Grand Rounds Time

For those of you searching for your weekly smorgasbord of the best of the medical blogosphere--otherwise known as Grand Rounds--you'll find it at The Efficient MD. This week's theme is "Healthcare Innovations and New Technologies." Click over and enjoy your Tuesday morning read!

And on a more serious note, I hope all Americans will take a few moments today to remember the events of six years ago--when we sat horrified in front of our television sets watching the unimaginable happen before our eyes--and to honor the thousands of our fellow countrymen who lost their lives on that fateful morning. Terrorism is very real, and less than half a world away there are fanatics who live each day with a burning zeal to see each and every one of us meet the same fate as those who were in the World Trade Center on September 11, 2001. We would do well never to forget that, and to honor and support the American soldiers fighting for our right to live our lives peacefully and without fear of such atrocity happening within our own borders.

Time for Grand Rounds

Tuesday mornings would be so much duller without Grand Rounds--the weekly selection of the best of the medical blogosphere. This week's host is Dr. Emer at Parallel Universes. With this edition he becomes the third blogger to be a four-time host for GR; having done it once, I truly appreciate the magnitude of this accomplishment!

This week's edition is hefty: thirty-five blog posts to savor, including yours truly! I was delighted that Dr. Emer was able to squeeze me in, as I was quite late in getting a submission to him. Thanks, Dr. E.

Grab your coffee and click over to Parallel Universes for some excellent reading.

Grand Rounds Vol. 3 No. 39

The latest edition of Grand Rounds is posted at Code Blog, Tales of a Nurse. This week's host is Geena, one of the few bloggers to take on this monumental task for the fourth time. For this edition, Geena relies on her inner advice columnist, "Dear Henrietta" who allows medbloggers to answer her readers' questions. It's an amusing format, chock-full of good posts from the medical blogosphere. Grab your coffee and settle in for a good read.

Tuesday's Joy

...is another edition of Grand Rounds. This week it is up at impactED nurse. Our host threw down a challenge to medbloggers: pick your single best-ever post and submit it--with an explanation of why it is your best.

The challenge was taken up, and the result is a great edition of Grand Rounds--the best of the best. Grab a hot cup of coffee and enjoy!

...and in case there are any blogosphere tourists left who are unfamiliar with this, Grand Rounds is a weekly blog carnival with rotating hosts, offering a selection of the week's best medical blogging. The schedule for upcoming hosts (and the archives of past ones) is maintained here.
.
.

If It's Tuesday, Grand Rounds Must Be Up

Of course it is! The host for Vol. 3 No. 33 is The Blog That Ate Manhattan. TBTAM presents us with an excellent collection of posts. This week's edition is a tribute to Barbados Butterfly, the blog of an Australian surgical registrar which was closed by her employer. Those of us who were her regular readers miss her voice; the blog was well-written, interesting, lively and entertaining. TBTAM's tribute is timely and appropriate. And her choices for this week's Grand Rounds give us some excellent blog-reading. Thanks for hosting, TBTAM!

Grand Rounds 3.31 Is Up

A cosmic Grand Rounds is up over at Med Valley High blog. Liana has done a nice job presenting a hefty number of submissions. And she generously included mine, though I was late in submitting. Thanks Liana. Strong work!

Ground Rounds is a weekly carnival of the best blog posts submitted by medical bloggers across the spectrum of health care. Check out this week's edition for some good reading.

Time for Grand Rounds

Tuesday morning means that another edition of Grand Rounds is blowing through the blogosphere. The home for this week's carnival is Musings of a Dinosaur, where our host, the #1 Dino, has done a superb job of fashioning a readable collection of the medblogosphere's best blog posts.

This week's theme is about change in medical practice--what does, what doesn't, what should, what shouldn't. Overall, I have grown somewhat tired of "themed" Grand Rounds, but this edition is so well handled that the theme does not feel like a concrete mold into which the post must be poured. I haven't submitted a post for Grand Rounds for a while now, and the Dinosaur's lively edition this week makes me wish I had. Great job, #1 Dinosaur!

Grand Rounds Is Up

Grand Rounds is up at an early hour this week over at the blog of Dr. John LaPuma. His theme is diet and food, and he presents an excellent collection of posts. Drop in for some good blog reading at the weekly roundup of the best of the medblogosphere.

