July 7th, 2011 by Peggy Polaneczky, M.D. in Health Tips
2 Comments »
A friend of mine had a hard time getting in to see her doctor for an urgent visit last week. Reeling from an unexpected and sudden family upset, she was depressed and anxious, unable to sleep or function, and her therapist was advising an antidepressant. She called her family doc, who works at a large hospital-based multispecialty group, and told the woman at the call center that she wanted to see the doctor on an urgent matter. She was given an appointment 6 weeks in the future.
Summoning her courage, my friend told the woman her story – and that she was really worried about herself and did not think she could wait that long.
“Sorry, that is the best I can do” was the reply.
Increasingly upset, my friend told the woman that if she had to wait that long, she just might kill herself in the interim. Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
April 28th, 2011 by Paul Auerbach, M.D. in Health Tips
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Along with blisters and sprains, muscle strains are among the most common afflictions for active persons in the outdoors. Common medical dogma is to use the “RICE” approach for sprains and strains of—rest, ice (application of cold), compression, and elevation.
This is more applicable to sprains (e.g., an ankle sprain) than to strains, because the sprained body part is usually a limb (ankle, knee, wrist)
that is amenable to this approach. Strains more often involve larger muscle
groups, such as those in the back, chest, thigh or abdomen, or difficult-to-approach areas, such as the neck or groin.
Prevailing theory for treatment of a muscle strain is that one applies external cold for 24 to 48 hours, and discontinues it after 72 hours, at which time one begins application of external heat. The rationale is
that swelling (from leakage of blood and tissue fluid) and inflammation prevail in the first two days, and that after three days, one wishes to increase local circulation and augment reabsorption of the fluid that has collected. There is some science to this, and these recommendations have been around for as long as I can recall. Read more »
This post, Muscle Strain: Should You Treat It With Hot Packs Or Cold Packs?, was originally published on
Healthine.com by Paul Auerbach, M.D..
March 17th, 2011 by ChristopherChangMD in Health Tips, Opinion
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Occasionally, I see patients who have received throat swabs for strep that have come back positive… even if they have no signs or symptoms of pharyngitis.
In this situation, there are 2 main actions a physician may take (I am biased towards one):
1) Prescribe antibiotics until throat cultures are normal
2) Do nothing
Personally, if a patient is without throat symptoms and has no history of rheumatic fever or kidney damage, I would not have even bothered obtaining a strep test. What for??? Read more »
*This blog post was originally published at Fauquier ENT Blog*
November 19th, 2009 by Bryan Vartabedian, M.D. in Better Health Network, Opinion, True Stories
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Last week someone posted on Twitter that they had swallowed a plastic toothpick. What to do? So they turned to the hive for help. “What should I do?” I thought as I read my Twitter feed. I was paralyzed in a way. I wanted to share my experience with hundreds of patients had swallowed pins, toothpicks and other pointy things. I specialize in just this sort of thing. But short of a random comment about gastric emptying, I kept to myself. Why? Because once I lend a hand I’m all in.
The simple offer of patient-specific advice constitutes a relationship in the eyes of the law. Once involved, I potentially share responsibility in whatever happens to someone. Crazy but true. It’s just a matter of time before slip-and-fall lawyers hold physicians accountable for helping out in the social sphere.
Doctors aren’t the only ones wearing targets. Read more »
*This blog post was originally published at 33 Charts*
November 10th, 2009 by Happy Hospitalist in Better Health Network, Opinion
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When a patient decides they are leaving against medical advice what responsibility does the physician have to their care? When I was a resident in training, and even early on in my position as a hospitalist, I would get a call from the nurse that Mrs Smith was demanding to leave the hospital against medical advice. I would tell the nurse “Fine. Let her go. I’m not her father.” I would tell the nurse to discharge Mrs Smith with no medications and leave it up to them to find follow up.
I would suspect this is a prevalent attitude for many hospital and emergency based physicians. I’ve seen it over and over again. And I still see it today. Many doctors and nurses feel obliged to let grown men and women make poor decisions. However, being a grown man or woman able to make poor decisions is apparently not enough to keep a doctor for being sued and losing that lawsuit because a patient chose to make poor decisions. Read more »
*This blog post was originally published at A Happy Hospitalist*
A friend of mine had a hard time getting in to see her doctor for an urgent visit last week. Reeling from an unexpected and sudden family upset, she was depressed and anxious, unable to sleep or function, and her therapist was advising an antidepressant. She called her family doc, who works at a large hospital-based multispecialty group, and told the woman at the call center that she wanted to see the doctor on an urgent matter. She was given an appointment 6 weeks in the future.
