In case you haven’t noticed, it’s cold and flu season again in this neck of the woods and this may have you wondering if an antibiotic might be the solution for whatever is ailing you.

Well, Dr. Rob Lamberts, pediatrician, internist and author of the ever popular medblog, Musings of a Distractible Mind has decided to weigh in on the subject in his latest post, Common myths about infections and antibiotics…

Much attention has been given to the fact that antibiotics are given too often. The reason for this concern is that the overuse of antibiotics can create resistance in the bacteria a person carries, making it much harder to treat serious infections in the future.

For that reason, the physicians in our practice are trying to avoid using antibiotics unless they are necessary. The problem is that many patients come to the office already convinced that their infection requires an antibiotic and so will not be satisfied unless they get one. This puts our staff in a difficult position, as we want to practice good medicine, but also strive keep our patients happy.

Dr Rob then goes on to compile a list of common misconceptions about when antibiotics are appropriate. Here are a couple examples…

Sinus pain means you need antibiotics

Dr Rob explains…

Sinus pain is caused by a difference in pressure between the inside of the sinuses and the outside world. This is usually caused by thick mucous, and not necessarily infection. Decongestants can help with this (although they may not be appropriate with certain heart conditions and hypertension), as can salt water spray in the nose. The pain is best treated with acetaminophen (Tylenol, etc), or ibuprofen (Advil, etc.).

“The last time I had this I needed antibiotics, so I wanted to catch it early this time.”

The straight scoop…

Most infections that do require antibiotics start with a virus infection and then turn into bacterial infection for which antibiotics are appropriate. To treat an infection “early” means that you would treat it when it does not yet need antibiotics. This is exactly what can cause resistant bacteria. If your symptoms are that of a virus, then antibiotics are a bad choice.

And the list continues with equally good information and advice.

Naturally, I’m tempted to just reprint Dr. Rob’s entire post, but then I’d be denying you the fun of discovering his blog for yourself. If you’re like most folks, you’ll want to bookmark his homepage (or add it to your list of RSS feeds) so you can keep up with every installment.

That is unless you’re afraid of llamas.

***************

I knew there was a nursing shortage in this country, but here’s something I didn’t know…

Kim at Emergiblog wrote in her latest post, A Notice for the POTUS:

Oh, there is no dearth of potential nurses in the United States. There are so many applicants that nursing students are often chosen by lottery and many wait years to get into a program.

There is not enough space in our current nursing programs, because there aren’t enough nursing educators.

On the one hand, it is comforting to know that there are still young people seeking to enter this most noble of professions. I was under the impression that the lack of nurses was due solely to the fact that it is a difficult and challenging job… both physically and emotionally… and that not enough people were willing to go that route. I didn’t realize that the real problem was one of logistics.

(Oops, just got interrupted by a phone call and now I can’t remember what I was going to write next.) Oh well, suffice it to say…

Let’s hope that the powers that be will heed Kim’s message and take the necessary steps to attract more qualified nursing instructors to help fill this void.

All for now,
Dean

***********

If you’ve been reading this blog on a regular basis, you already know that I’m a big fan of the blog, Dr. Val and the Voice of Reason. Well, long story short, she was on vacation a couple of weeks ago in California and while there took the opportunity to enjoy a nice massage.

She relates the experience in her post entitled, Conversations at the Spa. (While you read this, keep in mind that she is a medical doctor.)

Those of you with healthcare backgrounds may especially appreciate this dialog:

Therapist (scrutinizing my back as I’m face down on a table): have you seen a chiropractor recently?

Dr. Val: Um, no. Why?

Therapist: Well, two of your ribs are out.

Dr. Val: They’re ‘out?’ Where did they go?

Therapist: A chiropractor can put them back for you so your muscles won’t pull in the wrong direction.

Dr. Val: Will a chiropractor be able to fix this permanently?

Therapist: No, you’ll have to keep going.

Are you starting to get the drift? Well, it only gets better. Here’s another little sample:

Therapist: I’m using my elbows to stimulate repair cells.

Dr. Val: Ahum…

Therapist: You have lactic acid build up in your shoulders so we have to flush the toxins out with special oils. You should also drink a lot of water.

Dr. Val: What sort of toxins?

Therapist: Like, dirt and metals and stuff that you’ve been exposed to.

[Snip]

Dr. Val: How do I know how many toxins I have in my body?

Therapist: Well, your shoulders are really tight and your ribs are out so I think you probably have a lot. You’ll need a lot of massage and you need to see a chiropractor. The oils I used on you will have a calming effect, though. You’ll probably sleep really well tonight.

Dr. Val: I see (inhaling, exhaling). I hope I do.

Yikes! Makes you wonder where massage therapists get their education.

Be sure to head over and read the whole post. It’s a stitch. And be sure to check out the rest of Dr. Val’s blog. She always has lots of good information for health conscious consumers.

