Little Black Bag

Swine Flu is here... and will probably be around for awhile.

2009-04-26T21:45:00-05:00

For all that are interested, here is a great little google map that shows all the reported and suspected cases of Swine Flu in the world.

Remember: lots of hand washing!

I will post more about this as it emerges.

Google Swine Flu Incidence Map

A Personal Hero of Mine.

2009-02-27T21:01:10-05:00

Not only is this a fascinating read but it is a remarkable TRUE story.

Tea had the pleasure of working with Dr Catena in Kenya. Since that experience and after hearing her stories about the remarkable skill and determination that Dr Catena has I am humbled beyond belief.

I count him as one of my Heros.

Dr Tom Catena- An American Family Doctor in Sudan

Telemedicine or McMedicine?

2009-01-11T00:00:00-05:00

This CNN report shows how telemedicine is beginning to expand into retail medicine. Here in Florida there are state laws that will not allow this kind of "telemedicine."

I certainly think that telemedicine is an important area of medicine and has a role... somewhere. But in retail stores?!?!?

I cant imagine that this can POSSBILY be equal care to an actual doctor visit. I think time will show this.

Smells of more McMedicine to me. I guess we are all going to get what we want to pay for.

Telemedicine Clinics in Walmart

When will the public and the government understand...

2008-11-30T22:04:00-05:00

When will people understand. The primary care if the heart of a good medical system and amazingly... it is the most cost effective. we can not continue to run primary care practices into the ground and expect ANY meaningful reform in our health care system.

Mass. Health Care Reform Reveals Doctor Shortage

most interesting point about this article is that you can give people all the insurance they need, but it is worthless if you do not pay your doctors well enough to stay in practice. just something to think about.

Flu Epidemic in the Making for 2008?

2008-02-11T00:00:00-05:00

Well, it's official. The CDC released surveillance results last week of the 2008 Flu season which suggests that we are heading for an epidemic this year.

The 08 Flu season has gotten off to a slow start but in the last couple of weeks has fired back with a vengeance.
The problem seems to be that this years vaccine is not a good match for 2 of the 3 circulating strains of Flu. Therefore, offering less protection from the illness.
The good news (so far) is that the number of deaths and hospitalizations related to the flu has been low.

Be on the look out and remember to WASH YOUR HANDS(a lot!)

CDC-2007-2008 Influenza Season Week 5, ending February 2, 2008

Robot to Help Doctors Talk to Patients

2007-12-31T00:00:00-05:00

Would you like to have a robot help you talk to your doctor? In Japan they actually have invented such a thing. The Japanese Muu Socia robot.

I really hope it never comes to this for me and my patients. :)

But who knows... Maybe the government will decide to mandate all Docs carry one of these little critters in ordered to be paid by Medicare.
You know... to improve healthcare quality.

Keeping Holidays Simple for Grandma

2007-11-10T00:00:00-05:00

This is some great advice. We often want to do so much for our elderly yet... most of the time. SIMPLE is Better.

Six Creative Holiday Ideas For Your Senior Family Member

"But I dont like taking medicine"

2007-10-19T00:00:00-05:00

It has been brought to my attention once again that the American public has a poor misconception of what is medicine.
Whether it is the "natural" supplements that patients forget to mention to the doctor, or the 7 cups of coffee that the anxiety patient has each day. There is one simple truth about medicine.

It is ANYTHING you put on or into your body for a desired effect.

well, you may say... that seems silly Dr B. think about it.

We take medicine into our body to produce some specific effect.
Water? of course it's medicine. without it we die. We use water to treat people all the time in the hospital. it can even make you sick if you take to much (an adverse side effect.)

Food? almost the same as above. we eat so that we feel good and not hungry. To much and we again, can become sick.

Sun-Tan Lotion? applied to the skin to protect from the sun and prevent aging and burns.

what about the Sun? some people chose to allow the suns rays to enter their body so they can change their skin color or to feel "rejuvenated." But of course, to much and you burn and even can get cancer.

I hope readers can understand. Obviously I have taken this to an extreme, but the point is that we are surrounded by medicine. it is everywhere! And it is silly for us to believe that side effects and adverse reactions are somehow limited to the "medicines" that you buy at a pharmacy.
I encourage people to always consider everything in their lives when they have medical problems. The source of the problem may lay with the simplest and most natural thing in your house.

