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	<title> &#187; Opinion</title>
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		<title>Formalin, the flavor of the day.  Stony Brook MD posts cadaver picture on Facebook.</title>
		<link>http://www.medicalbarista.com/2010/02/cadaver_on_facebook/</link>
		<comments>http://www.medicalbarista.com/2010/02/cadaver_on_facebook/#comments</comments>
		<pubDate>Tue, 02 Feb 2010 19:12:59 +0000</pubDate>
		<dc:creator>Dr. Kona</dc:creator>
				<category><![CDATA[In the News]]></category>
		<category><![CDATA[Opinion]]></category>
		<category><![CDATA[doctors in the public eye]]></category>
		<category><![CDATA[Facebook]]></category>
		<category><![CDATA[medical education]]></category>

		<guid isPermaLink="false">http://www.medicalbarista.com/?p=250</guid>
		<description><![CDATA[The Boston Herald reported today that an emergency medicine resident at Stony Brook University Medical Center in Long Island posted an inappropriate picture to her Facebook page.  The photo is of a fellow classmate smiling and giving two thumbs up over a cadaver.  The picture was taken while the two were medical students at Stony [...]]]></description>
			<content:encoded><![CDATA[<p>The Boston Herald reported today that an emergency medicine resident at Stony Brook University Medical Center in Long Island posted an inappropriate picture to her Facebook page.  The photo is of a fellow classmate smiling and giving two thumbs up over a cadaver.  The picture was taken while the two were medical students at Stony Brook taking a gross anatomy class.</p>
<p>Here&#8217;s the photo, with the face of the deceased person blurred out&#8230;</p>
<p><a rel="attachment wp-att-251" href="http://www.medicalbarista.com/2010/02/cadaver_on_facebook/cadaver/"><img class="aligncenter size-full wp-image-251" title="cadaver" src="http://www.medicalbarista.com/wp-content/uploads/2010/02/cadaver.bmp" alt="" /></a></p>
<p>The resident who posted the photo, Dr. Erica Katz, has apologized profusely to the media and to her coworkers and former professors/mentors at Stony Brook.  The hospital has yet to say whether or not they will formally reprimand the physician.  The student who is posing for the picture has also made an apology for his actions.</p>
<p>Although most medical schools continue to offer cadaver labs for teaching anatomy, some are going to virtual labs as methods of teaching, as cadavers donated for medical teaching are becoming more scarce.  Many anatomy labs are also employing &#8220;pro-sections,&#8221; where the professor dissects one cadaver in front of the student audience.  The students then use the dissected specimen and computer models to study.  In light of the current scandal, it is easy to see that the standard methods of teaching anatomy are going to have to adapt.    News like this certainly doesn&#8217;t make the public want to go out and donate their bodies to science.</p>
<p>All medical schools have policies regarding the photography of cadavers and behavior in the cadaver lab.  It is treated as a very sensitive subject.  Some schools, like the University of North Carolina, even have student-run memorial services at the end of an anatomy course to honor those who have donated their remains to medical education.  Clearly these students were less sensitive.</p>
<p>This comes just days after inappropriate pictures were posted on Facebook of Puerto Rican doctors partying in the field clinics of Haiti.   I wish people would stop misbehaving for the sake of the profession.  And at the very least they should know by now what to post and what NOT to post on Facebook.</p>
<p>Here&#8217;s the full article courtesy of <a href="http://bostonherlad.com/news/national/northeast/view.bg?articleid=1230020&amp;srvc=news&amp;position=recent" target="_blank">bostonherald.com</a>.</p>
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		<title>Concierge Doctors: Brew Haha</title>
		<link>http://www.medicalbarista.com/2009/11/concierge-doctors-brew-haha/</link>
		<comments>http://www.medicalbarista.com/2009/11/concierge-doctors-brew-haha/#comments</comments>
		<pubDate>Mon, 23 Nov 2009 17:55:51 +0000</pubDate>
		<dc:creator>doubleshot</dc:creator>
				<category><![CDATA[Opinion]]></category>

		<guid isPermaLink="false">http://www.medicalbarista.com/?p=192</guid>
		<description><![CDATA[So there is  a lot of brew haha about the emergence of concierge medicine. People who can pay with cash, credit card or by check will be seen faster and get more attention. Primary care doctors have been doing this for a number of years and trend is increasing. But concierge medicine is not limited [...]]]></description>
			<content:encoded><![CDATA[<p>So there is  a lot of brew haha about the emergence of concierge medicine. People who can pay with cash, credit card or by check will be seen faster and get more attention. Primary care doctors have been doing this for a number of years and trend is increasing. But concierge medicine is not limited to primary care. It is a form of practice taken up by radiologists and also surgeons. My feeling is that concierge medicine works best in big cities and affluent areas. There is no way that a doctor in a &#8220;working class-rural-town-in-the-middle-of-nowhere &#8221; is going to have an &#8220;elite cash only&#8221; practice. At least no doctor in Alaska- hint, hint. The health care reform bill is not about stamping out concierge medicine. The media should should take a closer look at what it means for a concierge primary care doctor. The doctor is &#8220;on call&#8221;  24/7 for the needs of about 600 patients all year. Does that sound like a fun job?</p>
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		<title>Bubbled Brain-Postoperative Cognitive Dysfunction</title>
		<link>http://www.medicalbarista.com/2009/09/bubbled-brain-postoperative-cognitive-dysfunction/</link>
		<comments>http://www.medicalbarista.com/2009/09/bubbled-brain-postoperative-cognitive-dysfunction/#comments</comments>
		<pubDate>Wed, 30 Sep 2009 02:29:22 +0000</pubDate>
		<dc:creator>doubleshot</dc:creator>
				<category><![CDATA[Opinion]]></category>

