Blog

Surprise


When I got to work this morning, my nurse surprised me with the cake above, a thoughtful card, and a "congratulations" balloon. How sweet of her. Of course, the cake was gone before the end of the morning. I guess I need another 30-45 minutes on the treadmill tonight - oh well. BTW, the above photo was taken by my iPhone and tweeked a little bit by iPhoto and then posted here. How neat is that?

Work-iversary


Is your anniversary at work something that should be celebrated? Well, for me it is. I see it as kind of a landmark or a benchmark. I've been working at the same place for six years now. (image credit) For those Family Medicine docs out there, you've probably already done the math and see that I need to take my Boards next year to remain Board certified. That will be a fun process next year.

Big shout out to those newly graduated Family Medicine residents and other newly minted residents who may be starting new jobs today. For the great majority of people (in the US), residency ended June 30th. and the new graduates usually take July off to take their Boards and/or vacation, and then join the real world on August 1st with their new jobs. At least that's how I started.

Of course, the practice I'm at right now placed me on call overnight on August 1st. That was quite a joy. I remember that night on call. It's not like it was that busy, but it was like I was a first year resident all over again. I couldn't find my way around the hospital. I didn't know how to work the computers or the dictation machine. Looking back it was quite comical.

But, I got through it and not it's six years later. Every so often I get the "business" talk from the senior partners about how well or not well I'm doing from a business standpoint for the practice. "The numbers" as they call them always could be better. Industry in the part of the state is not exactly growing, even maybe getting more economically challenging.

With decreasing jobs around here means decreasing people with health insurance. Of course it's not great for patients, but from a business standpoint, that makes things challenging for me as well in trying to improve my business standpoint. Don't get me wrong, I'm not whining. It's just when I reach a work anniversary like this, it doesn't hurt to re-evaluate things.

When I look at my peers whom I graduated residency with a few years ago, some of them have had six different jobs in these six years - some even more than that. The medicine industry is not immune to the turbulent business cycle that's taking place in this part of the state and region.

So, all in all, I'm happy where I'm working. Yes, it's an economically deprived area of the state. Yes, young people and young families are leaving the area for success elsewhere in the country. And, yes, I myself could probably move down south or out west somewhere to make more money and have a better lifestyle with less on-call hours.

But, this is home for me. I was born in this area. I grew up in this area. My family is still in this area. I could not see myself living or working anywhere else. This post is probably one huge rationalization of why I'm still here. But, I don't care. I still love what I do and I have no regrets on my career choice. How many docs can say that these days?

Rest & Relaxation


Absence makes the heart grow fonder - This source credits Eleanor Roosevelt with this quote. I don't know about that, but this quote certainly applies right now in my blogging life. For most of July, as you know, I've kind of stepped away from posting.

What have I been doing? Well, I got an iPhone - and I'll talk more about that in a minute. One of the commitments I made to myself this summer was to take a little bit more rest and relaxation for myself. Getting away from my computer is a major challenge for me, but I got outside, and made a new commitment to exercise (I've been a slob for quite a while now).

I've also tried to re-connect with my non-blog friends. We've talked about them before on this blog. Unfortunately, I've neglected my blog friends somewhat. Thanks for your understanding for me being away. And, thanks for all the e-mails that people have sent me just to say hello or to check up on me.

I wanted to clarify again that I did not take a break because "someone" stopped me or because I was afraid of blogging. I never thought about quitting. As Dr. Crippen so eloquently said, sometimes you just need to recharge the batteries. (In no way am I comparing this piddley little blog to the mighty NHS Blog Doctor. Hope you come back soon Dr. Crippen.)

So, I've put the training wheels on and trying to find my way back to blogging. In the past, I've done a lot of news items. I'm thinking of taking a slightly different direction, but not sure yet. We'll just see how this thing evolves (again).

As previously mentioned, I purchased an iPhone. And, besides the total coolness factor, I've really tried to apply it to my professional life - and I may be blogging a bit about that. This thing has wi-fi and so does my hospital. So, I'm trying to do things like look up my patient lists and labs. We'll just have to see how that goes.

I've also been trying to read all that I can about medical applications for the iPhone. I've been reading Medgadget and some iPhone sites out there. If anyone out there has some suggestions, post a comment here and I'll check it out.

I also have a new interest in listening to podcasts - Of course, My Three Shrinks and Dashing MD are my favorites. But, I've also found some iPhone podcasts and trying to find some iPhone podcasts specifically dedicated to the iPhone in medicine.

So, that's the short story of what I've been doing this month. Maybe I'll share more of what I've been doing this month in future posts. It's great to be back blogging again....

iPhone


Guess what I got last weekend? To be fair, I have to give you the full disclosure. I own an iMac, iBook, and iPod. Plus, the first computer I ever sat at was an Apple IIe. So, this definitely qualifies me as an a Apple advocate - or, as others call me, an Apple freak.

All that being said, this is the coolest gadget ever! Like I don't have enough reasons why I haven't been blogging lately. The iPhone has successfully made me forsake my work and family for the joy of an iPod, cell phone, and organizer - all rolled into one device. LOL

Maybe I can blog from my iPhone, or write and post to twitter? That is in addition to sending text messages, checking my e-mail, watch videos, listen to podcasts, and all the other cool stuff this thing does. Forget Harry Potter - iGot the iPhone. Yay!


Update: What would you do for an iPhone? Check out what this guy did....

Update


Seve Ballesteros, one of my favorite golfers, announced his retirement Monday on the eve of the beginning of the British Open this week. Here's a quote from the Associated Press article.

