Grand Rounds Volume 7 Number 24

This week for Grand Rounds I asked for submissions of the best work from blogger’s sites in the last week or two, and promised to judge them on Olympic scoring of 0-10.   I also asked readers to submit posts from blogs other than their own (these have a *** after the score), and to agreed to give these submissions extra credit in the scoring.  Each post has two scores, one for content, and one for writing.   I think of content as the importance or interest of the topic of the post, and writing as how well and interestingly written the post itself is.  I’ll take full blame for the fact that these are absolutely subjective, that only I did the judging, and that there is no appeal process.   Nobody should feel be discouraged as I truly enjoyed every submission, and am honored to host Grand Rounds again this week.  Thanks for your submissions, and keep up the great work.

Gold Medal for Content goes to  John Goodman’s Health Policy Blog he writes The HMO in Your Future.  He takes to task the march towards ACO’s and suggests that this is far from evidence based.  We do seem to be moving quickly towards ACO’s whatever that really means.   Check out this post at least to hear Aretha Franklin sing I Say a Little Prayer.

Content  9.7                Writing   9.0

Gold Medal for Writing goes to At the Road the Hellth blog where Dr. Doug Perednia writes How American Healthcare Gets Hellthier in a satire and sad but believable post where he shows the unintended consequences of instituting a three handed clock to improve patient care in a hospital.    Content   9.0   Writing   9.7

Silver Medal for Content and Bronze Medal for Writing goes to  Dr John M who writes about A Five Minute Cardiac Screen for Athletes where he addresses many of the issues with testing in general.  It is such a shame that 100 young athletes die in America each year of sudden death primarily due to prolongued QT syndrome or Hypertrophic cardiomyopathy.  He presents an elegant discussion of the issues of mass screening for uncommon problems with tests that have a significant subjective component to the results,  and false-positive test rates.  Nice post Dr. John.   Content  9.5      Writing  9.5

Silver Medal for Writing goes to ZDoggMD who professes to be only slightly funnier than placebo, but I suspect just needs a bigger sample size to prove he is far funnier.  He writes Immunize, with a video worthy of my own musical doctors page.                  Content   8.5,     9.6

Bronze Medal for Content goes to Mokitas and Taquitos in Health on The Healthiest State in the Nation site.  This is an insightful list of health care Toquitos, meaning truths we know about health care, but are reluctant or afraid to admit and confront.     8.7          9.0

Special mention to the next two posts that I just really like:

In The Blog that Ate Manhattan is Essure – Bad Marketing.  FDA Pull This Ad. How bad can the taste of markerters get?  Here is a good example.     Content  8.0    Writing  8.0  ***

At Reflections of a Grady Doctor is Thursday Top Ten: Fighting Words.  This is good comic relief at the potential for misinterpretation of the common things doctors say.    Content  6.0  Writing  9.0  ***

The rest are in the order received.  Better billing for more timely submission seems fair to me.  Enjoy.

A Word About Morgellon’s Disease on Insureblog is a post about a disorder I suspect close to none of you have ever heard about.  I certainly had not.  It’s one strange disorder.    Content  6.5   Writing  6.0

In the post Health Care Reform: Politics, Computers and the Individual HUB’s List of Medical Fun Facts writes a very insightful and satirical post that because it is so true is not very fun at all.    Content 8.0 Writing  9.5

At Mad in America Robert Whitaker writes Andreasen Drops a  Bombshell:  Anti-psychotics Shrink the Brain about the release of a study in the Archives of General Psychiatry that claims that antipsychotic drug use leads to lower gray matter volume with long term use.  This is especially concerning in light of the increasingly widespread use of these drugs in children and diseases other than schizophrenia.   This is certainly not common knowledge among primary care physicians.  If any psychiatrists have a comment about this I’d love to see it here.    Content  9.0   Writing  7.5

In Diabetes Mine Allison Blass writes about Five Diabetes Dogmas that Need to Go… , an interesting discussion of some myths and dogmas that are widely believed, but have little or no science behind them.  A good read for physicians and others alike.    Content   8.5                      Writing  7.5

In Behavoirism and Mental Health: An alternative perspective on mental disorders Philip Hickey Ph.D.  writes More on So-Called Bipolar Disorder.   I have to agree that patients who carry a diagnosis of bipolar disorder are a diverse and group, but he goes so far as to suggest that for these patients the focus should be on recognizing the behavior that need to be changed, and “this behavior can be identified, specified clearly, and remediated.  And in this regard you have to do what we all have to do with life’s problems – exploit your strengths to counter your weaknesses.  In other words – use your ingenuity.  Find solutions to the problem.  Don’t give in.  Don’t go on doing things the same.  Break patterns, etc..” He is bold in this major break from the practicing norm.  See what you think.    Content  6.0   Writing  6.0

In  New York to Cap Medical Malpractice Awards? (An Open Letter to the Legislature) Eric Turkewitz writes passionately about how NY needs to avoid limiting awards for pain and suffering.    Not what most physicians want to hear, but as he stated in his e-mail a word from the “dark side.”   Content   6.5, Writing  7.0