		<guid isPermaLink="false">http://www.medicalbarista.com/?p=156</guid>
		<description><![CDATA[POCD- This is the term used when &#8220;gradma is not exactly the same person&#8221; after surgery. Yes, it is true that a few brain cells are knocked out each time you go under anesthesia. The stories about becoming more demented after anesthesia are not far fetched.There is intense research going on about this subject right [...]]]></description>
			<content:encoded><![CDATA[<p>POCD- This is the term used when &#8220;gradma is not exactly the same person&#8221; after surgery. Yes, it is true that a few brain cells are knocked out each time you go under anesthesia. The stories about becoming more demented after anesthesia are not far fetched.There is intense research going on about this subject right now. Cognition is about mental perception, memory, processing information, acquiring knowledge, problem solving, and the ability to plan for the future. Up to this point studies have shown that the elderly, and people with pre-existing dementia are prone to a decline in cognition after anesthesia. This so called blunted brain can last about a week, improve after 3 months or get worse. Having mutiple surgeries at an advanced age is of no help. But advanced age is exactly when people do undergo surgery. A double whammy.</p>
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		<title>New Ingredient?: As old as mother&#8217;s milk</title>
		<link>http://www.medicalbarista.com/2009/09/new-ingredient/</link>
		<comments>http://www.medicalbarista.com/2009/09/new-ingredient/#comments</comments>
		<pubDate>Fri, 04 Sep 2009 01:06:46 +0000</pubDate>
		<dc:creator>Dr. Kona</dc:creator>
				<category><![CDATA[Opinion]]></category>
		<category><![CDATA[Michael Jackson]]></category>
		<category><![CDATA[propofol]]></category>

		<guid isPermaLink="false">http://www.medicalbarista.com/?p=115</guid>
		<description><![CDATA[I know the whole Michael-Jackson-death-by-propofol thing is no longer making the news, but I just wanted to share my experience today.  This is what&#8217;s happenning to anesthesiologists everywhere (I presume) now that propofol has become a household word. Today, on three separate occasions, during my shift in the preoperative evaluation clinic, I had the pleasure [...]]]></description>
			<content:encoded><![CDATA[<p><img class="aligncenter size-full wp-image-116" title="propofol bad" src="http://www.medicalbarista.com/wp-content/uploads/2009/09/propofol-bad.jpg" alt="propofol bad" width="300" height="300" /></p>
<p>I know the whole Michael-Jackson-death-by-propofol thing is no longer making the news, but I just wanted to share my experience today.  This is what&#8217;s happenning to anesthesiologists everywhere (I presume) now that propofol has become a household word.</p>
<p>Today, on three separate occasions, during my shift in the preoperative evaluation clinic, I had the pleasure of educating patients about the common and proper use of propofol after they had expressed some desire to not end up like Michael Jackson.</p>
<p>1. A 40-something woman coming for evaluation before bariatric (gastric bypass) surgery asked me what I thought about how MJ died.  I told her it was tragic, shouldn&#8217;t have happened that way, and was the result of a negligent doctor.</p>
<p>2. A 70-something woman called to ask about the anesthesia for her colonoscopy and was concerned that she would be getting the same drug as MJ.</p>
<p>3. And finally a 40-something woman coming for evaluation before a gynecologic procedure, who even brought in a tabloid article underlined in certain parts where propofol was explained.  She even went as far as claiming to have an allergy to propofol so that it wouldn&#8217;t be given to her for her procedure.</p>
<p>Well, I will take this opportunity to educate the public (or the minority that will actually read this post) about the history of this newly popularized, but not really<em> new</em> drug.</p>
<p>Propofol has been around since the 1970s.  It was first synthesized and tested in 1977 by Imperial Chemical Industries.  It&#8217;s first formulation resulted in allergic reactions due to the solvent it was prepared in; however, it was reformulated and gained widespread use.  It&#8217;s advantages over other widely used intravenous anesthetics at the time was that it was very short-acting (meaning that patients fell asleep quickly after administration and woke up quickly after discontinuation) and had some anti-nausea effects.  Propofol has been a popular anesthetic ever since.  Annual sales in the U.S. is somewhere between $350 million and $400 million, and worldwide annual sales are around $700 million.</p>
<p>So, propofol is not some new experimental drug; it has been around for over 3 decades and is quite popular among anesthesiologists and intensive care doctors for the reasons mentioned above.  These doctors are trained in using the drug safely, as opposed to the one who is responsible for Michael Jackson&#8217;s death.  Although most doctors have some knowledge of the drug, most do not use it on a daily basis, and therefore shouldn&#8217;t.  It is also important to stress where the drug is to be used -  a place where a patient&#8217;s vital signs can be monitored regularly (i.e. not for home use).  Rest assured, it can be and has been provided to patients for sedation and general anesthesia in a controlled, monitored setting (such as an operating room) for over 30 years.</p>
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