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Intro to Grand Rounds

For those of you who are new to my blog and who are not regular readers (yet), you're probably wondering what this whole Grand Rounds thing I've been talking about this week. Hey, a special shout out to those referred from NaBloPoMo and Bestest Blog. Welcome!

Every Tuesday, Grand Rounds is an accumulation of the best posts from the medical blogosphere. Its original intent was to be written with the non-medical blogger in mind (this means you). I mean, who isn't interested in medical topics?

And, what kind of stuff would you find? Just about anything! It can be stories about patient interactions. It can be commentary on the latest medical news and research. It can be explanations of clinical disease processes. (I know I'm leaving out a lot more possible topics.)

Grand Rounds has been around for about two years now, and has been growing by leaps and bounds. However, I've received some e-mails this week asking me if Grand Rounds was in trouble because of the discussions this week.

In my opinion, I think the discussions this week among the medical bloggers is merely just "growing pains." If I can use a medical analogy, as you're going along, sometmes you have to stop and re-evaluate the patient and modify your treatment plan. I think that's what happened this week. Undoubtedly in a few months, a similar Grand Rounds discussion will take place, and that's not a bad thing.

So, if you intend to submit for my Grand Rounds, what are you waiting for? Do it today! The deadline is Sunday at 11:59pm. Submission guidelines here.

For the rest of you out there in blogland, stay tuned here Tuesday. Because, you're going to see the BEST that the medical blogosphere has to offer - with me being your humble host.

You're not going to want to miss this! Either it's going to be the best Grand Rounds ever, or my last internet sighting for a long time - because I'll be hiding in a cave until the embarrassment is over. Either way, you'll have to see what happens...

Five Days until Grand Rounds

As you can see, this whole Grand Rounds thing has taken over my blog life, at least temporarily. The Doctor Anonymous blog has kind of become "the crash course on being a GR host" blog, at least until next week.

For anyone curious, here are the poll results as of this posting:

  • Which do you prefer? (69 total votes)
    • Grand Rounds with a theme: 42%
    • Grand Rounds without a theme: 58%
  • Ideal number of Grand Rounds links each week? (75 votes)
    • Less than 25: 35%
    • From 25-30: 47%
    • From 31-35: 9%
    • From 36-40: 4%
    • More than 40: 5%
I got a few more submissions Wednesday. From what people have told me, this is par for the course (sorry for the golf lingo). I read a few more GR postings from the past few months, just to get a feel of how things have been done in the past.

And, in fact, a similar discussion on the number of GR links occurred about nine months ago (look here, here, here, and here). This was before I was even blogging. I don't know if it's good or bad that this discussion is coming up again. Because, the points that have been brought up this time were the same as back then.

Now, Nick is probably going to think that I'm stalking him, but in doing more background research on GR, I wondered how this entire thing got started - so I went back into the Blogborygmi archives.

Did you know that Grand Rounds was almost called things like "Carnival of the Caregivers," or, "Melee of the Medics," or, "Party of the Providers," or, "Hulabaloo of the Healers?" How different would things have turned out if one of those names were chosen?

Here are some other things I found:
August 6, 2004: Now, a certain fraction of medi-blog posts are too esoteric for the lay reader, but actually not that many. And that's part of the appeal: Each week authors would pick a post that general blog readers could understand and enjoy, and a rotating volunteer blogger would host the links. What gets linked would be at the host's discretion -- hopefully a nice mix of quality patient stories, science news, and policy points.

September 13, 2004: If you're a medical blogger (which so many of you are), and if you're interested in reaching more nonmedical readers, listen to this: I've received a lot of positive feedback about the idea for "Grand Rounds" (Carnival of the Caregivers) -- a series of "best-of-the-week" posts from around the medical blogosphere, with rotating hosts.

September 28, 2004 (The First Grand Rounds): Welcome to the debut of Grand Rounds, the weekly summary of the best of the medical blogosphere. It's our hope that this new feature will introduce a wider audience to the expanding array of talented doctors, nurses, techs and students writing online today. This week, we've got a roundup of new medical reports, opinions on current health topics, and a look into several medical specialties. Plus, some stories from caregivers to make you laugh, cry, or spur the contemplation of your mortality.