Ballesteros officially retired from golf on Monday, ending a charismatic run filled with spectacular shots that carried him to a record 50 victories on the European Tour, five major championships and a Ryder Cup career that helped Europe shed its underdog image.

Ballesteros didn't just win majors. He won them with shots that won't be forgotten, perhaps the most famous a recovery from the parking lot along the 16th hole at Lytham in 1979. He also won in 1984 at St. Andrews, beating Tom Watson, and he captured his final major in 1988 at Lytham by holding off Nick Price.

I remember watching this guy on television. And, he would come up with these crazy shots, and actually pull them off. It's sad to see him go. But, when asked why he was retiring, he simply said this...

"I don't have the desire," Ballesteros said.
That quote has been circling in my mind since yesterday when I heard it. And, that basically sums up my attitude toward blogging right now - I just don't have the desire. It's not that I hate it, and I certainly don't want to quit. But, right now, so to speak, "I'm just not feeling the blogging bug."

So, my blog break will continue. I just wanted to update everybody on what was going on. Thanks for all your e-mails checking up on me. I want to make it clear that there was no "event" or no person (other than me) that suddenly halted my blogging.

I am enjoying my summer and hope to be writing new posts soon. Don't worry, I'll be blog hopping and leaving comments every once in a while. Take care and talk to you soon....

Independence Day Podcast


Opening Music: In honor of the closing of this club in New York City.

In The News:
Courtesy of Cathy's Place: The banning of smokers by the Cleveland Clinic

From Fat Doctor: AMA News article, "Blog At Your Own Risk."
(I'm mentioned in this AMA article - Yeesh!)

Around the Blogosphere:
The #1 Dinosaur talks about Ratings, Rankings, and Grades (oh my)

Next, just some really random thoughts on the first days of residency.

Closing Music: In my opinion, the most patriotic song I've ever experienced.
(I'd give it away with a link, but, this time you have to listen to the podcast. HA!)

I've been messing a little bit with my Garageband software. I think the sound quality is a little better. Enjoy Podcast #7! Download in mpeg-4 (11mb) or mp3 (32mb) format.

Happy Independence Day




I know July 4th is tomorrow, but ever since 1996 when the movie Independence Day was released, I always think of this cheezy speech near the end of the movie. What can I say, I'm pretty silly, or, maybe I just need some sleep. Sorry I haven't updated the blog in a while. Work has just been crazy/busy. Hopefully, more updated coming up soon.....

"We will not go quietly into the night!
We will not vanish without a fight!
We're going to live on!
We're going to survive!"
Today, we celebrate our Independence Day!

Blogaholic Podcast


So, I'm trying this podcast thing again for the sixth time. Here are the show notes...

Opening Music by Kathy Reynolds (The song InSideOuT from the album Songs of Life)

In The News: Researchers to Docs: Shut Up!

Around The Blogosphere:
My Three Shrinks - Hopefully I'll be able to be a guest on your show soon...
Internet Radio: Here's an article about The Day of Silence
BlogTalkRadio: Want to host a radio show? Check out this site...
Dr. Blogstein - Hilarious stuff!
The Mo Show - Great first show. Can't wait for the next one...

Patient Story: A recent visit to our local extended care facility (nursing home)

Closing Music by Lori Malvey (The song When I Talk 2U from the album Love)

Just FYI, the file is 30MB (Yeesh!) and it's in the MP3 format. Enjoy Podcast #6.

Update: You can now either download in mpeg-4 format (11mb) or mp3 format (31.5mb)

Researchers to Docs: Shut Up!


In the past, physicians have been criticized for not spending enough time with their patients. In fact, many alternative and complementary medicine websites have used this research to promote themselves.

VI. ALTERNATIVE MEDICINE APPLICATIONS

Alternative medicine has quietly jumped into the mainstream. By 1993, one in three people have used at least one alternative therapy and $14 billion was spent on those therapies according to the New England Journal of Medicine. Half of all U.S. medical schools teach about mind-body connections; alternative medicine is now offered at Georgetown and Columbia University.

Why the surge in interest? Many Americans find alternative approaches to be less expensive, with fewer side effects. Some feel that modern medicine is blind to the connection between mind and body. For others, the human touch is the real appeal. According to one source, the average doctor interrupts his patient 12 to 14 seconds after the patient starts talking. It is hard to feel cared about in that kind of environment. The alternative practitioners tend to spend time with their clients and actually listen to them.

Well, now there is research published in the Archives of Internal Medicine stating that physicians are "wasting" time of patients by talking about themselves during office visits (WebMD).
Researchers sent a group of actors posing as new patients to primary care doctors and found a third of doctors made unprompted comments about their own health, personal life, or political views. The vast majority of those comments (85 percent) weren't viewed as useful or relevant to the patient.

While a good bedside manner is important, researchers say that in an era of ever-shortening office visits doctors should keep the conversation focused on the patient.

"We found that physician self-disclosures were often non sequiturs, unattached to any discussion in the visit, and focused more on the physician's than the patients' needs," write researcher Susan H. McDaniel, PhD, of the University of Rochester School of Medicine and Dentistry, and colleagues in the Archives of Internal Medicine.

"Longer disclosures, both not useful and disruptive, interrupted the flow of information exchange and expended valuable patient time in the typically time-pressured primary care visit," they write.

This study is actually kind of funny to me. I like to establish a rapport with my patients, and that sometimes means talking about me. The "time-pressured primary care visit" phrase particularly strikes me as funny.

I believe at the core of Family Medicine is relationships - relationships with my patient and relationships with my patient's family. I admit that sometimes the banter I have with patients may not directly relate to their medical visit, but I still think it's good medicine - despite what these researchers say.