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Don't Sweat It

Posted by mdaware on September 09, 2014

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Great perspective from Matt Pirotte on residency* personal statements:

*probably most

education mjp

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Brussels Sprouts + Math = A Recipe for Confusion

My wife is a dietitian and a very good, healthy cook. Today she was cooking some Brussels sprouts (which I, evidently incorrectly, have been calling "brussel sprouts") and it brought up a great lesson in how hard it is to try to eat healthily in America. Rather, I just finished 26th grade and my wife went to school for this and has literally done this for a living for nearly a decade, and yet we can't figure out what we're eating. We have a 1-pound bag of Brussels sprouts: 1 pound bag = 454 grams According to the label, the serving size is 4 sprouts, or 84g, which contains 40 calories. There are 5 servings per container, which should be 20 sprouts in the bag for a total of 200 calories. The label (photo) is identical to the official USDA label (image above). My wife counted how many sprouts came in the bag, and we have 40, not the 20 the label says we should have (4 sprouts per serving x 5 servings). Which, on the one hand, is great, because, hey, who...

On "unnecessary" ED visits: background reading

Here are a bunch of very informative pieces on why trying to blame excessive costs or busy-ness on low acuity patients in the ED is, at best, a misguided effort: 1) Great overview of many systemic issues which funnel patients to emergency departments, by Annals of Emergency Medicine Editor in Chief Mike Callaham*: The Prudent Layperson’s Complicated and Uncertain Road to Urgent Care 2) We can't discern low acuity diagnoses from chief complaints, by Maria Raven , Robert Lowe, Judith Maselli, and Renee Hsia in JAMA: Comparison of Presenting Complaint vs Discharge Diagnosis for Identifying “ Nonemergency” Emergency Department Visits and accompanying editorial by my (now) chair: some intuitive, oversimplified, yet enduring beliefs about nonurgent patients in the ED should be abandoned. Trying to discern low-acuity conditions and putting up barriers to receiving care or denying payment after receiving care will work no better in future generations than in the past. Attenti...

Empty the Dishwasher

True story: a few months ago, I walked into my apartment, and noticed the sink was overflowing with dishes. My first reaction: The dishwasher must be full. I had been taught a few years ago that the main cause of crowding in the ED is boarding of admitted patients: patients who came to the ED, got admitted, and are waiting for beds upstairs. It seemed a bit odd at first, but the explanation makes sense. There are 3 possible causes: input, throughput, and output. Either there are too many patients coming to the ED; patient time in the ED is too long; or, we can't get patients out of the ED. While the mainstream media and many policy people who aren't fluent with the topic are quick to attribute crowding to armies of low-acuity patients clogging up EDs with sore throats and ankle sprains, empirical evidence shows that's just not the case . And it makes sense. If an admitted patient sits in the ED for an extra 6 hours, that's the equivalent load as 6 low-acuity pat...

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OPINIONS ARE NOT THOSE OF EMPLOYER NOR MEDICAL ADVICE

Don't Sweat It

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