Tuesday, March 16, 2010

Grand Rounds Vol 6 No 25

Welcome to Grand Rounds Vol 6 No 25. Grand Rounds is a weekly summary of the best health blog posts on the Internet. I wish to also extend a special thanks to those medical bloggers who are participating in Grand Rounds for the first time. This week, we had many submissions, so let's get started.

Glenn from EHR Bloggers asks the question, "Should the FDA Regulate EHR Safety?" As physicians switch from paper charting systems to electronic systems, are they likely to make certain mistakes? Perhaps the FDA should get involved with the safety issues surrounding the use of EHRs.  Rita from Supporting Safer Healthcare writes about risk management. Physicians and Risk Managers may differ on their approach to medical error disclosure, but in general, their goals are closely aligned. Maybe the use of health IT will reduce medical errors and improve how we report errors.  David from HealthBlawg blogs about how John Glaser, CIO of Partners Health Care, speaks with David Harlow about health IT and meaningful use in a $7.9 billion health system.

Vinny from FutureDocs asks the provocative question, "Is the Future of Residency Training Like Avatar?" If you've never watched the movie or if you haven't gone through residency, then it may be a bit difficult to really answer this question. With Match Day approaching, everyone is thinking about residency.

The ACP Hospitalist blogs about the obvious. You might already be aware of this week's finding if you've watched baseball in the past decade or so and noticed that Mark McGwire's arms are about the circumference of the average ballplayer's waist in the 70s. But just to be sure, researchers recently compared the BMIs of professional baseball players from 1876 to 2007 to find that, like serving sizes and master bathrooms, they've gotten bigger.  The ACP Internist writes that health care is bizarre. I agree. Anyone who spends significant time in its ranks will attest to the many quirky and downright ludicrous things that go on all the time. But I am not sure people realize just how strange our system is. Perhaps it would be interesting to see what it would be like if other parts of our lives were like health care. Meanwhile, Joel from Precious Bodily Fluids shares his perspectives about the risks and benefits associated with Kayexalate (Sodium Polystyrene). Trust me, you don't want to be assigned to bedpan duty after a patient takes a ton of Kayexalate. 

Nancy from Teen Health 411 writes about the importance of communicating clearly with teens when talking about sex. Simply asking, “have you had sex” is not sufficient since many teens don’t consider other forms of sex to be sex.  On a related note, the Happy Hospitalist asks the question: when do men stop thinking about sex? Do they ever stop? Not according to the BMJ.  Jacqueline from Laika's MedLibLog writes about sugar-sweetened beverages and other drinks like Diet Coke by reviewing some of the clinical data associated with these types of drinks. Do you know how much sugar is in a can of soda? (you probably don't really want to know).

At the HealthAGEnda, you'll read a post written by Chris Langston, Program Director of the John A. Hartford Foundation. The post explores shortcomings of Medicare’s fee schedule and how it impacts the quality of care older adults receive.  Speaking of Medicare, let's look at some other perspectives on health insurance.  Don't miss Louise from the Colorado Health Insurance Insider. Perhaps the question we should be asking is not who should be paying for healthcare, but rather, why in the world are we paying so much in the first place?  Health insurance premiums will continue to rise as long as health care costs do the same.  It won’t do any good to try to address premiums without first figuring out why we’re paying so much for our health care in the first place, and doing something about it.

Ramona from Suture for a Living writes about a recent study published by Stacy A. Rudnicki, MD from UAMS (we went to the same medical school) and it's about preventing peripheral neuropathy in patients who undergo gastric bypass. Now how do we supplement all those vitamins and minerals?  Chris from Life in the Fast Lane blogs about strange smells from the autopsy lab. He describes how one of his teachers taught him to maintain equanimity in the face of a horrendous stench, and has links to Michelle Lin's 'Tricks of the Trade' for those who did not receive such training.

Patrice on GeriPal blogs about the importance of clear communication when you're speaking with a group of health care professionals who work in palliative care. Stop Using the Words ‘Terminal’, ‘Dying’, ‘Hospice’, ‘Advance Directives’ and ‘Bereavement.’  Lyle on Pallimed writes about implantable cardiac defibrillators (ICDs) in dying patients. If you're working in a hospice setting and your dying patient has an ICD, do you know what to do? 10 engaged comments, linked to by Dr Wes (EP doc) reviews a study showing about hospice who have had patients shocked with ICD's and how the conversations happen around deactivating ICD's. Speaking of death, John from GlassHospital writes about working in a hospital and dealing with death.  So many people die in hospitals. Is that where you hope to die? Of, would you rather die at home?

Mary from Dr.J's HouseCalls writes about how the Anti-SLAPP Suit Legislation Is In The Works. What's a SLAPP suit? A SLAPP suit is a "Strategic Lawsuit Against Public Participation."  To read more, make sure to visit her blog.  Paul from Medicine for the Outdoors blogs about Raynaud's phenomenon and altitude. What would happen if someone with Raynaud's phenomenon goes out to climb really high mountains? Does that high altitude affect the RP?

Ves at  Allergy Notes writes about allergies and living on a farm. Have you ever been to a farm? How do you think parental allergen sensitization is reflected in utero? At the gene expression level.  Ves also blogs at Clinical Cases where he writes about the health effects of salt and smoking. Cutting back on salt reduces heart attacks. Smoking cessation also reduces heart attacks. How do they compare?

Steve from The EMT Spot writes about the passion associated with any career. Do you have passion about your work? Passion is essential if you're working in health care. Otherwise, you could experience burnout very quickly.

Next week, Ramona from Suture for a Living will be hosting Grand Rounds Vol 6 No 26.


  1. Nicely done! And I love health IT up at the top. Also, it was great meeting you at HIMSS a few weeks ago.

  2. Thanks. I take Happy's Happy and raise him a Happy.

    Before you ever consider blowing a whistle, it would behove you to read my post about getting "SLAPPed". Many people have the naive asumption that if they do the right thing everything will fall into place and they will be protected. More often than not the reverse is true.

    There's a lot that needs to be reformed that the reformers aren't even touching.

  3. Great work mate and thanks for including the 'Smell from Hell'. Since hosting SurgeXperiences I have even greater respect and appreciation for the time and effort that goes into making a blog carnival. Well done.

  4. Rob Lamberts ("The ACP Internist writes that health care is bizarre.") has written a followup piece on his blog, Musings of a Distractible Mind (http://distractible.org/2010/03/14/what-if-life-were-like-healthcare-part-2/). Both posts are simultaneously thought-provoking and smile-inspiring.