It’s a special, more patriotic version of Grand Rounds this week (now with 50% more love for America!) You’ll also notice if you’re reading this from the actual site a temporary make-over to the classic Over My Med Body layout (click thru, I swear it’s worth it), as I have no particularly clever textual way to present Grand Rounds. ( Here’s the Pre-Rounds article . Thanks Nick!)

I’m proud to bring you The Best of the Medical Blogosphere this week–and what a historic occasion, what with the Vice President declaring he’s not a member of the Executive Branch of government . Call out the hounds! Revamp the textbooks! Huzzah!

Medical patriots that we medbloggers are, we’re here to share our stories and experiences (in order to better our countries, of course), and we’ll break it down by the classic tenets of the Patriotic Medical Blogger (those of course being SiCKO, Insurance and Policy, The Practice of Medicine, Humanity, and Humor). Feel free to listen to the Star Spangled Banner, as performed in 1898 (the former) or 1969 (the latter), depending on your mood.

[audio:http://www.grahamazon.com/etc/ssb.mp3]

SiCKO

• A healthy debate makes for a healthy medical blogosphere, right? The Petri Dish has a good review of SiCKO , and is fairly similar to how I felt about the film myself. Sorry Michael Moore, I have to use the line on you, too: the plural of anecdote is not data.
• Val Jones over at the new-ish Revolution Health explains different countries’ health care systems based on their cultures , and it makes sense–the systems are a result of a society’s shared experience. In another post (sometimes we feel like doing a twofer here at OMMB) she notes that medical systems often devalue the person and the individual –that a patient’s unique circumstances often present them with unfair, unreasonable options. Keep’em coming, Dr. Jones!
• Interesting interview with an RN who founded Medical Tours International from the Health Business Blog. Also touches on SiCKO as well.
• “He takes a very complex problem, the American healthcare system, and presents the idea that it does not work very well. This is not earth shattering news for most Americans.” Lone Coyote, another med student, with an another great review of SiCKO.

Insurance and Policy

• Family history may not be enough for early breast cancer, says Eye on DNA. The problem is that small families may not have ever had the opportunity to present with a BRCA phenotype (a major breast cancer gene) if they are carrying it.
• InsureBlog argues that the government is paying mental health professionals too little to care for our vets returning from active duty. While I’d agree, I’d argue the private plans aren’t a whole lot better: mental health reimbursement stinks all around. (And one less stealth bomber could pay for a lot of therapy, too.)
• Speaking of government, it’s alphabet soup at MSSPNexus blog (no, we’re not talking about the Hepatitis virii, we’re talking about NPPES , of course!) That’s National Philanthropy Protecting Each Seagull. A fascinating organization and incredibly important to health insurance! Errr, wait…
• Chief Experience Officer ? Isn’t that the new position up for grabs at Disneyworld? No, it’s the new job at The Cleveland Clinic, trying to make the hospital stay a more pleasant one. (Totally low blow: First order of business, leave Cleveland, move to California! I kid, I kid!)
• The sky did not fall in New York City, now with an 83% city-wide ban on trans fats , a topic close to my heart (pun intended). Couldn’t agree more with the patriotism analysis.
• I’m in the wrong business, if removing a lipoma nets you 1,800 bucks . Colorado Health Insurance Insider gets an initial estimate of $200-$300. I heart our health care non-system!
• Junkfood Science takes on some of the issues with the British NHS (National Health Service) , recognizing that their system is far from perfect as well. I remind the medical blogging world: NHS Isn’t NHI (ie: The UK isn’t Canada.)
• Dr. Mileikowsky provides us with his thoughts on patient safety, via a small business forum he spoke at . Go watch!
• Best of the best of Teen and Tween Health Resources from Teen Health 411. I love it when medbloggers point out their favorite resources. I feel another blog carnival coming on…

