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Obtaining informed consent is one of the most important things that a surgeon does.

I’d argue that obtaining informed consent is one of the most important things that a surgeon does — akin to the last stitch of an aortic anastomosis, the life-saving jolt of electricity to jumpstart a fibrillating heart, or the first pass of a scalpel during an emergent laparotomy.

Informed consent defines 21st-century medicine, contrasting sharply to the days of paternalistic care. Informed consent, when done properly, puts decision making into the hands of our patients. It can serve as a checkpoint to discuss goals of care and what constitutes a meaningful life for a particular patient.

It’s time we teach our trainees how to obtain informed consent the proper way. We need to slow down, pull up a chair, and look people in the eyes. We need to truly know our patients — how they understand their diagnoses, how they interface with medicine, their socioeconomic status, and education level. We must address goals of care with clear “if-then” statements.

When I teach younger residents how to obtain informed consent I often harp on a concept I learned in my undergraduate psychology class called theory of mind. Theory of mind is defined as “being able to infer the full range of mental states (beliefs, desires, intentions, imagination, emotions, etc.) that cause action.” In my opinion, theory of mind is an integral part of the consenting process that allows us to reverse roles, to see the world how our patients see it.

Halfway through obtaining informed consent from my patient, my attending steps in. He snags a stool from the corner of the room. He sits directly in front of the sick man. He talks about what life will be like for him as a new amputee.

He emphasizes the importance of diabetes control and smoking cessation. We may do everything we can and the man still may die. Would he want to live if it meant he could never go home again? He conveys the gravity of the current situation in a way that is pitch perfect. This, I think to myself, is how it’s done.

For surgeon trainees, just like making our first cut, informed consent is a skill learned by example and should be done under the watchful eye of our mentors. It’s time to pay it forward. Next time you are the chief resident, the senior attending, or anywhere in between, take a trainee with you and teach him or her how to obtain informed consent the right way. Do away with the notions of “efficiency” and speed. Your patients and your pupils will be eternally grateful.
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Managing time is a major issue for all professionals in today’s fast paced world. This is even more so for many doctors, especially those who work at multiple locations: Clinics, Hospitals and Medical centers. Workshops on effective time management are regularly organized at different financial and IT firms to help hard working professionals. Gyan is imparted on setting Alerts for Reminders, and To Dos for Task management and the importance of diaries, blackberries and calendar reminders is emphasized here.

Physicians have a slightly bigger problem. Their schedules are majorly dependent on set appointments with patients. While they do have other areas of concern, the majority of their daily schedules are built around patient appointments. What complicates this for a consulting doctor is that every day he may have different visiting hours at different locations. This makes Time management even more crucial for Physicians.

Mandatory Requirements for an Appointment Management System:

It should allow for different mediums of Appointment Scheduling
E.g. Via a Website, Via A Phone Call, Via SMS
It should permit Rescheduling
It should be able to handle Walk-In Patients
Besides the process, the screens should be simple – Non IT friendly users should be able to easily use it
Color Coded Entries: Pending, Completed, No Show, Bill Pending
Point And Click with Minimum Data Entry
Should be rigid enough to prevent Scheduling Errors
Should Support Multiple Doctors and Multiple Specialties
Maintain 2 Daily Calendar Views
Appointment View for Front Desk staff, Online Portal
Scheduled Visits View for Physicians

more at
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Imagine going to the doctor with an infection and being sent home with a course of drugs. Unknown to your doctor you actually have two infections. If you take the drugs will the other infection go away by itself? What if you take the drugs and the other infection gets worse? This quandary faces those treating patients with multiple infections.

A new study led by former University of Sheffield PhD student Dr Emily Griffiths, in collaboration with the universities of Edinburgh, Liverpool and Zürich, has taken a novel approach to understanding this problem, shedding light on how multiple parasites interact within humans.

The study compiled a list of many of the parasites that infect humans, another list of the parts of the body consumed by each parasite, and also information about how the immune system responds to each parasite. This information was used to construct a large network of multiple infections in humans - a bit like a food web of infections inside the human body.

Building this network revealed some previously unknown patterns, something that could pave the way for new treatment strategies which help tackle multiple infections. For example, groups of parasites often share similar parts of their host, and these groups are prime candidates for coordinated treatment.

Dr Griffiths, who carried out the research during her PhD in the Department of Animal and Plant Sciences at the University of Sheffield, said: "After studying the fascinating range of hundreds of different infections that can occur in the same person at the same time, we've shown that we could better treat patients if we know what parasites are eating inside our bodies.

"Our web has revealed the ways hundreds of parasites could live together, which means that we can develop new coordinated treatments that help fight more than one infection.
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The central theme of personalized medicine is the premise that an individual’s unique physiologic characteristics play a significant role in both disease vulnerability and in response to specific therapies.

The major goals of personalized medicine are therefore to predict an individual’s susceptibility to developing an illness, achieve accurate diagnosis, and optimize the most efficient and favorable response to treatment. The goal of achieving personalized medicine in psychiatry is a laudable one, because its attainment should be associated with a marked reduction in morbidity and mortality.

