Docnotes

George Soros

George Soros made a compelling speech last week at the National Press Club.  This election is too important to remain idle.

Last week, I heard a local commentator on the radio describing his assessment of the Bush Administration's "Compassionate Conservatism."  While he acknowledged that one could argue with the Bush Administration's compassion -- his real beef was with their Conservatism.  Dr Leibo's essay is wonderful. 

So when I read essays like Dr Leibo's and Mr Soros -- I honestly wonder how anyone could consider voting for Bush.  It just doesn't make sense ...

Geek Notes

Dave installed FCKeditor into our MovableType installation.  It's better than HTMLArea, but it will take a bit of getting used to.  HTMLArea had been acting funky ever since we installed the new version of MT.  I'm surprised that MT doesn't come with a WYSIWYG editor.  There are so many available ... 

Let's see how it handles images.    Not bad.

Sam's baseball team (which our practice sponsors) won the "majors" division in little league this session.    See .. that's us .. Slingerlands Family Medicine .. in 1st place!

I took the picture with my Treo 600 .. and I continue to be impressed with it, though I'm on my 3rd one ... (all replaced for free by Sprint) so I can't say much for the quality control.

Still not able to get a good moblogging tool to work on it... any suggestions? 

Well .. if you do have a suggestion, you'll have to post it on your weblog and send me a trackback .. or send me an e-mail.  I've turned off comments on the site, since I now get over 200 comment spams a day.  MT 3.0 lets me screen them before they get posted, but I just don't have time to review 199 spams to approve of one "real" comment every day.  Soo ... comments are gone.

Final Geeknote:  We're playing with an rss feed of rss feeds .. it's an RSS version of medlogs.com.  Still in the early stages .. and not yet clean .. but here's a peek.

 

Trust

Marcus posted recently about trust.  I think he's talking about it in the context of the physician-patient relationship .. but maybe he's discussing it more globally.

The physician-patient relationship (or the physician-parent relationship) is very tricky .. to some degree because the physician may need to trust the patient much less than the patient needs to trust the physician.   Yet without risking anything, aren't we expecting too much of our patients to trust us .. if we don't invest some trust in them?

The EBM/Malpractice discussion that went on about a month ago seemed to focus on trust. 

• Our trust in evidence-based medicine as a way to deliver good care.
• Our patients' trust in their physicians.

The trouble is that the perceptions and expectations can become cloudy in the context of fear and insecurity. 

Reading Ross' discussion (1st link above) - he puts this very clearly:

How can they possibly determine how to conform to the "standard of care," when they could be dragged into a lawsuit for doing exactly what they've been trained to do? How can a doctor be doing the right thing by keeping up to date with his medical education and respectful of his patient's autonomy, and yet be found wrong by being too curent and not being directive enough?

No kidding.  By presenting choices to our patients, we risk providing a window into the true uncertanties of medicine (of which there are many!) In so doing, we are sharing decisions with them - and trusing them with this vulnerability.

I'm convinced it's better healthcare, but as my legal advisor reminds me, this decision entails risk.  So be it.  Paternalistic physicians who dictate the mythical "standard of care" to their patients are at less risk legally, yet the care they provide can hardly be fulfilling -- or even challenging! 

Habits

Busy week - and now I notice I've not posted since last weekend.

Some tips from the week:

a) There's a great review on Lyme disease in The Lancet.  This article is free, but most are not.  Free registration required.

b) Analog and digital don't mix.  I received a fax from a reference lab.  The thoughtful person on the other end had used a "hi-lighter" to draw attention to the abnormal lab values. 

This made the abnormal lab values impossible to read - as the fax machine changed them to very nice darlk black lines.

Motto:  Don't use a hi-lighter when you're going to fax (or scan) something.

c) Seven Habits - corny but useful.

Yeh .. when I finished by residency, one of my mentors gave me Steven Covey's book .. and I read at least some of it and I found it helpful. 

Time for a reminder:

Habit 1: Be Proactive

Are my actions based upon self-chosen values or upon my

moods, feelings, and circumstances? 

 

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Habit 2: Begin With The End In Mind

Have I written a personal mission statement which provides

meaning, purpose, and direction to my life? Do my actions

flow from my mission? 

 

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Habit 3: Put First Things First

Am I able to say no to the unimportant, no matter how

urgent, and yes to the important? 

 

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Habit 4: Think Win-Win

Do I seek mutual benefit in all interdependent relationships? 

 

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Habit 5: Seek First To Understand, Then Seek To Be Understood

Do I avoid autobiographical responses and instead faith-

fully reflect my understanding of the other person before

seeking to be understood? 

 

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Habit 6: Synergize

Do I value different opinions, viewpoints, and perspectives

of others when seeking solutions? 

 

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Habit 7: Sharpen The Saw

Am I engaged in continuous improvement in the physical,

mental, spiritual, and social/emotional dimensions of my life? 

 

Popular Entries

A few notes today ...

• Aside from the entries in which I mention not-to-be-mentioned body parts, this post from nearly two years ago is one of the most linked-to posts I've written.  I like it too.  Kinda poetic, eh?  .. and if you ask "googlism.com" what Jacob Reider is ... the answer comes from this post.  I now know what I am .. or at least what I'm doing! 
• I have a heckler now that my wife  has found the weblog.  Sorry ... Cerumen = "ear wax"
• Jacob's famous chicken surprise .. goog and good for you.
• Handful of frozen chicken breast strips.  Get a 5 pound bag at BJ's or Costco for $10 
• Plop into hot cast-iron skillet .. fire on at med-hi
• Splash of Olive Oil
• ok ... another splash of Olive oil
• Blob of mild salsa ...
• Splash of V8 juice
• 2 oinions - sliced well.
• Get the onions UNDER the chicken now ... cover and cook for about 15 minutes.  As Maura always said ... "Chicken is not like a burger ... you don't need to flip it"

 

Chronicle of Acute PVR Disorder

isography is my brother's website.  Yesterday he posted a wonderful review of his efforts to record TV shows at home without buying a Tivo.

Very well done.

Speling

The title is a joke.  I can spell pretty well.  I just can't type - especially on this little keyboard on my Tablet. 

Microspell looks like it may work for me.  I used to use IEspell, but it's slow and hard to access from mt's edit-entries windows.  Microspell copies over the whole text of an entry, helps me to edit out the typos and plops it back. 

We'll see. 

Dr Robot

Dr. Robot Tested at Hopkins

It lacks the warm bedside manner of Marcus Welby or Dr. Kildare, but a high-tech robot being tested at The Johns Hopkins Hospital could be used to link patients with their physicians in a whole new way.

Yeh -- I'm  a geek -- but I don't see adding one of these to my practice any time soon.

Sock of the month club

Sam's Sock of The Month Club isn't getting much business.  I think he should lower his prices.

Dave Winer

Dave Winer, who is a great thinker and is celarly a leader ... is getting a bit big-headed  today.