Remember that everything that goes on or into your body can potentially harm you. Even "natural" things. Rattlesnake poison is natural, doesn't make it good for you!

Doc, I think I got bit by a spider!

2007-10-18T00:00:00-05:00

This has been brewing for several years now but it is sadly becoming a frequent problem. Severe skin infections caused by MRSA (Methicillian Resistant Staph Aureus.)
MRSA is a Staph A. bacteria. MRSA is a form of this bacteria that has developed resistants to several classes of antibiotics. What has made this Bacteria scary in the community is it's production of potent toxens that make it an increasing cause of skin infections. These infections have been frequently misdiagnosed (often attributed to spider bites, which are very rare!) The poor Brown Recluse spider is also frequently blamed but is rarely the cause.
All should be aware and vigilant of severe (often blistering) skin infections and should seek medical attention to have them treated. Of note: the community form of MRSA is different from the Hospital aquired form of MRSA. Confusing, but the distinction is important because they are treated differently.

Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States

Welcome to the Real Problem of Healthcare Reform

2007-10-12T00:00:00-05:00

Thanks to this website for the picture.
http://www.tipotheday.com/wp-content/uploads/2007/10/good-cheap-fast.jpg

The Religion of Medicine

2007-09-17T00:00:00-05:00

On my first day of medical school, the professor walked in and she said, "Despite my best efforts, I know that by the end of your four years here, 75% of what I will tell you will be wrong."

Sobering and terrifying for me on a daily basis.

Once again, I have found a great article written in the New York Times to help me with my thoughts.

Do We Really Know What Makes Us Healthy?

Science and medicine are all to often looked at as "sterile" and absolute. I would like to challenge this assumption. Is Science really all that different from Religion? Religions seek God and choose to do so through belief and faith, avoiding the need for rationality. But what about science? Is science really doing more than just looking for God (or The Answer, if you will.) Instead of blind faith, scientist do this through rigid rationality, but they still MUST have faith. Faith that the universe follows certain rules. Faith that "The Answer" is worth finding. Faith that knowledge will lead them to "salvation" when in actuality it is only going to lead them to more questions (not to different from religion, but that is another topic:)

But what does that mean for medicine?
well, it's back to medicine being an art. Just like traditional art often reflects and commentates on religion, medicine reflects and commentates on science.
We take an immense amount of information and reflect our best guess as to the right answer. But given the sheer complexity and almost infinite variables in our biology and our lives it's a miracle that we get anything correct. Alas, modern medicine (for all it's faults) has been successful. Average life span and quality of life have all risen over the last 50yrs, despite rapid declination of "healthy" lifestyles in America.
Do we know what makes someone healthy? Well.... no. but, we have a good guess and I'm confident our jobs as physicians are to make people comfortable and to help them enjoy their lives. A job that we can do if people have a good relationship with their doctor and faith.
Faith of good intentions and the will to live and be healthy. This is what makes us healthy. (I hope.... :)

Your Doctors Neck Tie Might Kill you.

2007-09-17T00:00:00-05:00

Ok.... so we have known this for a long time. I'm just happy to see someone do something about it.
By this point, I have antibodies that attack small dogs. But we should be so careful not to spread our cuddies to patients. HAND WASHING is still the most important rule for infection control. But I think this is a good step to. No more Neck Ties for me :)

End for traditional doctor's coat

An Incredible 1st Month...

2007-01-31T00:00:00-05:00

January 2007 was a month of INTENSE changes for me an my family. I am proud to say that I have the greatest patients and friends in the world. I am constantly reminded how blessed I am and how misfortunte life can be. I will say it again and again, THANK YOU to all that have supported me and my crazy ideas. My dreams of creating a personalized patient-focused doctor experience is comming true and I have so many wonderful patients to thank for it.

Start of something new...

2006-12-29T00:00:00-05:00

This is a very simple blog entry. Simply a start. After completing Residency almost 1.5yrs ago I wanted something different. Something better for my patients and better for me. I rediscovered House call medicine and I have been practicing it ever since. I see my patients when and where they need me and I develop a real relationship with my patients. Something that I cherish deeply. As I grow my practice and continue to learn CONSTANTLY I hope to add to this blog regularly for all that are interested. I also hope to use this blog as a forum to educate myself and others about this fantastic condtion known as human life. I hope and encourage comments and questions. I will respond to as many as possible.

enjoy.