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Teens of the week: Where are they now? Featuring Helen Selonick, daughter of Dr. Stu Selonick and wife of AAMC’s emergency room doc, James Prevas

by jmiller on December 27, 2016

This is a beautiful piece, published December 26th in the Capital,  revisiting a 2003 Teen of the week:  Helen Selonick, daughter of Dr. Stu Selonick, who also became (and married) a physician.  This is a delightful piece to share.  To read full article, click here.

Meaning and the nature of physicians’ work by Abraham Verghese, M.D.

by jmiller on December 8, 2016

This excellent Perspective from the Nov.10th issue of NEJM, written by Dr. Abraham Verghese, author of Cutting For Stone, is a very insightful piece on the timeline of where we are now in medicine, versus where we were.  He poignantly comments that “patient centered care”, despite all the rhetoric, is not the center of things.  His vision of the future is that “the U.S. medical community will have to rethink the human-computer interface and more thoughtfully merge the real patient with the ipatient.”  Click here to read full-text.

Mindfulness Meditation-Based Intervention is Feasible, Acceptable, and Safe for Chronic Low Back Pain Requiring Long-Term Daily Opioid Therapy

by jmiller on November 3, 2016

“Findings of this study indicate that the targeted mindful meditation-based intervention is feasible and safe in patients with opioid-treated chronic low back pain.  Mindful meditation-based interventions are particularly attractive for the treatment of chronic disabling conditions because they promote an acceptance-based, self-reflective process, which can encourage a patient-empowering and personalized approach addressing the whole patient.  This approach extends beyond the traditional, disease-focused treatment model of chronic pain and passive nature of pharmacotherapy, offering a valuable therapeutic option for those with refractory chronic low back pain requiring daily opioid therapy.”  (Journal of Alternative and Complementary Medicine, August)  Click here to read full-text.

“Interventions to Prevent and Reduce Physician Burnout: A Systematic Review and Meta-Analysis” and Accompanying Editorial “Doing Something about Physician Burnout”

by jmiller on November 3, 2016

“Physician burnout has reached epidemic levels, as documented in national studies of both physicians in training and practicing physicians. The consequences are negative effects on patient care, professionalism, physicians’ own care and safety, and the viability of the healthcare systems. The literature indicates that both individual-focused and structural or organizational strategies can result in clinically meaningful reductions in burnout among physicians.”  (Lancet, Sept. 28)  Click here to read full-text..

In the News: Acute Flaccid Myelitis Outbreaks Resulting in Childrens’ Deaths across the Country

by jmiller on November 3, 2016

Several articles attached related to acute flaccid myelitis, which has been a topic in the news this past week. Several articles are attached. Click here to read full text.

Hearing without Listening: NEJM Perspective Piece

by jmiller on November 3, 2016

Jeffrey Drazen, MD, takes us through a scene of “pre-rounding” in an ICU unit, in which the attending physicians are rounding with their computers, giving the latest data on each patient without connecting with the patient. The residents who really know their patients’ overnight story don’t read from the computer; instead, they look at the group when they present. They consult the computer only on a rare occasion when someone asks a question to which they don’t know the answer. “Freed from the hypnotic power of our screens, we can once again engage with other human beings and pool our knowledge and expertise in satisfying and productive ways. Ultimately, that can’t help but benefit our patients.” Click here to read full text.

Guidelines for the management of severe brain injury, Fourth Edition

by jmiller on October 12, 2016

The purpose of this article (Neurosurgery, Sept.), is two-fold: “to synthesize the available evidence and translate it into recommendations. This document provides recommendations only when there is evidence to support them.”  Updated treatment recommendations are offered in bold in their tables. There are now 28 evidence-based recommendations; 14 are new or changed from the previous edition, while 14 have not changed. Click here to read the full text.

Rethinking the primary care workforce – an expanded role for nurses

by jmiller on October 5, 2016

In this “Perspective” article (NEJM, Sept 15), “the adult population of the U.S. will soon have a different primary care experience than we’ve been used to. In the primary care practice of the future, the physician’s role will increasingly be played by nurse practitioners (NPs). In addition, the 150 million adults with one or more chronic conditions will receive some of their care from registered nurses (RNs) functioning as care managers. Although NPs and RNs are increasingly central to primary care, there are still obstacles to their performing these roles that need to be overcome. Despite these challenges, the shortage of primary care physicians and the increasing prevalence of chronic diseases are powerful forces pushing primary care toward stronger NP and RN participation. It’s fortunate that the growth in the supply of NPs and RNs enables us to rethink who does what in primary care.” Click here to read full text.

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