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Category Archives: Neurology

"How to Conquer Your Fear of Doctors"

The term "content farm" describes a company that employs large numbers of often freelance writers to generate large amounts of textual and/or video content which is specifically designed to satisfy algorithms for maximal retrieval by search engines. Their main goal is to generate advertising revenue through attracting reader page views (source: Wikipedia).
This is what the content farms are producing nowadays:
How to Conquer Your Fear of Doctors (HowCast video). A mix of good and bad advice, don't take it seriously:

"How to Live to Be 100" (HowCast video). Some tips in the video may fall in the category "Do not try this at home":

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Managing fever of unknown origin in adults – BMJ review

Few clinical problems generate such a wide differential diagnosis as pyrexia (fever) of unknown origin. The initial definition proposed by Petersdorf and Beeson in 1961 was later revised. Essentially the term refers to a prolonged febrile illness without an obvious cause despite reasonable evaluation and diagnostic testing.

Definition

Classic adult fever of unknown origin (FUO) is fever of 38.3°C (101°F) or greater for at least 3 weeks with no identified cause after 3 days of hospital evaluation or 3 outpatient visits
Causes of FUO
Common causes of FUO are infections, neoplasms, and connective tissue disorders.

Investigations almost always include imaging studies. Serological tests may be indicated

Treatment of FUO

Empirical antibiotics are warranted only for individuals who are clinically unstable or neutropenic. In stable patients empirical treatment is discouraged, although NSAIDs may be used after investigations are complete. Empirical corticosteroid therapy is discouraged.

References:

Investigating and managing pyrexia of unknown origin in adults. BMJ 2010; 341:c5470 doi: 10.1136/bmj.c5470 (Published 15 October 2010).
Image source: Wikipedia, public domain.

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Only 62% of referring PCPs received consultation results from specialists

Communication between primary care physicians (PCPs) and specialists regarding referrals and consultations is often inadequate, with negative consequences for patients.

A study found that perceptions of communication regarding referrals and consultations differed.

For example, 69% of PCPs reported "always" or "most of the time" sending notification of a patient's history and reason for consultation to specialists, but only 34.8% of specialists said they "always" or "most of the time" received such notification.
Similarly, 80.6% of specialists said they "always" or "most of the time" send consultation results to the referring PCP, but only 62% of PCPs said they received such information.
The 3 practice characteristics associated with PCPs and specialists reporting good communication regarding referrals and consultations were:
- "adequate" visit time with patients
- receipt of quality reports regarding patients with chronic conditions
- nurse support for monitoring patients with chronic conditions
Twitter comments:
@westr: Case for EHRs...
@Kind4Kids: but then the inpatient and outpatient EHR need to "communicate".
@GruntDoc: 0% of ED docs... -- Only 62% of referring PCPs received consultation results from specialists
References:
Referral and Consultation Communication Between Primary Care and Specialist Physicians. Arch Intern Med. 2011;171(1):56-65. doi:10.1001/archinternmed.2010.480

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Sports Health With Cleveland Clinic (video)

There are a lot more sports health-related video from Cleveland Clinic on YouTube. I find many of these useful but they often don't get the numbers of views they deserve, for example the video embedded above was watched only 20 times as of 03/23/2011 (it was posted on 01/10/2011).

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86% of Australian doctors report high rates of job satisfaction – see why

More than 80% of Australian doctors are moderately or very satisfied with their jobs, a national survey has found.

The survey, of 10?498 doctors, 19% of those who were contacted and eligible, found that 86% were moderately or very satisfied with their jobs, with no significant differences between GPs, specialists, and specialists in training. Hospital non-specialists were less satisfied.
The predictors of high professional satisfaction included:
- a good support network
- a household with a high income
- patients with realistic expectations w
- being able to take time off
- being younger or close to retirement
- having good self reported health.
Female GPs earn an average 25% less than their male counterparts and that GPs on average earn 32% less than specialists. The average annual pretax personal earnings of GPs and specialists were $US 180?000 and $US 316?570, respectively.
With Australia in the throes of national health reform, the researchers said that their findings set an important baseline for examining the effects of policy changes on doctors’ job satisfaction.
The survey was conducted between June and November 2008, before the Australian government announced its national health reform agenda.
The survey findings were published in the 3 January edition of the Medical Journal of Australia.
Twitter comments:
@gastromom (Meenakshi Budhraja): What are comparative figures in the US - 80% of Australian doctors report high rates of job satisfaction http://goo.gl/mchQT”
@PMillerMD (Philip Miller): 80% of Australian doctors report high rates of job satisfaction. / What is it in US? And if lower, why? I suspect payment morass.
@cotterj1 80% of Australian doctors report high rates of job satisfaction http://goo.gl/mchQT -> Explains why half the HSE docs are gone!
References:
Australian doctors report high rates of job satisfaction. BMJ 2011; 342:d119 doi: 10.1136/bmj.d119 (Published 10 January 2011)
Image source: Wikipedia, public domain.

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When physicians prescribe a new medication… confusion ensues

According to a 2006 study of physician-patient communication during primary care visits, when physicians prescribed a new medication they:

- did not tell the patient the name of the new medication in 26% of the cases (the other way to look at the data is that the physicians stated the specific medication name for 74% of new prescriptions)

- did not explain the purpose of the medication to patients in 13% of cases (explained the purpose of the medication for 87%)
- did not tell patient about adverse side effects of the medication in 65% of cases
- did not describe to patients how long to take the medication in 66% of cases
- did not tell patients the number of pills to take in 45% of cases
- did not tell patients about medication dosing and timing in 42% of cases
References:
Physician Communication When Prescribing New Medications. Arch Intern Med. 2006;166:1855-1862.
Image source: Wikipedia, public domain.

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