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Corey Heitz
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Twitter poll for the #SGEMHOP episode, active today only!

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Chromebook Pixel gets an awful review. And by that, I mean the article, not the Chromebook.

#ifihadglass , I would be able to show my medical student and physician learners exactly what I’m seeing and doing while providing patient care and performing procedures (and vice versa), allowing for more accurate feedback and instruction. Try teaching endotracheal intubation without seeing what the learner is doing. 

Here's one for the collective: 73 year old male with umpteen medical problems (what? It's a number...) include chronic renal insufficiency, CHF, peripheral vascular disease, TIAs presents altered and hyperventilating (RR ~40-45). Nothing else focal on exam, lungs clear. SpO2 mid-90s on RA (despite the fact that he needs 4L O2 at baseline?)

ABG: pH 7.739, pCO2 24.1, pO2 85, BE 13, HCO3 32.6.

Thoughts on this gas? I've never seen a pH that high...

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oh. wow.

I feel the need to publicly respond. +abcnews are you paying attention?

1) "have your doctor spend 15minutes explaining..." AND you'll be booking yourself 2 appointments, because most primary care bookings are 10 min.
2) I try on a regular basis to explain why colds and sinus infections don't need antibiotics. And on a regular basis, I get skeptical looks from my patients, or the response "well it always gets better if I take a zpak..." (hint: colds last a few days, zpaks are 5 days long...cause and effect or coincidence?) Maybe YOU should take 15 minutes learning and 5 minutes listening instead of telling the doctor what you "need."
3) "...up to $5000 for enrolling patients in clinical trials." Probably pretty rare. Most day to day docs aren't getting huge kickbacks, if any, for enrolling patients. If they're affiliated with an academic center, chances are they CAN'T.
5) clinical trials, once they're moved to the real patient stage, are anything but crapshoots. Ask which phase the trial is in and find out what the different phases are.
6) I do agree that drug makers taking doctors to expensive dinners is a problem. So is drug advertising on television. Generics don't have those resources, but before you argue "they shouldn't be allowed", think about how you feel about government "intrusion". If you're a fan of regulation, great...they shouldn't be allowed. If you're a fan of small government and market capitalism, well...who's supposed to stop them?
7) "in many doctors value systems, surgery is the default..." In many SURGEONS' value systems, surgery is the default. In some conditions mentioned, if the patient is having problems, surgery can be curative and prevents serious complications (hernias).

Oh and as for the first point, about "hiding" costs? Many, I hesitate to say most, doctors don't know what your copays are going to be (their front desk staff might, or maybe the pharmacy), how much you'll pay out of pocket, etc. A lot of that is very insurance company-dependent.

I realize this may come across as somewhat cynical and crusty, but the article was quite one-sided. I present some of the other sides. I in general believe that patients should take more responsibility and learn about their conditions their costs etc so they can save money and be more involved and informed. But to say "doctors are hiding things" is quite alarmist.

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Oh my! Adele!

Her voice is simply exquisite, damn this lady has pure, undeniable raw talent.

Enjoy these three wonderful songs and you will remember why music soothes the soul.

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