Grand Rounds Volume 3 Number 12

The Christmas edition of Grand Rounds is up at Nurse Ratched's Place. Her theme is A Charlie Brown Christmas, and she serves up an excellent collection of posts from the medblogosphere. Nicely sized at thirty posts, it is readable in a couple of hours. And I am delighted to have made the cut, though I did not write a Christmas-themed post. Nice work, Mother Jones, and thanks for hosting!

Pour yourself a celebratory beverage of choice and enjoy this week's best of the medical blogosphere.

Grand Rounds, Volume 3 Number 10

Tuesday has become my favorite day of the work week because I love Grand Rounds. So much good blogging, and always a few new blogs to explore. The medical blogosphere is growing so quickly that I feel like an old-timer after nearly seven months.

This week's host for Grand Rounds is Dr. R.W. Donnell at Notes from Dr. RW. He does an excellent job of organizing and moderating a reasonably-sized edition with 32 posts. I was pleased to be included in this week's GR.

Pour yourself a nice hot cup of coffee and enjoy the best of the medical blogosphere.

Grand Rounds Vol 3 No 9

Doctor Anonymous is the host for this week's edition of Grand Rounds, the weekly carnival of "the best of the medical blogosphere." Until recently, the trend has been for Grand Rounds hosts to include all posts submitted in the carnival, which makes it not necessarily "the best", but simply a potluck of whatever any blogger wanted to submit. A grass-roots initiative, spearheaded by Kim over at Emergiblog, has called for improving the quality of Grand Rounds by reducing its size and including only the best posts.

This calls for some stringent decision-making on the host's part, and Dr. A has done an excellent job of it. The post summaries are clear and concise, the links are easy to find and follow, and the look is clean and professional. His solution to the inclusion vs. exclusion problem is to include a link dump at the end with those he did not include. Which is sort of like including them, but not calling them "the best." Seems like a manageable compromise.

Grab your coffee and enjoy some great reading!

Grand Rounds Vol 3 No 8 is up

This week's edition of Grand Rounds is posted at The Rumors Were True. Our host this week is topher, an American studying medicine in the Caribbean. His theme is Monty Python, and he weaves it skillfully around the posts without detracting from them.

Of note is that this edition of Grand Rounds is more manageable in size than recent editions have been; he included the best 26 of the 60 submissions. As a GR reader, I appreciate that; I want to read the best of the medblogosphere. An edition that includes 50+ posts is simply too big. This particular question, of quality vs. quantity in GR, has been the subject of brisk discussion today over at Kim's Emergiblog; she has a well-stated post opining that quality is where it's at. I have to agree, as do most of the commenters.

Thanks, Kim, for saying what needed to be said. And thanks, topher, for an excellent edition of Grand Rounds.

Grand Rounds at MSSP Nexus

Grand Rounds Vol. 3 No. 7 is up at MSSP Nexus blog. This week's host is Rita Schwab and she does an excellent job of organizing a huge edition. Grab your coffee and enjoy some good reading--the best of the medical blogosphere.

Halloween Grand Rounds

A fiendishly clever and totally delightful edition of Grand Rounds is up at the aesthetically tasteful blog of Dr. Michael Hebert, Dr. Hebert's Medical Gumbo. Dr. Hebert is a Cajun physician, formerly a resident of New Orleans, displaced since Hurricane Katrina to a community in Mississippi. He is an excellent writer and crafts his posts elegantly; I encourage TMD readers to spend some time browsing through his archives. You won't be disappointed.

What he has created for our Halloween delight is an entire Grand Rounds in the format of Edgar Allen Poe's poem The Raven. It is amusing and clever and quite impressive, all at the same time. Well done, Dr. H!

You can find his pre-Rounds interview with Dr. Nick Genes on Medscape by clicking here.

Grand Rounds Vol. 3 No. 2 Is Up...

...at R Doctor Medical. This week's edition of the best of the medical blogosphere is hosted by Dr. Aleksandr Kavokin, a physician born in Kazakhstan and trained in Moscow. His research into medical applications of artificial intelligence has led to the nickname "the robot doctor." His pre-Rounds interview by Nick Genes, M.D., of Blogborygmi, is posted at Medscape.

This week's edition is, as usual, an interesting assortment of articles. I was thrilled to have been chosen for Editor's Pick! Stop by, pour yourself a cup of hot coffee and enjoy some good reading.