This is all great stuff. Definitely puts some things into perpective for me. As little as two years ago, it seems to me that the medical blogosphere was a little blip on the map. Now, we're having discussions that GR is getting too large? Hmmmm. Interesting....

Stay tuned: My Grand Rounds "Pre-Rounds" interview with "the man" Dr. Nick Genes should be coming to a Medscape site near you soon....

Countdown to Grand Rounds

Have you turned in your GR contribution yet? What are you waiting for?

Topher from The Rumors Were True (yesterday's GR host) commented here (comment #34) that there were over 1000 hits to the "Grail Rounds" site yesterday. Wow!

The GR polls are still open. Do you prefer a Grand Rounds theme, or not? What is the ideal number of links for a GR edition? The results up to this point have been quite surprising to me. Just when you think people feel one way, the votes come out differently. Please check out my sidebar and make your selections if you haven't yet.

On a personal note, I've got to say that this is becoming tough for me. It's great that I've already gotten some submissions -- thanks so much for that. As I read more and more from previous hosts, I find out that the concept usually is all figured out by now.

I've got to admit that I have all these concepts going through my mind on what I want to do. I haven't really figured out what my vision for this GR post is yet. Maybe like other things I've written, it will just come to me and everything will just fall in to place.

GR has to be informative, yet entertaining. It has to be inclusive but not too exclusive. Ah, the life of the Grand Rounds host! As I've said before, I wish this work thing didn't get in the way of blogging. Life would be so much simpler, right?

Grand Rounds

Grand Rounds 3.08 is now up and running at The Rumors Were True. Thanks Topher for hosting this week. Here's my contribution:

With all of the forward-looking, its important to remember why we’re doing any of this. This week, Doctor Anonymous writes a great story about counseling a difficult patient to undergo a stress test that may have saved his life.
Next week's host is Doctor Anonymous - ME! Yay! What the heck have I gotten myself into? We'll see. The deadline for submissions will be early - because I'm on call this weekend and will need more time to put things together.

The deadline will be Sunday, November 19th, 2006 at 11:59PM eastern time. E-mail submissions to doctoranonymousblog [at] gmail [dot] com. Please place "Grand Rounds" in the subject line. Also, please follow this format. It will definitely help me stay organized.

Blogger Name: Doctor Anonymous
Blog Name: Doctor Anonymous
Blog URL: /
Post Name: Are you an idiot?
Post URL: /2006/06/are-you-idiot.html
Description: [insert one line description of post here]

I went into the "way back machine" to see how Nick originially described what he was looking for in a GR post. You can read the full post here. But, I thought these words are still true today - even after two years since GR number one. I have always found it helpful to look back before looking forward.

Remember, the target audience here is NOT other medical bloggers, or people in the health care industry. It's the educated but nonmedical readers coming from general-interest blogs. So write for that audience, if only for this one post (even if your blog is about echocardiography). The idea is to introduce the wider world to the growing medical blogosphere -- the doctors, nurses, students, administrators, EMTs, techs, and patients who blog.

Two questions that are frequently asked:

1. Is Grand Rounds just limited to bloggers in the health care field? No -- I'll look at any medical-related post. There are some patient-perspective blogs in particular that I hope submit links. But like I said, the point of Grand Rounds is to promote the nascent medical blogosphere, and submissions from health-related blogs will take priority.

2. I'm a doctor / nurse / researcher / student / EMT / health care economist / patient who writes mostly about gardening / dating / reality television. Will you link to my post? Maybe. I'll certainly look at it, if it's medically related. And very few blogs are 100% medicine. But like I said, submissions from mostly health-focused blogs will take priority.

It's the host's discretion as to what gets included. This week, that's me. In addition to linking to your posts, I'll be providing the groan-inducing puns, and snarky comments, that readers have come to expect and dread. It's nothing personal.

So, I'm putting everyone on notice! 100 percent of submissions will NOT get in. I agree with those who say that there are just too many links, and that possibly drives people away. The number that will get in this week will depend on the quality of the submissions.

This may be my last time hosting Grand Rounds, and I may get a lot of flack (and all my future submissions may be rejected). But, hey, I'm the editor and I'm deciding what's in and what's out this week. Being included in Grand Rounds is not an entitlement; it's not a right; it's a privilege.