In this review, we summarize an illustrative selection of studies that are laying the foundation towards personalizing medicine in major depressive disorder, bipolar disorder, and schizophrenia. In addition, we present emerging applications that are likely to advance personalized medicine in psychiatry, with an emphasis on novel biomarkers and neuroimaging.

Excerpt From the Conclusion:

The prospect of personalized medicine in psychiatry more or less reflects ideals still largely unrealized. Currently, the field is at the information-gathering infancy stage.

The greatest progress can be expected at the intersections of the categories described above, such as gene × environment and genes × biomarkers, which will poise psychiatry to make biological system-based evaluations. Furthermore, some of the emerging applications, including imaging genomics, strengthen our conviction that the future for personalized medicine is highly promising.
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As the number of self-tracking health and fitness tools available to consumers continues to climb, a persistent question has been whether the data they collect might be useful to health researchers. Along with that: Are people who self-track comfortable sharing their data with researchers?
<br/>A new, must-read report from San Diego’s California Institute for Telecommunications and Information Technology (Calit2), funded by the Robert Wood Johnson Foundation, explores these and other questions.
<br/>Based on a survey with hundreds of self-trackers, a majority — 57 percent — said one critical assurance they would need before agreeing to make their self-tracked, personal health data available to researchers was that their privacy would be protected. More than 90 percent also said it was important that their data remained anonymous. Respondents said they’d be more comfortable sharing data if they knew it was only going to be used for “public good” research.
<br/>One open-ended survey that the report’s researchers posed to self-trackers found that 13 percent of respondents specifically mentioned an aversion to commercial or profit-making use of their data, according to the report. One respondent wrote: “It depends who gets it. Research using these data will be instrumental in the future of personal predictive services, but also for that reason are likely to be exploited by marketers and the politically short-sighted. Thus I would like transparency for who has access to my data.”
<br/>Among the almost 100 health researchers interviewed for the report, 46 percent said that they had already used self-tracking data in their research previously. Some 23 percent reported that they had already worked with digital health companies that offer apps or devices to consumers to track their health.
<br/>Overall, the researchers interviewed for the report were “generally enthusiastic” about the prospect of using self-tracking data in the future — 89 percent agreed or strongly agreed that such data would prove useful to their research efforts. Almost all of those researchers surveyed said that kind of data could answer questions that other data could not.
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A protein in the central nervous system could provide a useful tool for diagnosing concussions and allow doctors to assess when it is safe for athletes to return to competition.
<br/><br/>Swedish researchers have found, through examining studies in sporting injuries, that a protein in the central nervous system could provide a tool for diagnosing concussions. They published their results in JAMA Neurology.
<br/><br/>Previous studies have measured changes in the levels of protein biomarkers present in cerebrospinal fluid or blood in athletes who participate in contact sports.
<br/><br/>Certain biomarkers - neuron-specific enolase, S-100 calcium-binding protein B, neurofilament light and total tau (T-tau) - have been shown to increase in boxers, correlating with the number and severity of head blows received. After a rest from boxing, these biomarkers return to normal levels.
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With his Google Glass, Stanford University physician Dr. Homero Rivas pinpoints a target on the skin of an anatomical human model.
The surgeon and his assistant then direct their Glass at the target to reveal an augmented reality display on their screens. To their eyes, looking through the Glass, they can see the procedure illustrated step by step with images superimposed over the skin of the model.

Stanford University live-streamed that demonstration to physicians around the world. It wasn’t a particularly complicated procedure, but it was one of the first times that augmented reality has been introduced to Glassware for the benefit of surgeons.

“You don’t need to go in blind anymore,” said Dr. Rivas in an interview with VentureBeat following the demonstration.
“Now, we have an educated impression of where a mass is. We can better understand exactly where to make an incision so we can create less trauma.”
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Basic Computer Security for Doctors
Computer Viruses are evil. Period... They are the biggest reason why those new to technology don't use more of it. Viruses cause computers to behave sluggishly, randomly and sometimes illegally.
Here we have put together a Simple Presentation about Computer Security and Anti Viruses keeping in mind health professionals. In this presentation we go through Common PC Security Issues and explain what causes them.
We then look at what can one do to Protect their computers. This includes Definitions, Educational Content, Precautionary Steps, Options of Complete Solutions and a Simple tutorial on How to use a popular Free Antivirus.
Please help us with your feedback in the comments section below or email us directly.
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Emails for Improved Doctor Patient Communication
E- Mails are a convenient medium for communicating in today's times.
Slowly they have started being adopted in healthcare and as research shows, the percentage of physicians using emails to communicate with patients has increased gradually over the past 5 years.

A lot of communication between a doctor and patient is best done physically.

Doctors need to see patients in person to accurately gauge the patient's health and determine if a plan of care is being followed or whether changes in care are needed.

But …there are plenty of interactions that don't require face-to-face communication and that can be more effective via email.

The presentation below contains information for clinics, hospitals and doctors to help them use Emails effectively with patients to improve Patient Engagement, Patient Satisfaction and Quality of Care
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