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DB's Medical Rants Contemplating medicine and the health care system

English - Health, Medicine, Science
http://www.medrants.com/
DB's Medical Rants · 3d ago

The Emperor of Performance has no clothes

Our greatest and worst attribute is seeing and saying that the Emperor has no clothes.  It requires intellectual honesty, a willingness to overcome confirmation bias and perhaps some hubris....
DB's Medical Rants · 1W ago

On setting achievable goals for behavior change

Long time readers know that I lost approximately 40 pounds in the year starting with Memorial Day 2013.  When I started, I did not have a big goal, rather I had a small goal.  The day I star...
DB's Medical Rants · 1W ago

May physician targeted performance payment finally receive its death toll

Long time readers of this blog know my disgust with pay for performance.  P4P has many incarnations, all of which are harmful to patients and physicians.  The blogosphere has ranted about th...
DB's Medical Rants · 2W ago

Thanksgiving Challenge 2017

For many years I set a Thanksgiving Challenge to myself.  The goal was to lose weight between Thanksgiving and New Year’s.  It was a resolution. This year I do not need to lose weight.  So m...
DB's Medical Rants · 3W ago

When to give bicarbonate for metabolic acidosis – increased versus normal gap acidosis

Last week I posted a list of topics that we discussed during a 5 day period of rounding.  I was asked to share my teaching points. We had 2 patients, one who had a normal gap acidosis and on...
DB's Medical Rants · 3W ago

Being a physician – lessons learned from Harry Bosch

I just finished listening to the latest Michael Connelly mystery – Two Kinds of Truth.  His main character in many books is Harry (short for Hieronymus) Bosch.  Bosch is a police detective w...
DB's Medical Rants · 4W ago

Things we discussed last week on rounds

Each week on rounds several very interesting topics arise.  In December I plan to discuss these issues on a daily basis, but today I am reflecting on 5 days of ward rounds last week.  I just...
DB's Medical Rants · 1M ago

Tips for IM attendings – Chapter 20 – why we ask questions

I had a wonderful dinner with some medical students last night.  Earlier in the day at morning report I had asked them multiple questions.  Given the ongoing debate over pimping (a debate th...
DB's Medical Rants · 1M ago

The neverending IM rounds debate – what is the best style?

I could stop with one sentence – there are several styles that work.  Let me explain. Internal medicine rounds have several goals.  First, we owe our patients the best diagnostic evaluation ...
DB's Medical Rants · 1M ago

The major medical issues of 2017

Periodically we should reflect on what challenges face patients and physicians.  Over the past few days I have worked on a list of the issues that concern me the most.  I welcome suggestions...