On Hosting Grand Rounds

This has been an exciting week in the blogosphere for me, far more so than I anticipated. Hosting Grand Rounds was a very positive experience, one that I enjoyed immensely. I strongly encourage you wavering medbloggers out there to step up to the plate and do it!

Before I hosted, I read with interest the post-Rounds posts created by some hosts (is that iambic tetrameter?) with their recommendations for future hosts. I wish to offer the same for those who may be curious.

My two most important recommendations are to give yourself adequate time, and be organized. Try to be realistic about yourself on those two items.

The adequate time question will be different for each host, and probably for each week. If it is at all possible for you, arrange not to be working on Saturday, Sunday, and Monday before your GR date. Put up your call for submissions post seven to ten days in advance, state your submission deadline, and request early submissions.

Put some serious thought and energy into the pre-Rounds interview questions Dr. Nick Genes will send you. He does his homework by reading your entire blog before the interview and asking well-considered and open-ended questions; do your part by giving him substantive answers. Once he posts your interview on Medscape, put a post on your blog announcing and linking it, and again encourage early submissions for your GR edition. As you will see, many bloggers will comply; as a future submitter to other hosts, I will make more of an effort now to do the same.

For GR 2:52, I received 47 submissions. They came in as follows: Tuesday 1; Wednesday 4; Thursday 6; Friday 7; Saturday 12; Sunday 11; Monday 6. So most (41 of 47) came in before the last day. I put the deadline for submissions as Monday at noon Eastern time (8 am Alaska time), which gave me 16 hours to work with. I planned to put the Grand Rounds post up at one minute after midnight Monday night, Alaska time. If I had had to work on Monday, I'd have never made it.

One thing that was interesting to me was the variety in submission emails. As requested, all had "Grand Rounds" in the title, which helped in my first step. When I submit, I generally just say "here's my submission: url-of-the-post". Many people do just that, but some were more elaborate. They included blog name, blog URL, post URL, and post summary. I found these to be really helpful, and it will guide my behavior as a future submitter.

So, how to be organized? This is what worked for me. I created a folder in my email just for GR. As each submission arrived, it went into the folder unread, so the title (containing GR) remained in bold. As the folder grew in size, it was easy to see where I was in the post-reading process. When I opened the email, I clicked on the link, went to the submitter's blog, read the submitted post (and sometimes a few others), decided which category it should be in, and gave it a rating on a 1 to 5 scale, with 1 being awful and 5 being fabulous. Most ended up being 3s or 4s.

I decided ahead of time on seven categories I would use to sort the posts. This came about originally because I intended to organize the whole GR edition like an issue of The New England Journal of Medicine. I was going to call it The Blogosphere Journal of Medicine. So I used the categories that NEJM uses, slightly adapted for the blogosphere, in essentially the same order they use. I subsequently decided that would be waaaay too boring, and decided to treat you to Postcards From The Edge of The Planet instead; but the categories worked pretty well, so I kept them.

Once I started reading posts (pretty much as they came in; don't get behind) I kept a notebook next to the computer (yeah, real paper and a real pen--I'm an old fart) and made an ongoing list that contained six items: blog name, blogger name, URL of submitted post, quality rating (1 to 5), category, and one-sentence phrase describing the essence of the post.

This list is what made the job the easiest. By Monday morning it was five pages long, with three lines for each submission. I should have organized the list by category to start with, giving each category its own page and listing the posts after I read them under their appropriate catagories. I didn't think of this until I was looking at five pages of posts listed in the order of their receipt. Those of you with more computer skills than I have will not have a problem with this, as you will do it all on computer and let the editor do the sorting for you; I found it too cumbersome to switch back and forth between a Word document and my email, so went to the paper system. Out came the scissors and tape. I cut the pages into 3-line strips, one for each post; sorted them by category; ordered the posts in each category by rating and/or my own preference; and taped them down to new pages.

Once that was done, it was a simple matter to go through the new ordered list and write the Grand Rounds post. As many of you know from my earlier writing, loading photos on Blogger has been a thorn in my side from the very beginning, and the GR post was no exception. It took me nearly five hours to find, scan, load and arrange the dozen photos I used. For some reason, Blogger would not load any photos on the left, and some it simply would not load at all. They were all less than 200 KB, so it was not a size issue. I wanted to close with a beautiful shot of the Northern Lights, but Blogger said NO.

