Another great week in the medical blogosphere. Here's a few posts that lit a fire under me:
First of all, can I just say how much I love Dr. Rob's blog? He always picks gotcha topics and it's uncanny how often I agree with his perspective. For example, he quite rightly criticizes Internet information about adverse drug effects. I've had the same thing happen to me: I prescribe a drug I feel will help a patient, and next thing you know I get phone calls saying, "But I just read about the terrible things it does to the body!" Just as bad are the automatically-generated drug info sheets pharmacists give to patients when they pick up their meds. Those things are so densely written and include every possible adverse effect, rather than representing the average person's experience with a drug. These competing sources of information severely limit the primary care doctor's ability to manage serious illnesses.
Dr. Rob had another great post this week on the incredibly stupid things doctors are asked to write excuse notes for. Boy this one is familiar to me. I have written notes excusing people from jury duty, school, work, and probation hearings. I have written notes asking for refunds on plane tickets, event tickets, cruise tickets, you name it. I have written endless letters supporting therapy dogs in low-income housing. At times, I feel like Leticia Baldridge or some version of an overly-technical etiquette teacher.
Dr. Happy is another of my perennial favorites. I admit I like to check out his blog just to see photos of Marty and Cooper, but he writes some hilarious posts too, and this week he produced an absolute winner on top internal medicine tips. I already follow some of the same guidelines, but there were a bunch I never considered before. Required reading for hospitalists.
There's been a lot of references to residency work-hour restrictions lately. I wrote a post a while ago criticizing the suggestion that work hours be restricted to 56 per week. I'm supportive of the idea of some reasonable limit on work-hours, but I have to admit some reservations about loss of rigor in medical training that will--inevitably--result. Some people have implied that today's med students will turn into tomorrow's wussy physicians. Vitum Medicinus rebuts that argument by comparing medical students and medicine in 1960 and 2000. Midwife With a Knife wrote a reasoned argument in favor of work-hour restrictions, noting:
"I'll take the resident who's not so tired he's envying the patients under general anesthesia, and the resident who's not so tired he resents it when my nurse calls for an anti-nausea or pain med order over the resident who's been in the hospital with me every day and night for a week, if it ever comes to that. I also do not expect that resident to risk injury/death due to fatigue in order to "take care of me". Besides, what kind of a society are we when we expect a class of essentially indentured servants (admittedly, indentured servants who can expect a healthy reward at the end of their servitude) to take such risks on our behalfs?"
Every week, there's a few posts that make me wonder at the joy and grief of doing this work. Bongi's story of K made tears come to my eyes. I don't know how he carries on, but I'm grateful that he does. Speaking of gratitude, Dr. David's story of D, a teen living with recurrent cancer, will remind me not to feel sorry for myself, but to find happiness whatever life dishes out. And on one of my new favorite blogs, Notes From a Country Doctor, I read about a man-to-man appeal to become a father to a newborn baby. I love this stuff. Finally, the unequalled Dr. Val has written a tear-jerker about the healing power of Disney.
For the nitty-gritty types, Grunt Doc and Shadowfax have great new tips for EM grads, most of which apply to newbies in all specialties.
I have to end with Dragonfly's new insights into the world of women's health:
You might be doing OB-GYN if...You have said to someone “lets go have a baby”, and neither of you are pregnant.
You got that right, sister.
Hey There! Really nice job compiling these! Glad you enjoyed D's story.
Posted by: Doctor David | June 29, 2008 at 07:22 AM