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db's Medical Rants



Internal medicine, American health care, and especially medical education



Last Build Date: Mon, 16 Oct 2017 00:19:14 +0000

 



Tips for IM ward attendings – Chapter 19 – the attending as coach #meded

Mon, 16 Oct 2017 00:19:14 +0000

Today I have been listening to a podcast featuring a boxer.  This boxer discusses coaching and its importance. Anyone who has competed in a sport can relate to the importance of accurate coaching.  Coaching requires immediate feedback, both positive and negative.  The feedback works best when you receive it immediately after you perform. What do […]



The adverse consequences of premature diagnosis

Tue, 10 Oct 2017 11:35:14 +0000

I have spent 3 days at the Society to Improve Diagnosis in Medicine.  Whenever I come to this meeting, I have insights from listening to talks and many conversations with leaders in the field. When one considers diagnostic errors, one must consider two important factors – physician factors and system factors.  We have a major […]



Recognizing the wonderful clinician educators

Mon, 09 Oct 2017 12:11:38 +0000

When asked to describe my career, I consider myself primarily a clinician educator.  Recently I have reflected on the influences that allowed me to have a successful career doing what I love.  This post is not meant to mention all those influencers, but just some that I recall often.  As I have thought about this […]



The responsibility to prioritize

Fri, 29 Sep 2017 00:31:44 +0000

Each day when we work with patients, we prioritize their concerns, their diseases, and their economic situation.  Our patients often have great complexity and we cannot address every problem during at one time.  We must prioritize their problems and address the most urgent, perhaps spending less energy on the least urgent. But who determines urgency; […]



Exercise, a purpose statement

Tue, 19 Sep 2017 20:14:11 +0000

Regular readers know of my exercise addiction.  As a 68-year-old man, what drives me to improve my cardiovascular and strength conditioning?  An interesting running podcast, Rogue Running, poses a challenge for runners that they train.  Write down your statement of purpose for running.  The trainers argue that until you commit to your purpose, then your […]



Ban the term productivity from medical care

Mon, 18 Sep 2017 16:37:09 +0000

According to Wikepedia: Productivity describes various measures of the efficiency of production. A productivity measure is expressed as the ratio of output to inputs used in a production process, i.e. output per unit of input. Productivity is a crucial factor in production performance of firms and nations. Please tell me how this relates to being […]



Rekindling the Joy of Medicine – thoughts after Dr. Kelley Skeff’s Grand Rounds

Thu, 14 Sep 2017 14:53:52 +0000

Yesterday, we had the treat of hosting Dr. Kelley Skeff for our 7th Research and Innovation in Medical Education Week at UAB.  He gave a brilliant Grand Rounds that I hope everyone will get a chance to hear.  He talked about the Joy of Medicine and the threats to that Joy. Readers of this blog […]



Where did diagnosis education go, and why?

Tue, 12 Sep 2017 13:52:38 +0000

As I wrote recently, We must once again make the term diagnostician the most prestigious term in medicine.  We should celebrate the great diagnosticians for they truly help patients. While we were not looking, diagnosis became a second class citizen.  This article in the Annals of Internal Medicine echoes many blog posts – Diagnostic Reasoning: […]



2 years of Orange Theory Fitness – impacts and lessons learned

Sun, 03 Sep 2017 11:13:20 +0000

2 years ago this weekend, my wonderful daughter asked me to check out OTF with her.  She had started going ot OTF in her home town, and was visiting for Labor Day Weekend.  At the time I was running, had already lost almost 40 pounds, but was doing minimal variety in my workouts. I like […]



Patients need more time with their physicians; Physicians need more time with their patients

Wed, 30 Aug 2017 14:04:33 +0000

One of my favorite songs of the 60s, Does Anyone Really Know what Time it is?, and the song has a great line “Does anyone really care?” Both patients and physicians really care.  My friends, neither physicians nor my patients, often tell me stories about brief visits.  Occasionally I hear praise about a physician who […]