Whether you agree or disagree with me, my vision next week is to put the best medical STORIES (ie - first hand anedcotes) out there for people to read (I wouldn't call it a theme). When I talk to people about medical television shows, sure they talk about the technical jargon and the science. But, what really draws people to good medical shows are the stories that they tell. And, I agree that's something that first drew me to Grand Rounds, and has fallen off a bit in the last few months.

So, put your best medical STORY together and send it to me. Don't make me come after you! Early submissions are greatly, greatly, greatly appreciated (did I say they would be greatly appreciated?). Also, please feel free to hype up GR on your own blog. From what I've been reading, Grand Rounds may have lost a little luster in recent months. Maybe it's time to bring people back to Grand Rounds, and this is the week to do it!

Grand Rounds Poll

For you Grand Rounds readers out there, if you haven't checked out the discussion on Emergiblog yet, please do so. Here's a sample of the quotes from over there.

--
Here’s my thoughts on the matter of GR these days.
1) It’s too long. GR is supposed to be the BEST of medical blogging, not everything that every blogger wants to submit.

2) Don’t let your theme obscure the posts. Sometimes the host doesn’t tell you about the post itself, but rather, they come up with a “cute” blurb that may or may not be representative of the post’s content. Theme’s are great, but the posts are why we read.
--
I think you are right on, Kim. I am pretty new to the blogosphere and in my short experience with grand rounds I would have to say it is way too long. I don’t have hours and hours to sit in front of the computer so I pick and choose rather than taking it all in.
--
Kim- You’re on gal, right on the money and said it well to boot. Giving permission to those who host to edit what they want to include would be a big start. Maybe there should be a limit of 25 or 30 that is about my limit for reading and probably way over what most hosts want to provide. Thanks for this.
--
Having also hosted twice, I have to say that it was much tougher to get excited about the quality of the writing the second time around.

All of the posts I included (and it was nearly everything submitted) had merit, and most of them were well written.

What the majority lacked, and what I read Grand Rounds for, is heart. I want to develop greater understanding of the humanity of medicine.

I would support a maximum number of allowable posts - no more than 30. It gives the host a bit of leverage for picking and choosing. As it is everyone expects to be included, and as host, you do hate to disappoint anyone.
--
Things I would like to see more of on GR: More stories, more literary posts. I like the multidisciplinary approach - I enjoy the perspective of the MD, the patient, the pharmacist, the pastoral care representative - Reading these always brings a fresh approach to my own practice.

Things I would like to see less of: Themes (yes, some are clever but overall they are too cutesy - they take away from the posts, themselves). And less posts! I would skim it down to no more than 20. That would in theory ensure more quality.
--
Kim, first let me say that this post has all the elements…well written, brave, and something to say. Way to go! I feel grand rounds should be edited. And sure, it’s no fun to be left out but I don’t think a professional medical forum should hold ‘don’t want to hurt feelings’ as a criterium.

I thinks themes need to be handled delicately…some people get so wrapped up in their theme, that the content almost becomes secondary.
--
I, too, like the more anecdotal posts. The posts that are patient information and educational, I close immediately and don’t read. (in otherwords, they might have gotten my hit, they did not get my readership, and if it was a first time visit, didn’t even get enough of my recognition for me to return visit). I get enough patient information from my doctor’s, nurses, physical therapists and the like as it is. What I don’t get, I can look up … I don’t need it unsolicited. I have email support groups for my specific conditons.
--

Since I'm hosting next week, and since I'm curious, I've put two poll questions in my sidebar for your consideration when it comes to Grand Rounds themes (yes or no) and the ideal number of Grand Rounds links per week. Please vote. This information will really help guide me in what I'm going to do.

One of the things I love about the internet and the blogosphere is the interactivity with the reader. So, place your vote now and tell your friends about this poll because it's important. Thanks so much!

Press Conference


Thanks so much for attending today's much awaited press conference. I know that there has been a lot of rumors about me on the internet over the past week:
Is Doctor Anonymous ok?
Why has he not been posting as much lately?
What's the big announcement?

First of all, you've probably heard the latest news on people like Iowa Governor Tom Vilsack, Wisconsin Senator Russ Feingold, and Arizona Senator John McCain.

I would like to put the rumors to rest. I am definitely not going to seek either the republican nor the democratic nomination for President of the United States in 2008. I have decided to spend more time with my family and with my blog. I feel that I can better serve the country doing fake political announcements like this so that I can announce what I really wanted to say.... HA!

