What Doctors are Thinking

Underwriters take note and read the entire article, especially the section on pattern recognition.

Musings of a Dinosaur

Ever wonder what your doctor is thinking while taking your history? If we’re doing it right, we’re looking at you instead of a computer. We’re making appropriate eye contact while displaying welcoming body language. And we’re letting you tell your story with as few interruptions as possible. Clearly we are listening intently, but did you ever wonder what’s going through our minds while you’re speaking?

I’ve been thinking about this lately in the context of teaching medical students about history-taking. They’re being taught all the right questions to ask and how to ask them (body language, open-ended, etc) but it often seems like they don’t know what they’re supposed to be listening for, or how to elicit the kind of information that will let them make a diagnosis (which is, of course, the necessary prerequisite for appropriate treatment.)

So here’s an analogy to try and help both patients and learners…

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Lower BMI Limit for T2D Screening for Asian Americans – Medpage Today

Hsu and colleagues made this determination based on the scientific literature, citing the distribution of adipose tissue as the explanation. Asian Americans tend to store excess weight around the waistline, where fat storage has been associated with higher risk for insulin resistance and type 2 diabetes, compared with peripheral fat stores in the legs and arms.

via Lower BMI Limit for T2D Screening for Asian Americans | Medpage Today.

I’m screwed.

Cannabis-Related ED Visits Rise in States With Legalized Use

Cannabis-Related ED Visits Rise in States With Legalized Use.

A second poster presented at the AAAP meeting examined “impact on the healthcare system” and showed that 10,532,658 ED visits due to any type of substance abuse occurred between 2007 and 2011 in the United States.

During that period, cannabis-related ED visits increased 67.8%, and alcohol-related visits increased by 49%. Also increasing were visits related to opioids (by 42%), hallucinogens (40.4%), sedatives (40%), and amphetamines (20.6%).

Interestingly, the percentage of visits related to cocaine use decreased by 67.9%.

 

“This poster is definitely starting to bring out some of the real concerns that I have as a healthcare provider ― that you are exposing more people to higher potency and riskier forms of the substance. This is not the shake weed that somebody smoked in the ’70s. This is four times more potent. It’s a much riskier proposition than a lot of people think.”  Dr Ryan Caldeiro

Diabetic Foot Ulcer – Medscape

Diabetic Foot Ulcer.

Diabetic foot ulcers occur as a result of various factors, such as mechanical changes in conformation of the bony architecture of the foot, peripheral neuropathy, and atherosclerotic peripheral arterial disease, all of which occur with higher frequency and intensity in the diabetic population. Diabetic foot lesions are responsible for more hospitalizations than any other complication of diabetes. Among patients with diabetes, 15% develop a foot ulcer, and 12%-24% of individuals with a foot ulcer require amputation. Diabetes is the leading cause of nontraumatic lower-extremity amputations in the United States.