– Dean

**************

Well, it’s Back-to-School time and you know what that means. Summer vacation is over and all the little kiddos (and Medical Students) are headed back to the grind.

But don’t let the theme fool you; you’re going to want to check this edition out even if you aren’t headed back to class.

If you like watching ER you’ll love reading The Surgeon’s Blog. It’s fast paced, intense, dramatic, thoughtful, on the edge of gut-wrenching, funny… I’m running out of adjectives.

For sheer speed, you cut between the ribs and then, at the end near the sternum, where cartilage takes the place of bone, you turn the knife northward and chunk through a few of those soft ends. It makes an ugly, L-shaped scar, but it’s quick, and you can reach in as if through a trapdoor. It eliminates the need for finding, opening, inserting, and cranking a rib-spreader, breaking a couple of ribs in the process.

[snip]

…to get blood circulating you hold that heart and work it, even as it’s still beating. And you can feel the engorgement, the ventricles filling more of your hand, the more powerful squirt in response to your grasp as the blood volume is restored. Carefully, with hope, you can begin to relax your grip, keeping your hand near, sensing the more effective beats; and finally, extract your hand from the chest, while realizing for the first time how awkwardly it’s been bent, reaching in from the side of the patient, through a small, tight, and bony hole. As circulation returns to the patient (at least his upper body!), so it does to your hand.

[snip]

It’s not over. Even with the aorta clamped, opening the belly releases the bled blood, and it gushes out under pressure as the belly deflates.

Like I said, this one will keep you on the edge of your seat. Very entertaining. Often funny. You’re going to like Dr. Sid Schwab’s writing style.

He’s definitely one of my new favorites.

While you’re there, be sure to leave a comment to let Dr. Schwab know you stopped by.

- Dean

*****************

Grand Rounds is up at Vitum Medicinus and as usual there are some very interesting posts for medblog enthusiasts including one from yours truly. Yes, this is my first submission to the medblog carnival and I consider it quite a privilege to have my post listed alongside such an illustrious collection of talented bloggers.

Be sure to check it out… just don’t tell ‘em I’m not a doctor.
(They let you in?)
(Yeah… go figure.)

**************

There is little question that medicine in America has its problems. Pick up any newspaper or turn on any television newscast and there’s sure to be a story focused on the healthcare industry.

The purpose of this post is not to rehash those problems. The purpose of this post is to point you to an article by Panda Bear, MD that I believe you’ll find interesting. He titled his post, Socialized Medicine: Survival of the Fittest. Here are a few select passages:

(My mother, who is an avid reader of my blog, is a native of Greece and while a fierce partisan of that country is never-the-less perplexed at the love so many of my readers have for socialized medicine of the kind which is the rule of life over there. I offer this brief description of a typical socialized system in a modern European country.-PB)

[snip]

The public hospitals are so understaffed that you need to pay extra to secure the services of a trained nurse who will watch over you or your relative while the low-paid government nurses do whatever it is they do for their small salary, a salary which is just enough to convince them to come to work but not enough to actually get them to do anything.

[snip]

In Greece on the other hand, enjoying as it does the bounty of socialized medicine, there is a three tiered system. In the first tier are the private hospitals which are the equal of anything we have in the United States. Unlike our hospitals however, they are in no way charity institutions and only cater to the wealthy. In the second tier is the public hospital system where those who can afford it bribe doctors and nurses and even hire maids to clean their relative’s otherwise filthy rooms. In the third and bottom tier are the poor who lay in cots in the hallways of the crowded public hospitals relying on their relatives for the basics of life and nursing care.

Following a firestorm of comments both pro and con to his initial posting Panda offered the following equally controversial second post:

See, you folks don’t get it. If all you expect the government to provide is crappy and relatively inexpensive primary care and would be content to eschew the expensive, admittedly low-yield technological and labor intensive medical care that we currently waste on the elderly, the terminally ill, and those with extremely complicated health problems like they do in most of the Socialist Freeloader Kingdoms… if this is what you want then why do you need the government to provide medical care? After all, in the big scheme of things a visit to your family doctor two or three times a year is not going to bankrupt the large majority of Americans. Surely even most of my poor patients could but give up their cell phones and instantly have the wherewithal to afford to take their children to a pediatrician now and then.

Needless to say, Panda’s articles have stirred up a hornet’s nest of controversy and debate.

But what do you think?

Do you feel that the answer lies in a national healthcare system? Should we scrap the present system and switch to socialized medicine? Or should we work to improve the system already in place?

Head on over to Panda’s blog and let us know your opinion.

***

So okay, it’s time to tell you about another great medical blog.

(Oh, goody.)
(What?)
(Nothing.)
(No, I wanna know. What’s your problem?)
(It’s nothing. Really. I’m thrilled.)
*
*
(Just sit there.)
(Fine.)

This one is called Dr. Val and the Voice of Reason. And yes, you’ve heard me mention her before. Dr. Val graciously hosted “Grand Rounds” last week, which is how I found her.

