http://www.medrants.com/archives/5108 Internal medicine, American health care, and especially medical education Sat, 11 Feb 2012 15:15:48 +0000 hourly 1 http://wordpress.org/?v=3.3.1 http://www.medrants.com/archives/5108/comment-page-1#comment-530801 david Sat, 19 Dec 2009 04:45:35 +0000 http://www.medrants.com/?p=5108#comment-530801 would not give bicarb for lactic acidosis. would do ercp and give abx to treat cholangitis. would not give bicarb for lactic acidosis. would do ercp and give abx to treat cholangitis.

]]> http://www.medrants.com/archives/5108/comment-page-1#comment-530799 M S Fri, 18 Dec 2009 20:07:18 +0000 http://www.medrants.com/?p=5108#comment-530799 I enjoy the blog, and very much like the VA series, but there is one concern I have that I HOPE has more to do with your writing style than your teaching style since I know you aim to be a conscientious teacher and I appreciate that greatly (and am stiving to do the same in my own practice!). As a senior IM resident back in the day, one of the best aspects of my VA ward month rotations was the opportunity to take charge of the team, including a substantial part of teaching, and of the care of the patients, with the attending's role more advisory than directive. More than at our tertiary/quaternary academic hospital where we often felt like the handmaidens of the specialty teams, we were happy to be the true primary decisionmakers at our VA. Thus, when I see you repeatedly using phrases in your blog like today's "I ordered a consult," or in the past, "I made some decisions," or, worst of all, "I sent the patient to the unit," I am very hopeful it was really your residents doing these things, primarily on their own initiative, perhaps with some nudging from you. If my hope is correct, and it is you collectively as a team, or better yet your residents really taking charge, then I would still suggest you consider changing your verbiage in your blog out of respect to your colleagues in training, since I am certain they must read your blog too, and they deserve to take part in the ownership of the patients. These little things mean a lot. Otherwise, I enjoy the blog, and I look forward to you continuing to champion the academic teacher's role! I enjoy the blog, and very much like the VA series, but there is one concern I have that I HOPE has more to do with your writing style than your teaching style since I know you aim to be a conscientious teacher and I appreciate that greatly (and am stiving to do the same in my own practice!).
As a senior IM resident back in the day, one of the best aspects of my VA ward month rotations was the opportunity to take charge of the team, including a substantial part of teaching, and of the care of the patients, with the attending's role more advisory than directive. More than at our tertiary/quaternary academic hospital where we often felt like the handmaidens of the specialty teams, we were happy to be the true primary decisionmakers at our VA.
Thus, when I see you repeatedly using phrases in your blog like today's "I ordered a consult," or in the past, "I made some decisions," or, worst of all, "I sent the patient to the unit," I am very hopeful it was really your residents doing these things, primarily on their own initiative, perhaps with some nudging from you.
If my hope is correct, and it is you collectively as a team, or better yet your residents really taking charge, then I would still suggest you consider changing your verbiage in your blog out of respect to your colleagues in training, since I am certain they must read your blog too, and they deserve to take part in the ownership of the patients. These little things mean a lot.
Otherwise, I enjoy the blog, and I look forward to you continuing to champion the academic teacher's role!

]]> http://www.medrants.com/archives/5108/comment-page-1#comment-530798 Jared Fri, 18 Dec 2009 17:37:13 +0000 http://www.medrants.com/?p=5108#comment-530798 RAM, a spot protein/creatinine has been shown to be pretty much equivalent to the 24 hour urine.  It is also much much easier for the patient. RAM, a spot protein/creatinine has been shown to be pretty much equivalent to the 24 hour urine.  It is also much much easier for the patient.

]]> http://www.medrants.com/archives/5108/comment-page-1#comment-530793 ram Fri, 18 Dec 2009 12:10:41 +0000 http://www.medrants.com/?p=5108#comment-530793 <!--Session data-->Thnx for bringing back VA series. I learned more from this VA series than any other resources on Acid Base balance. Urine proteinn/creat ration mentioned in this blog post, do we require 24 hour urine collection or is it spot test?   Thnx for bringing back VA series.
I learned more from this VA series than any other resources on Acid Base balance.
Urine proteinn/creat ration mentioned in this blog post, do we require 24 hour urine collection or is it spot test?
 

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