Here's a few posts that got the little grey cells working this week:
Bob Wachter wrote a great post about the problem of diagnostic errors, which inspired me to write about learning about my own diagnostic thought process.
Dr. Happy just posted about one way to keep dementia patients from wandering. This reminded me of an assisted-living center who managed to reduce the number of sleeping pills required to get their residents settled at night by offering evening entertainment: tea dancing, lectures, movies, etc. You see, the elderly clientele used to go to bed at 7 or 8pm, and wake up at 2 or 3am. This habit was defined as "insomnia" by both clients and staff, because the hours didn't conform to a standard sleeping schedule. Providing entertainment not only motivated the clients to stay up until 10:30pm (resulting in a standard sleep schedule) but also promoted more social interactions between them. Creative medicine sometimes involves no medicine at all!
Dr. RW outlined the perils of surgical co-management for hospitalists. This is an important issue, as hospitalist programs attempt to expand their programs, make themselves look more attractive to hospital administrators, and work toward standardizing delivery of inpatient care. The surgeons in my area of the world have to cover two hospitals when they are on call, and having hospitalists co-manage surgical patients appears to be a way of balancing our community's need for surgical services against surgeon burnout. I am happy to participate in a collaborative relationship but I do recognize the potential for miscommunication if co-management isn't fleshed out in more detail.
The prolific blogger, Dr. Crippen, described the frustration at having a patient come to him for a prescription his consultant could have written. This is the sort of absurd duplication of effort that healthcare bureaucracies seem to create--on both sides of the Atlantic.
Via KevinMD, I discovered a blog dedicated to personal finance for physicians: Doctor's Wallet. I anticipate this blog will be of great interest to me as I dissect my own personal financial profile on this blog.
Finally, some unfortunate experiences with meetings this week made me appreciate this post at Jessica Bond, Medical Careerist. Notes to self: demand an agenda, set time limits, and perhaps excuse myself from the meeting entirely. Words to live by.
Have a great weekend!