Welcome to Grand Rounds # 13
The Editor's Take
In the beginning I believed that the geometric proliferation of medical blogs indicated strict reproduction by cellular division. It looked like the simple production of two progeny produced by one parental act of division. I now realize that there is something more going on. A sort of medical blog meiosis that assures the mixing of information, the distribution of characteristics, and the spontaneity provided by point mutations.
These are not just clones budding throughout the medical blogosphere; rather, we are watching unique individuals produced with information crossed, passed, and punctuated by bloggists who are inhabitants all over the map of modern health care. It's a remarkable phenomenon -- an evolution in front of our eyes...so keep watching. It's sure to produce many new beings. here's a sampling of this week's best.
Clinical Corner
Men...Fear the tonsure? What are your options, scalp reduction? Kevin,M.D. prefers you consider modern medical therapeutics to combat your baldness and he succinctly spells out the options.
Clockwork not orange? If your biological timepiece is not recording 12 o'clock twice a day, maybe it needs to be reset? Michael Rack is a physician who specializes in sleep disorders and psychiatry (so he'll talk you through it as well), and he discusses the possible use (or not) of melatonin to grease the gears of your aging mechanism.
For mysterious reasons it is always hard to sort out the data laid out in "alternative" medicine studies. Many times the authors just wish you would jump to the "discussion" and read their conclusions without analyzing their facts. That's why we have The Journal Club to sort these studies out., and Michael Jacobsen does it again this week regarding acupuncture and osteoarthritis.
Daniel Boone as M.D.? Medrants draws the analogy in a brief but pithy plea for patients to get informed and take responsibility for their own care. It's the difference, the author says, between treating and recommending treatment.
Policy Analysis and Public Health
A doctor in pain gets pain...The DEA won their drug-trafficking case against pain specialist William Hurwitz. But everyone else lost. Trent McBride tells us the tale straight from "The War on Drugs," at Callarchy.
Do you want the same medical treatment Bobby Bonds gets (are you sure?)? Some providers are counting on it (just read the label on the cream before you spread it, okay?). Nick at blogborygmi has original thoughts and analysis on the subject.
Will intubation be a luxury tax? A Chance to Cut is a Chance to Cure explains the proposal of a trauma tax to help defray the costs of emergency medical care, which, according to his analysis, will save lives.
They may not eat what they kill, but now ER doctors can at least see what they bagged. Grunt Doc explains a small but important regulation that will wild ED physicians evaluate their productivity and it's worth. As a former contract physician, at the mercy of a contract holder, I especially relate to the plight of the ED docs and the type of moral victory this new regulation represents.
For those physicians out there who want to limit BIG PHARMA's advertising to the vulnerable masses, are you willing to similarly limit alternative medicine from promulgating dubious therapies? A new medical blogger, orac, at Respectful Insolence lays out a lengthy case concerning the pitfalls of alternative therapy and the dishonesty of associated advertising, especially for major diseases.
The obesity police state is coming in a snack pack: isemmelweiss analogizes the public health wars -- like that now raging against obesity -- to real war at his blog. Put down that Crispy Kreme and raise your sticky hands in the air!
I always thought it was home cooking, but apparently there are lots of reasons being married keeps your engine humming sweetly. The details of a recent report are enumerated by emer (and there are several follow-up posts along a similar line worth reading).
When consumers aren't informed they make bad decisions. A perfect example is the selling of whole body scans as reported by enoch choi at Medmusings. I could tell you first hand many unfortunate anecdotes associated with these rip-offs, but this article is a better place to start.
Friends, Final Thoughts
Recognition for the medical blogosphere will grow if we can attract more non medical contributors -- so I encourage everyone to spread the word and invite their blogger friends.
One of our good friends, Mike Pechar, at Interested-Participant consistently forwards his medically-related posts, and they are always well done, as is his site, which I recommend to all. This week Mike reports on a Chinese patent awarded to a professor at Fudan University in Shanghai, allowing the use of a traditional Chinese medicine as a rat poison.
Most physicians I know are interested in the insights of oncologists, and the public will be too when the read The Cheerful Oncologist as he explains the hard-won struggle to cheerfulness in a profession that bestrides death.
Got Blue? It's common during the holidays. Although normal, the holiday blues can be made a lot worse when family embers impose their expectations upon one another. Dr. Baker shares a case of a husband who needs to back off a bit from his expectations this holiday season.
Is there really a madman across the water? The Medical Madman instructs medical practice to a student who lives where yet there is no Internet access.
And Stories to Tell
Dr. Charles unearthing an article written by Mark Twain, opens a worm hole back into the year 1740, and does his best to cure a headache with leeches.
A new blogger, Bronwyn, graces us with a poem on one of my favorite little fellow, the homunculus.
And Diana, RN was kind enough to note and comment upon Gollum as seen through the eyes of some British medical students.
Finally, we will attempt to entertain you aurally, with an audio link from the Xiphoid Process, written by a third year medical student.
With the bang of a gavel I bring this Grand Rounds to a close. Want to host? Contact the gifted and talented GR progenitor, Nick, at Blogborygmi.
Check out the next rounds at Code Blog: tales of a nurse 12/28/04.



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