Paul Aurebach MD from Healthline writes an environmentally focused post called Save the Everest 2011: Improving Waste Management in Nepal.  It‘s as far off the usual topics here as Nepal is from the U.S., but I post it because it is interesting, and our environment is part of our global health.    Content  6.0    Writing   7.5

Ed Silverman at Pharmalot posts Most Docs are Unaware of the “Bad Ad” Program.  I certainly was unaware of an effort by the FDA to get physicians to report inappropriate, false or off-label advertising or promotion by pharma, so he is right on when he suggests for this to be more effective the FDA needs to get the word out to docs.  Maybe this will help.   Content  8.5   Writing   7.5  ***

Julie Rosen writes at Bedside Manner on The Personal Side of Personalized Medicine.  This discusses the use of medications specifically chosen to treat individual patient’s cancers.   Content    7.0   Writing   8.0

At the Smart Blog on Social Media Adam Gaub posts Wool.lab health care panelists  see pros, cons to social media. It’s no surprise to me that patients use social media to reach out to each other, and physicians are not really sure how to be involved.    Content   6.0   Writing  6.0

The ACP Hospitalist writes about the extent of MRSA contamination of traditional white coats vs. freshly laundered short sleeved uniforms, and finds Doctor’s Garments Colonized by Bacteria Within Hours of Starting Work.  I’m glad I can keep wearing my white coat and not have to wear a short sleeve uniform.   I like to look like a doctor, not an orderly.   Content  7.5   Writing   8.0

At ACP Internist is CDC Campaign Doesn’t Slow Inappropriate Antibiotic Use where in Michigan despite a program specifically focused at reducing antibiotic use there was little change in physician prescribing habits.    To change habits is not easy.        Content   7.5   Writing  7.0

At Health Care Agenda Nora O’Brien-Suric writes Social Workers are Best for Care Transitions.  I have to agree with her premise that physicians don’t do a great job at the details of facilitating the transition of patients from a hospital setting to a long-term care setting.     Content   8.0  Writing  9.0   ***

Dr. Val at Better Health writes Don’t Treat the Number, Treat the Patient.  In this case she is her own “patient” and I don’t envy her taking spin classes.  My son has another name for the person screaming at the class riders, but it’s not fit for this venue.    Writing  7.5   Content   9.0

At Residency Notes is  Acute Gatekeeper where the blogger, apparently an annonomous neurosurgical intern writes about the role of the lower level intern or resident in care of hospitalized patients.  I think the example he gives of two ways to present a case to get two potentially different responses are seen throughout medicine.  Physicians, intentionally or unintentionally guide patients, consultants, and in the resident’s case attending physician supervisors to decisions of their choosing by the flavor put on the case presentation.  A good read.      Content   8,0   Writing  8.5

Roy at Shrink Rap posts about Running Out of Psychiatric Beds where he discusses the overall reduction of and difficulty finding inpatient psych beds when patients need them, and a new electronic registry in Eastern Ontario to help ERs find a psych bed when they need one.    Content   6.5   Writing 8.0    ***

Amy Tenderich writes at Diabetes Mine a post called  Losing Control as she vents about the struggle of burnout and wearing down for patients dealing with chronic diseases like Type 1 diabetes, especially when trying to do so with gluten enteropathy at the same time.  Hang in there Amy, you can get back on track.  Diabetes Mine gets a second post here because they host Grand Rounds next week.  Thanks.     Content  8.0  Writing  9.0

Elaine Schattner MD writes at Medical Lessons that Radiologists’ Experience Matters in Mammography Outcomes,  She reviews and discusses a study that shows that radiologists who read a high volume of breast imaging studies have a lower false positive reading rate than those who interpret a lower volume of exams.  Sounds a lot like similar studies with surgeons, hospitals, etc where high volume leads to improved outcomes.     Content  7.0    Writing   7.5

From Health is Social is a post asking Will Social Media End Stigma in Health? It’s really a rhetorical question in the blog post, but one that makes you think.  Thinking is not bad, unless it’s bedtime.   Content    7.0   Writing   9.0  ***

I decided to submit a post from a blog I follow, Cat’s Eye Writer called What to Do When Blogging Isn’t Fun Anymore.  See what you think.  No grades here since I submitted it.

Be sure to visit Grand Rounds Vol. 7 No. 25 at next week and get your submissions in to her early.  Special thanks to Better Health for organizing and managing this useful forum.   While you’re here be sure to follow @DrEdPullen on Twitter, like on Facebook or subscribe so you don’t miss a post.  Thanks for reading, and leave a comment so future hosts, maybe even me, can improve Grand Rounds.

7 Responses to Grand Rounds Volume 7 Number 24

  1. Yo Dr. P,
    I’m thrilled to be mentioned in such illustrious company! Very cool rating system, thanks for shining a light on these great blogs.

  2. Hey Doctor Pullen,

    I’ve been bouncing around all day because of your kind words. I’m honored. You have made my platelets less sticky and my endothelium smoother today. For this, and for hosting a fantastic Ground Rounds I thank you heartily.

    Also thanks for the tip on Cat’s Eye Writer.

  3. Thanks for hosting and your careful review and rating of each post. I think both informed patients and clinicians will find this week’s collection informative and thought-provoking.
    Julie Rosen
    Executive Director
    The Schwartz Center for Compassionate Healthcare

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