Tingling, weakness, fatigue and abnormal labs
70+ year old man with recent admission for pneumonia. Discharge on clindamycin and levofloxacin. Now with progressive weakness, fatigue, tingling and confusion. 142 98 12 256 2.5 32 1.4 6.5 albumin...
View ArticlePimping or grilling – students generally like being asked questions
My colleagues and I ask students and residents questions constantly. I talk with students and residents constantly about their educational experiences. The great majority like being asked good...
View ArticleThe answer – hypokalemic metabolic alkalosis and hypocalcemia
To recap the story: 70+ year old man with recent admission for pneumonia. Discharge on clindamycin and levofloxacin. Now with progressive weakness, fatigue, tingling and confusion. 142 98 12 256 2.5...
View ArticleTeaching the thought process – some thoughts
I often write about teaching the thought process. Research that we (multiple clinician educators at UAB) have published documents clearly that learners value attending physicians who teach the thought...
View ArticleConsequences & why the train leaving the station means nothing
I read and listen to much fiction. While listening to a fantasy novel, one character verbalizes a most important concept. Every action has consequences. Those consequences are both expected and...
View ArticleThe work hours conundrum – focus on the work rather than the hours
The publication of the FIRST Trial adds fuel to the fiery debate over work hours. Reading this study provides a variation of a Rorschach test. A brief news report (with a biased title) on the study...
View ArticleOne physician’s journey to direct primary care – a burnout tale
Donald Ross (an obvious pseudonym) has practiced in a medium sized town for around 20 years. I count him as a protege as we worked together during his residency. As a clinician educator, we work with...
View ArticleA teaching secret #meded
Recently, I participated in a panel discussion. During the discussion I stressed the importance of humility in teaching. I challenged the teachers to ask their learners questions about the topic they...
View ArticleThe heroin epidemic – some thoughts
As a medical student and resident, I saw many heroin addicts. We got used to managing right sided endocarditis and overdoses. That epidemic diminished greatly until recently. Susan Collins points...
View ArticleSince when is medicine about productivity?
45 years ago I entered medical school to join the medical profession. My father, a psychologist, always expressed great admiration for the medical profession. He strived to convince psychologists...
View ArticleImproving patient experience – within reason
My friend, Dr. Gurpreet Dhaliwal, has a most interesting opinion piece in the Wall Street Journal today – If Only Health Care Would Focus On This One Thing In this post he suggests that we should not...
View ArticleThe ethics of performance measurement
For years I have argued that performance measurement has significant potential for unintended consequences. But today, I read an article that crystallized my concerns in an important new light. The...
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