Latest Posts

Press Ganey and HealthGrades.com Are Medicine’s Fake News

Whether you agree with the Trump administration assertions about “fake news” or not, the term has gained legs and has at least put the American public on notice that you can’t trust everything that you read in the media or on the internet. Fake News Definition As the term “fake news” has become more commonplace, it remains loosely defined, often being used as a blanket pejorative against information that counters the interests of those using the term. This article from the Daily ...

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Healthcare Update — 02-10-2017

So I hadn’t planned to continue doing Healthcare Updates, but there are always so many interesting healthcare-related articles that I can’t stay away. To wit … For women, it’s the birth control pill. For men, it may soon be a shot to the nuts. Literally. Researchers showed that an injection of Vasalgel into the vas deferens (the pathway leading out of the testicles) could temporarily block the flow of sperm and effectively sterilize monkeys. Other studies in rabbits showed that the ...

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Redefining the Pain Scale

The smiley faces just don’t seem to cut it any more. The Wong Baker pain scale was originally created for children. Now it is used by medical providers to precisely gauge pain in adults all over the United States because of the concept pushed on medical providers that “Pain is the Fifth Vital Sign.” Although this phrase was originally created by the Department of Veterans Affairs, The Joint Commission adopted it and ran with it, rolling out Pain Management Standards declaring in ...

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Patient Encounters

More Patient Satisfaction Ridiculousness

Dr. Whitecoat refused to remove something that was hurting my ear. He was rude, insensitive, and refused to help me with my medical problem. I would never come back to your hospital if I knew he was working. That little diatribe was in addition to all of the “1” scores that the patient used to rate my care. Of course, none of them were true, but satisfaction scores are a presumption of guilt, not a presumption of innocence. What did I do ...

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What’s the Diagnosis #21?

A patient presented for evaluation of dyspnea. Her trouble breathing had been going on for a few days and kept getting worse. No coughing. No fevers. No other symptoms. No medical history. She smoked a couple packs of cigarettes per week. Her physical exam was entirely normal. Lungs were clear. Heart sounds normal. Labs (including CBC, CMP, d-dimer, and cardiac enzymes) and chest x-ray normal. EKG normal. Intermittently, her pulse oximeter readings would dip down into the low 80s. Then ...

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The Bloody Knife

Patients seeking refills for chronic pain prescriptions are finding that those requests are being rejected more and more often by emergency departments. Due to the increasing incidence of drug diversion and doctor shopping, many hospitals are developing policies that limit or even prohibit prescription of controlled substances for chronic medical problems. But every time that people build a better mousetrap, Mother Nature builds a better mouse. Patients know that they won’t get prescriptions for chronic pain, so they often come ...

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An Amazing Little Girl

By Birdstrike M.D.   Off I go to work a few shifts at a desperately understaffed rural hospital in a state far away.  The rental car GPS leads me to the ED address and it’s not there.  All that is there is what looks like a small supermarket with a funeral home next door.  I see a security guard in the parking lot.  He has a lump in his cheek and a badge that says “Sam.”  I pull into the supermarket parking ...

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