The Practice of Medicine

• Diabetes Mine sums up some big points from the 2007 ADA conference . I was particularly interested by height being a predictor of diabetic neuropathy and that higher co-pays for meds led to higher A1C’s (a marker of long-term sugar control in diabetics): when drugs cost more, patients use less of them!
• You know, the saying in surgery is “You don’t mess with the pancreas,” but the spleen’s not a bad substitute. Sid Schwab of Surgeonsblog explains why .
• Bongi from South Africa tells a story of a gunshot wound and a job that means something . Great story, and seriously, how awesome is it to be reading about surgeons in South Africa? I heart the Internets.
• Beware the bikini wax is a maxim that I’ve really always held personally, but it’s only reaffirmed by Professor Smiths eye-bugging-out report of necrotizing fasciitis in an untreated diabetic . A rare complication? Yeah, sure, but it’s convincing enough for me.
• Health Connects snags an interview with the director of a new HBO documentary called Coma . Looks like a really fascinating movie.
• Healthline sends us another entry by way of The Fitness Fixer, talking about lower back pain, proper use, and right exercise (The Lunge is the new Pink.) I admit I try to lift with my legs, but it just doesn’t show off my butt that well. I figure that accounts for most of the lower back pain in the world.
• Med Journal Watch is stalking me, I swear: I start a Cardiology month this week, and this week’s Grand Rounds post discusses chest pain in women . Hint, it’s not always crushing chest pain. (And remember, high index of suspicion in not only women but diabetics, the elderly, those on steroids… they can often present atypically as well.)
• Another medical mantra I like to follow: Never let go of the guidewire! Clinical Cases tells you new interns what to do if it somehow slips out of your hands.
• Some people think that people are taught to be gay, but I don’t think this is what this practicing psychiatrist meant. I wish we could teach happiness , too! Tip I learned from Kurt Vonnegut’s uncle: Sometimes, when things are particularly nice, just stop what you’re doing and remark aloud: “If this isn’t nice, what is?”
• HydraCoach is a new water bottle that tracks your fluid intake –seems a bit like overkill, but I can see why it might be useful on the football field (and especially in the eyes of a nephrologist!) Personally I like the water restriction for hyponatremia even better.
• Calculating a target weight is a simple and effective way to determine if someone is becoming over- or under-weight. Eating With Your Anorexic makes a good point: 10th percentile on the height-weight curve is normal for some, but not if they started out at the 75th!
• Give me the data or give me death! says GruntDoc, and boy do I agree. In the ED, we’ve often got little to no data to go off of, and when nursing homes–or anyone–takes precious information away that is very relevant to a patient’s chief complaint, you’re doing everyone a disservice. Cut it out.
• Counting Sheep’s pre-take-off flight announcement script rings true , as I’ve just finished two weeks of anesthesia myself. She walks us through the anesthesia process. More milk of amnesia, please!
• Really interesting bit from Six Until Me about installing a glucose monitor into her belly (one because I didn’t have a clue how one inserted it and two I didn’t know they even existed as such). I’m predicting it’s the next addition for the iPhone 2.0.
• I hate to discriminate, but eating Brazil nuts just got added to my list of dealbreakers. Thanks for the warning, Allergy Notes . (How they knew it was the boyfriend’s semen and not his saliva is beyond me.) File that right up there with anal wart researcher for science’s worst job.
• NY Emergency Medicine blog has put together a fun visual diagnosis quiz , with a $5 prize! Great way to get new readers, I’ll say!
• ERNursey is spot-on : thank your EMS crews–if you’ve never done a ride along, you don’t know what they go through on a daily basis!
• Fellow San Franciscan Kim writes about her visit to the plastified posing dead people –sometimes I forget that nurses, many of which know a ton more than me–never took anatomy and saw everything up close!
• Medical-ese strikes again: this time, a patient tries to decode the language , only to get shot down by the EKG techs and docs. Those of us in the healthcare profession don’t even realize how we’re making our patients feel.
• Speaking of patients’ feelings, Laurie discusses how public her disease became and how it made her feel incredibly embarrassed. Mean people suck.
• If I can just memorize Dr. Trofatter’s recent post on Hypertensive Disorders of Pregnancy over at Fruit of the Womb (loving the pun, by the way), I will certainly rock my Ob-Gyn month. It’s a little more pre-clinical and molecular for my small non-researchy brain, but I’m sure my MD/PhD friends can explain it to me.

Humanity

• Dreaming Again tells a touching story about living with and caring for those with polio.
• Serenity’s Tide writes about t he experience and feelings of seeing a cadaver , wondering who the people were during their lives.
• Caring for those with chronic illness is a fantastic post that delves into the social issues that physicians often don’t realize or consider. The illness is often a burden not just to the patient but to the entire family.
• My Stanford colleague (if I may be so tree-hugging progressive and West Coast to call him that) Dr. Paul Auerbach, Wilderness and Emergency Medicine guru, tells about the power of education and the freedoms we often take for granted in our own country by recounting the story of Three Cups of Tea about a man who decides to build schools and improve education in Pakistan. Luckily I see there’s a book on tape version.

Humor

• Boy have I been where Vitus Medicinus is, comparing Jail to Med School (Why oh why did I do this to myself?) I promise it gets better–and then worse again! No, really.

Thanks to everyone that submitted, have a great, safe, fun 4th of July–I just found out I have the day off! (And sorry, no idea who’s hosting Grand Rounds next.) Update: Aetiology is hosting next week!

20 Comments »