• KevinMD and now the usually sensible Shadowfax continue to be wrong on teaching the business of medicine. (Don’t get my wrong, I completely agree these things should be taught, but it makes absolutely no sense to have the primary teaching be in med school.) Teaching it to pre-clinical students certainly makes no sense, they’re busy learning everything for Step 1. Teaching it to clinical students isn’t all that practical, as most are preparing for residency applications and wrapping up med school. (And my main point here: if you don’t use knowledge, you lose it. When will anyone but a senior resident be doing any sort of billing or admin stuff? You think an intern is going to retain knowledge of CPT codes? Perhaps if they’re in a continuity clinic or something–but then that’s something they should be learning on the job, in the clinic. Again, every single EM residency program I’ve seen so far has 2 weeks set aside for “Administration” in the final year, but honestly, if you all think it’s so important, residency programs could certainly find time for it. You could have it coupled with two weeks of X to make a 4 week block; you could have a morning lecture series for all the residents, or dedicate one noon conference every month or something to the topic. Med students are so far removed (remember, we’re not even DOCTORS yet)–what’s the point of filling our head with information that will just be quickly forgotten when it’s much more important for us to remember the possible side effects of ACE inhibitors we’re about to be pimped on?
• Beautiful irises (irides?) from this artist. Of note, no Kayser-Fleischer rings appreciated (see photo).
  
• Insurance does matter for cancer prevention , as Matthew runs through a recent study: “For all cancer sites combined, patients who were uninsured were 1.6 times as likely to die in five years as those with private insurance.” This is sadly one of those “duh” studies that has to be done anyway, because of well-insured, financially-secure naysayers who somehow believe their situations are no different from people without insurance.
• Ignore those calorie burning meters at the gym. There’s almost nothing more inaccurate in the fitness/weight-loss/exercise world. I’d previously heard the eliptical machines overestimate by 20%, but this article claims they’re just plain wrong. Break a sweat (after approval from your doctor, Mr. Quintuple Bypass with Chest Pain at Rest), and exert more than you take in. 1 pound = 3500 Calories. 500 less Calories a day = 1 pound of weight loss a week. Slow and steady wins the race.
• And finally… Google Talk introduces instant translation in IM conversations . This would be pretty awesome in medicine, if we ever chatted with patients. (Damn you, HIPAA!) The translation is actually pretty good, at least for Spanish. Your pretty typical conversation in the Emergency Department:
  

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(Had to post it. I’m a huge Beatles fan.)

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Earlier this year, one of our colleagues from Spain wrote to the New England Journal describing Acute Wiiitis after playing too much of the Nintendo Wii. I couldn’t remember the actual syndrome or muscle strain, but after having played the Wii for a couple days myself, I thought it must have something the do with the wrist, because my extensor carpi radialis longus tendon (or maybe extensor pollicis brevis ) was killing me.

Then today at the gym stretching, my shoulder was killing me, too. I thought I slept on it wrong or something–but no, it’s just classic acute Wiiitis, as described in the NEJM. Patte’s test positive and all. (Side note: this is a great shoulder examination guide , and this whole Orthoteers site seems like a pretty great orthopod resource, too.)

So no Wii for Mii for a wee bit. (See also: Wii Have a Problem for non-medical Wii problems.)

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Trying out a new feature here at Over My Med Body. Short little commentaries on links, a la KevinMD , as there’s tons of great blog posts and health policy news, and so little time to discuss them! (Also, this will be more productive than watching The People’s Court and Montel.)

• Dr. Wes pimps med students interviewing for residency on billing codes , and Kevin (I hope jokingly) says med students should have to get an MBA before starting med school. How silly. The point of med school (which most of the commenters point out) is to give you a foundation of knowledge to learn how to practice medicine, get exposed to all the medical specialties, and prepare you for internship. It’s residency that should be teaching doctors about how to be an attending. (All the residency programs I’ve seen so far have a specific “Administration” component to them where you learn about billing and getting paid.) Wes says med students “are woefully unprepared to enter the big wide world of medicine,” but if there’s some way to enter medicine without doing a residency, I missed that day in class.
• Via KevinMD, this great quote about the two sides of medicine we’re trying to turn into one: “Today, we are in between two images of the doctor. One image is the heroic personal savior, who uses his own experience and intimate knowledge of the patient to make the best decisions. The other image is the trained technician, who gathers data, feeds it into a decision tree, and implements that recommended course of action.” Totally agree. The best is the caring, experienced doctor who knows the data, when to use it–and when not to.
• College is not the time that many young women want to get pregnant, but Congress isn’t making that any easier , closing a provision that allowed drug companies to sell cheap birth control to student health centers. A monthly supply used to be $3-$10, now it’s $30-$50. Some members of Congress are aware of the issue, but can’t get it fixed, since birth control pills are so closely tied to abortion (that’s sarcasm). It’s amazing to me that tiny little oversights can have such huge impacts on people’s lives.
• Mitt Romney is taking heat for a Planned Parenthood fundraiser photo from years ago. People say this doesn’t go along with his views on abortion. But as we all know, esteemed readers, Planned Parenthood probably prevents more abortions a year than it performs .
• Speaking of bad daytime television, I saw this quack tell a poor woman suffering from pretty classic hypnopompic sleep paralysis that she was just doing “astral projection.” The poor lady was scared out of her mind, thinking the devil was visiting her.
• This pilot program at UCLA sounds pretty awesome –bilingual docs who train in Spanish-speaking countries get help preparing for US board exams in exchange for 3 years working in under-served areas in California. More surprising in the article is the claim that only 8 of the 27 family medicine residents at the highlighted residency speak Spanish. (I’d imagine all of them can at least speak basic Spanish.) But I agree–there are certainly nuances that you lose only speaking basic Spanish, and cultural nuances that affect what a person is saying.

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(If you’re squeamish, this isn’t the post for you.) There’s a total RIBBFOMP story and photo over at White Coat Rants , hand versus snowblower. If you’ve always wondered what the tendons look like that allow your fingers to flex and extend, but never wanted to take the anatomy class, there’s a perfect specimen in the post. Wow.

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Beware the rhododendron! (That’s the flower seen here.) There’s an interesting case report in the American Journal of Emergency Medicine from Turkey describing a man with NSTEMI (EKG changes and the release of a chemical in the blood indicating heart injury) after eating mad honey, which is apparently honey made from the pollen of some species of flowers, especially the rhododendron. These flowers’ pollen contain grayanotoxin, a class of chemicals that block repolarization of excitable cell membranes (nerve and muscle). Symptoms seem to be pretty cholinergic–diarrhea, nausea, vomiting, sweating– according to this review article in Food and Chemical Toxicology .

Interestingly it appears that mad honey is attributed with destroying more than a few armies in ancient history .

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Great Op-Ed from David Himmelstein and Steffie Woolhandler in the NYT about single-payer and employer mandates. The latter have been tried many times in many forms, and they still are failing.

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For the guy or gal who has everything comes the “eTime Home Endoscope.” Nope, not kidding. The BoingBoing review: “Disgustingly Effective.”

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My friend, classmate, and rockstar Cheri Blauwet has a blog now! Go read!

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