Articles related to PEER-TO-PEER

Uncover vital insights about supplemental oxygen use, demystify misconceptions, and learn best practices for managing respiratory diseases. Good day, physicians. Let’s talk about the controversial issue of supplemental oxygen use, frequently discussed by patients, clinicians, advocacy groups, and even politicians. In this summary, we’ll untangle misconceptions and illuminate best practices. To start with, the body’s oxygen utilization depends on three things: lung function, heart efficiency, and muscle oxygen use. These factors can improve with exercise, but worsen with inactivity. Remember, exercise matters. Why does oxygen matter? For patients with chronic obstructive pulmonary disease (COPD), pulmonary fibrosis (PF), or pulmonary hypertension (PH), impaired oxygenation can lead to hypoxemia and hypoxia. Hence, supplemental oxygen becomes a necessity. How do we assess oxygen levels? Two tests can be employed: arterial blood gas (ABG) or pulse oximetry. Normal partial pressure of oxygen, as per ABG, is around 75-100 mmHg, and a drop below 60 necessitates supplemental oxygen. Oxygen saturation, measurable via either test, should ideally be 95% or above, and values dropping to 90 or below indicate the need for supplemental oxygen. Now, let’s dispel some myths. Shortness of breath doesn’t always equate to hypoxia. A patient can experience breathlessness even with normal oxygen […]

Delve into the fascinating world of an integrated approach to brain medicine that amalgamates neurology and psychiatry, ushering a new era in patient care. Our understanding of the brain is constantly expanding. This unprecedented knowledge blurs the boundaries between neurology and psychiatry. However, an issue arises: current clinical training maintains a dichotomy stemming from 19th-century practices. This divergence is creating a shift. Neurologists, traditionally untrained in psychiatric management, find themselves treating more psychiatric patients. Likewise, new neuroscience-based precision treatments and diagnostic biomarkers demand skills beyond the psychiatric training purview. This status quo poses a significant challenge to training future doctors. We need to focus on establishing competence in whole-brain aspects and fostering subspecialized expertise. Additionally, implementing feasible and practical programs is paramount. In response, this article proposes a novel 4-year residency program. The first two years concentrate on common and urgent neurology and psychiatry aspects, followed by two years of elective subspecialty tracks. This concept mirrors internal medicine residencies and fellowships, without necessitating changes to existing departmental structures. The article further introduces ‘brain medicine’ as a fitting term for this unified practice. The name emphasizes a holistic focus on all brain aspects. Conventionally, the division between neurology and psychiatry relates […]

In a recent talk at the Internal Medicine Meeting 2023, hospitalist Heather Nye emphasized the need to update the “Ten Commandments for Effective Consultations” originally outlined by Lee Goldman and colleagues in 1983. Dr. Nye provided new insights for performing and requesting consults in the 21st century. Some key points she highlighted included the importance of going the extra mile to determine the patient’s condition, establishing urgency, providing clear and written recommendations, documenting all interactions, and following up on recommendations and actions taken. Dr. Nye stressed the significance of clear communication in consult relationships. For hospitalists requesting consults from subspecialists, she advised following the commandments outlined and overcoming reluctance in seeking clarification and follow-up. It was emphasized that hospitalists should manage consultants effectively, ensuring they follow up on recommended studies and document their recommendations in the patient’s chart. Additionally, hospitalists should be proactive in obtaining contact information and communicate with consultants even after they sign off, especially during patient discharge discussions. Overall, Dr. Nye emphasized that effective communication, documentation, and follow-up are essential in providing optimal patient care and ensuring collaboration between hospitalists and subspecialists.

In an interview with OBR Oncology, Hagop Kantarjian, MD, professor and chair of the leukemia department at the University of Texas MD Anderson Cancer Center, discussed the importance for young oncologists to think critically and avoid following the crowd. He warned that “herd mentality” can lead to poor decision-making and can ultimately harm patients. Dr. Kantarjian urged young oncologists to be open to new ideas and to challenge the status quo. He also emphasized the importance of lifelong learning and staying up-to-date on the latest research. By following these principles, young oncologists can make a real difference in the lives of their patients.

The viewpoint authors argue that excellence in medical education cannot be reduced to a simple set of scores for ranking. The formula used by USNWR is deeply flawed. The key question is, “what makes a good physician?” There are a multitude of skills and character traits that comprise the answer, and USNWR doesn’t have metrics for those essentials.

The journal was created 25 years ago to address the disconnect between typical residency behavioral health training the skills needed to treat patients with depressive and related psychiatric illness in primary care.