Grand Rounds, Vol 4, # 47

We here at MH Blog have the honor of hosting Grand Rounds this week.  No theme was provided, so let's dive in and see what the best of the med-blogosphere has to offer.

Mother Jones takes dead aim at Oprah.  What with her endorsement of the dubious salt hypothesis and her love of Mehmet Oz, she's an easy target, IMO.

The power of the Internets is the subject over at Healthcare Vox -- apparently, the subjects of the poll don't read their Onion . . .

Dr. Val interviews a patient who explains just how expensive treatment is for hemophilia, especially when current financing mechanisms do not cover the full costs of treatment.  Of course, this is par for the course for many kinds of chronic illness.

How do the med's folks take affect their insurability? Insureblog's Guest Blogger takes a look at a recent Business Week article on this subject, and offers an insider's view.

File under "H" for Humor: Vitum Medicinus, a Canadian medical student, recalls some of the more memorable addresses given to his class of future doctors.  Alas, graduate school is not as entertaining, in my view.

The Samurai Radiologist -- cool moniker! -- finds an amusing satire of the excesses of evidence-based medicine in BMJ.  That reminds me that EBM would make a great installment of the Medical Humanities Lexicon.  The hostility so many have to the notion that clinical practitioners ought, to the extent possible, base their interventions on the best evidence, is somewhat puzzling to me.  But that's a different blog post entirely.

Lisa over at the Cushing's Disease Journey details some gripes she has a veteran patient.  Here at MH Blog, we love pathblographies!

Canadian Medicine Blog offers a two-part post on Canada's Olympic doctors.  FYI, I have a paper forthcoming on the conflicts of interest that plague team physicians in the (American) National Football League.  I wonder if there are salient ethical differences for physicians representing amateur athletes in international competition.

Kim at Emergiblog suggests some ways for med bloggers to promote their blogospheric endeavors.  Who isn't down for same shameless self-promotion? 

In Medicine for the Outdoors, Paul Auerbach writes about ways for creating a defensible space against wildfires.  Here in Texas, we desperately try to avoid the outdoors entirely this time of year . . .

R.W. Donnell runs a thought-provoking blog, and he critiques some notions of patient-centered medicine.  My own view, FWIW: whatever specific problems there are with the concept of patient-centered medicine, the movement nevertheless suggests an important signaling effect: from the patient's perspective, too much of the their care is not patient-centered.  Given the empirical evidence, this latter point is difficult to deny.

At Teen Health 411, Nancy Brown has a post about ACL tears, which I understand may be a particular problem for female athletes.

Sandy Szwarc, at Junk Food Science, provides some always-needed perspective on the discourse surrounding obesity.  This has been a frequent topic here at MH Blog, FYI.

Google, Google, everywhere -- and not all is sunshine and roses, says David Williams.

Rural medicine is crucial in ameliorating health disparities (which are often distributed geographically, in addition to other variables); Theresa Chan discusses what happens when a woman suffers seizures during a home birth.  I know it is unthinkable to many Americans, but a substantial percentage of Dutch women give birth at home, and their outcomes are comparable to ours.  Food for thought.

The Cockroach Catcher details some of the latest goings-on in the Alaska-Zyprexa litigation.  There's also good coverage of this over at the Clin Psych Blog, and at Furious Seasons.

Do not even get me started on the travesty of House, M.D.  (For those unaware, my dissertation is on pain and pain management, and the depictions of the main character vis-a-vis chronic pain are frankly horrifying, but also revealing and quite consistent with the general stigma and attitudes towards chronic pain sufferers).  Monash Medical Student reviews the latest episode, for those more favorably disposed.

James Logan addresses the complicated issue of doping in international sports.  He's into it.  Reminds me of that great SNL skit from some time ago: the All-Drug Olympics.

The Anesthesioboist asks some great questions about virtue and the human capacity for evil -- and for good.  Milgram comes up, too, which remains an important note in the history of human participants research, for a variety of reasons.  Recommended.

At the tastefully decorated Health Blawg, David Harlow discusses the security implications for EHR of the DNS hole.

Nurse Keith has an evocative post on the importance of listening.  Seems so simple, yet patients' chief complaint about professional healers is virtually always that their healers fail to listen to them.  Listening is MUCH harder than it seems, as evidenced by the fact that we generally do it so poorly.

The Olympics seem to be a common topic in this month's GR.  Jolie Bookspan addresses performance enhancement, and performance in general.

At A Chronic Dose, Laurie Edwards brings the patient perspective to bear on the Massachusetts law requiring disclosure of gifts between physicians and pharmaceutical companies.  I am currently engaged on professional (and scholarly) work on conflicts-of-interest, so all I will say here is that it is crucial to hear the voice of the patient on these issues.

Dean Moyer of The Back Pain Blog examines the difference between anabolic steroids and corticosteroids in this latest installment in the series Sciatica and the Epidural, Part Three.  In this post he attempts to answer several common questions concerning epidural injections.

A new blog about the life of a pathology resident -- aptly named PathResBlog -- discusses some of the challenges facing pathology residents.

For you techies, PubMed is optimized for handhelds, though not the iPhone yet.  One day, I will understand the cult of Apple.  Yes, I have one.  No, I don't think it's the best ever.  Yes, I know I need to duck now.

Angioedema: a 24-hour photo diary by a patient posted on Flickr, at Allergy Notes.  Cool.

One of the most basic lessons of biology is that it is really difficult to define "life," and viruses are a major case study of the difficulty.  Turns out they may even be able to infect other viruses.  See Grrl Scientist for more.

The always-interesting Dr. Rich assails the use of guidelines in clinical practice.  Of course, the many problems with guidelines hardly suggest that practitioners ought to eschew trying to understand what the best evidence is in formulating interventions.  These problems do suggest some important considerations in thinking about what constitutes good evidence.

Having done some MMA in my time, I have some understanding for the notion that Cauliflower ear is indeed a badge of honor.  See RLBates for more.

Volunteer doctors as a way of defraying liability? Louise at Colorado Health Insurance Insider has the details.

That's all, folks.  Thanks for reading.  Comments always welcome.  As we like to say in Texas, y'all come back real soon, ya hear?

Okay, okay, so even we have trouble saying that with a straight face . . .

Comments

[hgstern]

Wonderful job, Daniel!

Thanks for hosting and for including our post!
 

[Mother Jones, RN]

I'm coming straight home today after a meeting at the hospital. It looks like you have a great line up of posts.
Thanks for including my post in this week's Grand Rounds.

MJ

[Dean Moyer]

Great job. Thanks for including my post.

[Kim]

What a great collection this week! Nice job pulling them together - thanks so much for including Emergiblog!

[Kerri.]

Great edition of Grand Rounds! I wanted to drop by and let you guys know I'll be hosting next week, so be sure to visit my blog for details. :)

-- Kerri.

[Nancy Brown at Teen Health 411]

Interesting assortment of posts this week - and thanks for including one from me.

[jeff]

good stuff. thanks for including my post on House MD

[Sandy]

A great GR! Thank you for hosting and including my post.

[Dr Am Ang Zhang]

Thank you for including my blog in Grand Rounds. Great sorting out of the entries.

The Cockroach Catcher

[Dr. R]

House, M.D. is not a real doctor, he is Stuart Little's daddy.

[NurseExec]

Great grand rounds!

[Medifull]

good stuff. thanks for including my post on House MD

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