So, I got this e-mail last week that piqued my interest.

I've been meaning to contact you, to see if you were interested in
hosting Grand Rounds -- your blog is excellent, and you're a frequent
contributor to the weekly carnival.

We are booked into 2007 -- but the scheduled host for 11/21 has just
dropped out. Would you be interested in stepping in to fill this role?
I and some of the other hosts have prepared some tips and pointers to
guide you through it, if you're interested.

Please let me know, Nick Genes

Who is Dr. Nick Genes? He is the illustrious "grand pooba" of Grand Rounds - the wildly popular and most prestigious medical blog carnival out there. The self-described "best that the medical blogosphere has to offer."

I've been toying with the idea for weeks of contacting Nick myself, but I really didn't know if I could handle putting something like that together. I've even commented in the past that the work load in preparing Grand Rounds - especially to maintain its high quality, could maybe be too much for me. Plus, I'm on call next weekend. So, it was probably the worst time for me to try to put something together.

So, what did I do? I said yes. What am I nuts? Probably. Last week, after I accepted, I started doing a lot of research and reading a lot of past GR posts. I also read advice from previous hosts on how to make the experience not too crazy. I mean, hey, if someone as busy as Kim Emergiblog can do it, maybe even on call, I could make it happen.

So Tuesday, head on over to The Rumors Were True to check out GR 3.08. Then, get ready for me! My goal is simple - To make this the best Grand Rounds, ever! Not too much pressure on myself, huh?

I'll have the GR 3.09 posting rules and deadline up Tuesday. But, for now, I'm still figuring out how I'm going to do this and still remain sane. I'll have to stock up on Diet Coke. But, hey, I'm Doctor Anonymous, and I'm a blogaholic....

Addendum: I just ran across this interesting post from said Emergiblog. She listed some concerns and some suggestions on how to make Grand Rounds better. I invite you to make comments over there. I'm going to be watching that discussion very carefully.

Major Announcement


Sorry I haven't been around this weekend. No, I wasn't at THE Ohio State University Vs. Northwestern game yesterday - although I wish I was (sorry Dr. Wes). I've been working on a very exciting project that presented itself last week. I can't wait to tell all of you about it. But, not until tomorrow. How's that for a tease? Hope all of you are having a wonderful weekend. Til tomorrow....

Why I do this

Tuesday night was crazy on call - more busy than usual. Then, on Wednesday, I had a 7am hospital meeting, morning office hours, a noon hospital meeting, then afternoon office hours, then back to the hospital to finish my hospital rounds. Sheesh!

Don't get me wrong, I'm not complaining. It's just the fatigue was more than usual - kind of interesting now that I re-read my post on jetlag. Hmmmmmm...

Wednesday afternoon, I was just totally dragging and could not wait to go home and go to bed. I was not really in that great of a mood - kind of cranky. And, I did not have any tolerance for whining and excuses from my patients or my staff.

I walked into the exam room and saw Russell and his wife. I haven't seen Russell for about two months. Russell usually sees another doc in our practice. In fact, the last time we saw each other we had a spirited disagreement on why I thought tobacco use is unhealthy. So, my first thought was that I really did not want to go through that discussion again - especially today.

In addition to smoking, during our last visit, he reported symptoms of mild chest pain which he attributed to his "chronic bronchitis." After another heated discussion, he was agreeable to a stress test which occured the next week. I was quite surprised by the abnormal result. Russell was immediately referred to our local cardiologist and I kind of lost track of what happened after that.

His wife told me that Russell was seen by the local heart doctor and immediately referred to Huge Legendary University Medical Center where he underwent triple bypass heart surgery about a month ago. He just returned home following some cardiac rehabilitation at Huge Medical Center.

We talked some more. And before the visit ended, Russell's wife said, "You know, they said up there that Russell's heart was right on the edge of something bad happening. I know he can be difficult sometimes, but I'm glad you ordered that stress test. Doc, you probably saved his life and I wanted to thank you."

Russell looked right at me, didn't say anything, but noded his head. At that moment, all of my fatigue disappeared.

Catching up

Had a busy night on call. Took all day to catch up on my work.
Now, time to catch up on sleep. More soon.
Thanks as always for stopping by today.
(Photo Credit: Dave Martinidez)