(That her picture?)
(Yes.)
(She’s cute.)
(This is really not the…)
(Kinda looks like Courtney Thorne Smith.)
(Yes.)
(I like Courtney Thorne Smith.)
(Everyone likes…)
(They could be sister’s.)
(I wouldn’t know about that.)
(I’m just saying.)
(Do you mind?)
(Sorry.)

It’s also one of the reasons it took me a while to get through last weeks’ submissions. I got distracted reading her blog.

(Not to mention, you’re a slow reader.)
(Yes, there’s that.)
(So, what’s so great about this one.)
(If you’ll shut-up, I’ll tell everyone.)
(Fine… proceed.)

What’s great about Dr. Val’s blog is that her posts cover a broad range of good general health topics. She’s smart, engaging and knows how to communicate to a diverse audience. In other words, most of her posts are written with the average consumer in mind. She doesn’t use a lot of technical jargon or talk over your head. And hey… she even draws her own cartoons.

(Is that one of hers.)
(Yes.)
(That’s funny.)
(Yes, it is.)
(The mouse is playing dead.)
(Yeah, I get it.)
*
*
(Is there more?)
(Yes.)
(Well… we’re listening.)
*
(You promise to just sit there?)
(Fine.)
*
*

Dr. Val is a licensed practitioner of Rehabilitation Medicine (a topic near and dear to my heart) and Senior Medical Director of the brand new “Revolution Health” web site… and that’s only the beginning of her long and eclectic resume.

(Do tell.)
(I will.)

Turns out she’s been a protestant minister, NYC bartender, bank spy, food critic,

(Wait a minute… did you say “Bank spy?”)
(Yes?)
(What’s a bank spy?)
(I have no idea.)
(Did she spy on banks, or…)
(I don’t know, it doesn’t say.)
(Okay… Sorry.)
*
*
(Can I continue?)
(Sure.)
*
*

… doctor, cartoonist, computer sales associate, yogurt mogul, nanny,

(Wait a minute… did you say, “Yogurt mogul?”)
(Yes.)
(What’s a…)
(Can we just get through this?)
(Sure. Sure.)
*
*

… motivational speaker, biophysics researcher,

(Was she the white spy or the black spy?)
*
*
*
(I’m just asking?)
*
*
*

… graphic designer and revolutionary medical director.

(Revolutionary?)
(That’s what it says.)
(What’s a…)
(I don’t know.)
*
*
*
(You could’ve asked.)
(Well, I didn’t.)
*
*
*
(I’m just saying.)
(Shut-up.)
*
*
*
*
*
(She is cute.)
(Yeah, we got that.)

***

I ran across an interesting item today entitled, Alarm Bells on the med blog, Reflections by Dr. Bruce Campbell. The original intent of the article was to encourage physicians to be fair in how they allocate their time between patients.

However, there are lessons to be learned for patients as well. After all, I hear from people all the time complaining that they don’t feel like they get enough attention from their doctor.

Maybe the answer is… if you want more attention from your doctor… try being a better patient.

Instead of complaining, insulting, demanding or fussing… try being warm and friendly. Instead of venting about all the things that are wrong with the medical profession (real or imagined)… try treating your doctor with friendship and respect.

You may be surprised at the result.

For example, Dr. Campbell references a quote from a recent article in New York Magazine:

In response to a question on how patients can get doctors to pay attention to them, a gynecologist responds, “The truth is, we’ll spend more time with patients we like. We’ll joke with them, we’ll laugh with them. You have fun with patients you like.” He implies that being charming pays benefits.

Doctors and Nurses are only human. They don’t try to play favorites or consciously ignore their patients. But let’s face it. Who would you rather spend time with? Who would you give the most attention to? The person with the negative attitude and a sour disposition? Or the person who is happy to see you and wants to know how your day is going?

Quick wrap-up:

Don’t use the precious little time your doctor has to spend with you discussing negative or irrelevant topics. Go in with a positive attitude and a friendly demeanor. Your doctor is going to see a lot of unhappy, unpleasant people that day. Be the one person who brightens his day and makes him (or her) glad they decided to go into medicine.

More often than not, you’ll be the person who gets a little extra time with the doc.

- Dean

*****

And btw, if you want to discuss what you don’t like about the medical profession or vent about healthcare issues, do what I do. Start reading (and commenting) on medical blogs. The healthcare professionals who create these blogs do so because they really CARE about making things better. They love blogging — it’s meant to be a social experience — and it’s a perfect chance to get some one-on-one time with the doctors and nurses who are shaping the future of modern medicine.

(And sometimes they talk about real icky stuff and it’s totally cool.)

***************

Speaking of finding new medical blogs to read Grand Rounds is another popular carnival that you should check out. This week’s edition is hosted by Dr. Val Jones, MD on her blog, Dr. Val & The Voice of Reason.

I haven’t even begun to go through all of it yet, so if you don’t hear from me for a few days, you’ll know where I am.

- Dean