaceutical industry in considering new drug releases.  I enjoyed reading Why the BMJ should Not Follow NEJU Author Ban.

At his Mind the Gap blog Steven Wilken’s MPH in a post Poor Doctor-Patient Communication is Closely Linked to Non-Adherence he makes use of a technique called Infographics.  It is very clever and gets his point across.  He must either be very good at creating snazzy infographics or have a lot more time for his blog than I do for mine.  It’s worth the read just to see the graphics.

At Behaviorism and Mental Health Phillip Hickey PhD posts on Behavior Therapy Dr. Hickey writes an elegant discussion of this type of therapy and how it can be used.  He mentions how both behavioral therapy popular in the 1960’s and the techniques of reality therapy that I was taught as a resident in the 1980’s have fallen away and replaced by the cognitive-behavioral therapy in vogue now.   I enjoyed the read and suspect you will too.

Dr Schumann at Glass Hospital posts a very cogent and helpful discussion entitled Generics where he explains why most physicians and patients prefer them.  He also tells about some of the issues occasionally encountered.   One of the few quick reads on this grand rounds and well worth the while.

 

At Prepared Patient Forum blog Jessie Gruman PhD tells us why we have gotten ahead of ourselves with Doctor Ratings.  How would you put metrics to what makes a good doctor?  I suspect my choices would not match yours.  So how does your insurance company, your state, or any given web site come off using their own metrics and giving you advice?  Read Rhetoric Ahead of Reality: Doctor Ratings Not Useful Yet to see one editorial on the subject.  Let’s hope how you pick your doctor is better than the “crap shoot” referred to in the post.

At Insure Blog Kelley Beloff, a certified medical office manager, writes What Were They Thinking, an article bemoaning the declaration by the administration that Medicare recipients need not worry, the only cuts to Medicare would come to the providers, not to them.  He suggests that if the physician providers have their payments from Medicare cut that patients will be hurt by decreased physician access as fewer physicians choose to accept Medicare patients and less students choose to become physicians.

You can’t be really great until you look at your results and figure out how to get better. In this post the ACP Hospitalist suggests that when physicians at some hospitals look at their outcomes they realize that they’re ordering invasive tests when they don’t really have to.  See his post:  Better Angiography Standards Needed at Low Volume Centers.

 

At ACP Internist Ryan DuBosar posts in a daily news flash on their site about a genetic defect that may put women at a risk of 1 chance in 11 of developing ovarian cancer.   According to the original article in Nature women with this defect have cancer cells that seem to respond to PARP inhibitors, a drug I’m all too familiar with as my wife is receiving it currently for her ovarian cancer.  It seems this may be somewhat similar to the BRCA gene defects, and add one more piece to the puzzle of why some families seem to be at risk for certain cancers.  Check out QD: News Every Day–Ovarian cancer breakthrough targets faulty genes.

QD: News Every Day–Ovarian cancer breakthrough targets faulty genes

After so many disgruntled posts from angry or discouraged bloggers it is nice to have a simple and positive post from Emmy at The Pink Tee Shirt blog on feeling like her primary physician actually listened to her and heard her concerns to come up with a mutually acceptable approach to her concerns.  I hope sometimes my patients feel like I listen and hear them even if they don’t post about it on their blogs.

Now for my not-too-extensive search of the world of bloggers to find some posts to make us all leave smiling. Let’s Start with a doctor having fun writing.  At The Examining Room of Doctor Charles you can always find great writing, and usually find a reason to smile.  With No Milk you get both.  Thinking about milk made me look on Kelly Aversa’s daily homemade blog and then to raspberry pie.  Thinking of pie made me think you need at least a few friends to help you eat it and to a post on the Stanford School of Medicine blog post Older brains get by with a little help from their friends.  That made me think of music and so why not check out my Musical Doc’s page and leave this site with your own smile.  Do you think I need to consult Dr. Hickey for some therapy for my looseness of associations?
Many thanks again to Nick Genes Val Jones, the sponsors of Grand Rounds at Better Health.  Check out the calendar each week to find the host.  Next week be sure to visit Suture For a Living to enjoy Grand Rounds Vol. 7 # 48.

4 Responses to Grand Rounds Vol 7 # 47

  1. Pranab says:

    Awesome round up of the medblogosphere! And erm, whenever looking for laughs, the best blog to go to is Dr. Grumpy’s blog! Thanks for including me in the rounds… this is the first time I put my name in the hat! YAY! \m/

  2. hgstern says:

    Great job, Doc!

    Thanks so much for hosting, and for including our post.

  3. You could have aptly name this Grand Rounds as the “10 Faces of Health Care.” Great job and thanks for hosting!

  4. rlbates says:

    Thank you for hosting. Love the sketches!

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