Dear readers…

It feels like fall this Midwestern Sunday morning.  We’re back to sweater weather (at least in the morning), the Tigers are headed to the playoffs, the Big House is full of maize and blue. Summer is sadly brief, and autumn, while beautiful, quickly descends into a maelstrom of wind, water, and blowing leaves.  I’m trying to find some way to make winter a little less glum.  My partner said he’d lend me his snowshoes to try out, but that whole sport is predicated on having a snowy winter.

It appears writing may be one of my primary winter hobbies.  And while I write mainly to please myself, I’d like to ask you, Dear Reader, if there’s anything you’d like to read about.  I’m certainly not guaranteeing anything, but I’ll keep a list to dip into in case of Muse dysfunction.

So here I sit in a strange time void.  I woke up before dawn for some early rounding at the hospital, and have to be back in a little while to stay the rest of the day.  Part of me wants to go home and go to sleep, the other part sees the futility in this.  A morning nap can only lead to no good.  There’s plenty of work left to do at the office, plenty of time-wasting to do online, plenty of exercise to blow off.



  1. Reuben

     /  September 18, 2011

    You write to please yourself? So science erotica it is!

  2. CanadianChick

     /  September 18, 2011

    I enjoy all your posts, but my favorites are the personal ones. Quirky cases, quirky patients. Your joy in watching PalKid explore the world and learn from it. Your love and awe of science and the responsibility of medicine.

    Your pieces on biology, quackery and that sort if thing drew me to you @ SciBlogs but it’s the personal ones that keep me following you around the net!

  3. Enjoy them all… Rounding this AM at DRH felt dismal- it IS cold and it was dark. Reading the blogs brought life back. I agree with CC, the quirky pt are the ones that provide a bit of a spark to my day.

    But the Lions had a good day, U of M is doing well, and it might be a turning point for Detroit sports.

    (I am an older PA student…;))

  4. Politics and PalKid.

  5. Oh! And childbirth/newborn/parenting woo.

  6. Old Geezer

     /  September 18, 2011

    Without stepping in any HIPPA, I would like to hear about funny patient encounters.

  7. Lisa R.

     /  September 18, 2011

    I always like a nice little slice-of life post. Everything I know about the medical field is from the patient side of the equation, so it’s interesting to read about how a physician’s take on a person or situation (even observations from outside the clinic) differs from mine. Thanks for much happy reading over the years!

  8. Karen

     /  September 19, 2011

    Tell us what you think of surgical methods of combating obesity.

  9. What does the evidence show about medicine dispensed via the so-called VIP or “concierge” model? I’m interested less about the individual who is able to enroll and more about the community in its entirety. I’m only an English Major but I can see several ethical issues here.

    My own primary care physician (an internist) announced earlier this month that he plans to limit his practice to 600 patients. I am scheduled to attend an informational seminar next month at which I possibly may “secure my place” in his practice if I am selected.

    I’m impressed at the marketing I’ve witnessed: It began with a phone survey conducted by a live person in Nebraska (1,100 miles away), followed by a longer, written survey that included the usual 1-5 scale opinion ratings and short essay answers. Then came a robocall with my doctor stiffly reading from a script, a follow up letter promising that “we can spend more time working together on your [my] wellness goals.” That communique culminated with an invitation that sounds remarkably similar to timeshare-vacation pitches. In fact, “healthcare opportunity” is exactly how the good doctor’s second scripted robocall put it — just this morning — in which thanks me for visiting his new website and signing up for the Oct. 11 meeting. Will I have to purchase a membership? I don’t know because that’s not disclosed or addressed in the pitch, but will keep you posted.

    MDVIP: Personalized Healthcare is the name of the corporation that my good doctor is undoubtedly paying big chunk of change to. Its branding slogan is “exceptional doctors; exceptional care; exceptional medicine.” But when I read that I see the root word, “except,” an unwitting admission that this is medicine except for those not invited.

    Ironic sidebar: Four or five years ago, I wrote an magazine story for the glossy regional lifestyle monthly about concierge medicine. This doctor was one of my quotes. When I later had to selected a primary care physician, I chose him because he had said, “That’s not how I’d ever practice medicine.”

    OK, I’ve aired my prejudices — but only just a few. Why am I so offended here when over there HMO’s and PPO’s, and etc., etc.,also “enroll” patients? Are there studies out there or suggestive anecdotes that point to a potential impact of this kind of practice on the community services? Will this doctor be able to “not invite” patients who aren’t sufficiently compliant (he once chided me for taking a weekend’s worth of Cipro before doing a lab test done for a UTI). If I’m invited to enroll, can he terminate that relationship? And, you know, I don’t really want a family physician or generalist or internist to be available to me 24/7, as this pitch promises — he needs his sleep and there are ER’s for stuff that can’t wait.

    Sorry for the length. I didn’t mean to write a whole blog post, but my blog is journalism focused ( — and I’m out of my depth on this topic.


  10. DLC

     /  September 22, 2011

    I like the case reports you do sometimes. the “what’s wrong with this Patient” stuff. It sort of lets an outsider get a glimpse of how things work, and perhaps even some insight into how doctors (or at least PalMD) think.

    Now, if only I can get my PCP’s office staff to stop confusing me and my brother!
    (same last name, etc. )

  11. LENW

     /  September 25, 2011

    I’d like to hear about non-scientists doing science poorly and what are the thinking errors that lead to poor conclusions. For example, the quality indicator for the complex job I do is post-op patient temperature. If the temperature is normal, then I’ve done a good job. Really? Or the patient’s family member fell from a chair that broke in the preop holding area. Our answer? FIx the chairs? No, prohibit family members from accompanying the patients to the holding area. This problem of answering a different question than the one that needs an answer makes me crazy… is there any cure?

  12. Shirah

     /  October 2, 2011

    Perhaps this is a bit late in the game, however I can think of two things:

    (1)Post-shift wind-downs: Always interested in how other people wind down from busy shifts. It can be hard to just let go of cases for however many hours or days!

    (2) I’ve found your posts on communicating/working with new people/interns/residents both interesting and helpful. More would always appreciated!

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