The amount of time I gave myself worked out perfectly. I spent the entire day on Monday working on it, and finished the edition with one hour to spare. The post went up at 12:01 Alaska time on Tuesday morning. It took an hour to then go through the post on my blog and click on every link to be sure it worked. I highly recommend this. Four of them did not work, mostly due to single-character errors in the URL. As a Grand Rounds reader, I hate dead links, so wanted to be sure I didn't have any. With all corrections done, I went to bed at 1:30 am, too wired to sleep for at least an hour.

By 7:00 I was up again, interested to see what readers would think of the post, what comments I would get, and what my sitemeter would do. I expected the sitemeter to show a good-sized bump, but I had NO IDEA what was going to happen that day. It practically exploded.

The comments were wonderful, very positive and encouraging, and thanking me for hosting. But one thing I did not anticipate was comment carry-over. Dr. Genes needs to have the URL of your GR post to include in the pre-Rounds interview, so he recommends putting up the GR post to establish the URL and then taking it down, saving it as a draft, changing the date to reflect your edition's actual date and reposting it on Tuesday morning. I figured out how to do this, but decided I would let the early GR address be my call-for-submissions, which I would leave up till the deadline, then take down and replace the content with the actual GR edition. It worked fine, except that I had comments on the call-for-submission which carried over to the GR edition, which I didn't want. But I didn't want to delete them, either. Do it Nick's way. He's really smart about this stuff.

Now about the sitemeter. Holy cow. For the last month or so, I have been averaging 70 to 90 readers per day. After less than five months blogging, I felt pretty good about that, since the first month was less than 30 per day. Of course I had blogenvy of Fat Doctor's 300 per day, and Life in Alaska's 7,000 per month. But still. Seventy to 90 is a good steady core (thanks, TMD regular readers!); on good days it was over a hundred, and my all-time high was 210 on a GR day back in May when I had submitted a popular post.

At 7:15 am the sitemeter registered 117 readers. I kept checking every hour or two throughout the day, and my eyes got bigger and bigger as the sitemeter just kept going up. By midnight Tuesday night, it registered 676 readers. Let me say that again: six hundred and seventy-six! I was totally floored.

The surge not only continued on Wednesday morning; up until 4 pm, each sitemeter check showed even more readers than the same time Tuesday. It dropped off after 4 pm, and by midnight the total was 557. Thursday continued the decline and ended up with 346 (about the ballpark I expected for Tuesday).

I attribute the huge surge to two things: more people read Grand Rounds in the fall than in the summer (this is Borneo Breeze's idea, and I agree); and more bloggers this week put up a "Grand Rounds is up" post than usually do. I am aware of 26 blogs with such a post, and I may have missed some. Thanks to all of you who linked!


I have had the luxury of hosting Grand Rounds in the midst of nine days off work, which I am sure was significant in decreasing the stress factor and increasing the fun factor. It was simply fortunate for me that Nick was able to let me have the date I wanted, since I had to request time off months ago. I have a lot of vacation time and have scheduled a week off every two or three months, primarily to have time for writing. My favorite vacation is to just stay home and write; I live in one of the most beautiful places in the world--why should I go anywhere?

Let me close by encouraging those of you who may be thinking of hosting Grand Rounds to go for it. It was a wonderful and exciting experience, and I am really glad I did it.

Blogger is SO tempermental!

Grand Rounds, Vol. 2 No. 52

Welcome to Grand Rounds, the medical blogosphere’s weekly carnival of the best writing and thinking on topics related to health and healthcare. This week’s edition comes to you from the beautiful state of Alaska.

Those who have visited this site before are aware that Tundra Medicine Dreams is about my life and medical practice on the tundra in the southwest portion of the state. For those who are new visitors, I hope you will return to read more about this unique and fascinating place. I love sharing the subtle beauty of this area with people, and have posted many photos on the blog; for this Grand Rounds post I will offer you images of the more dramatic beauty of Alaska found in the central and eastern regions of the state. If you have never visited the 49th state, you should. At least once in your life. Alaska is an American treasure that no one should miss.

Many thanks to Dr. Nick Genes of Blogborygmi for organizing and coordinating Grand Rounds, and for producing such consistently excellent pre-Rounds interviews with each weekly host. You can view mine here (free registration required).

So, without further ado,

GRAND ROUNDS

Volume 2, Number 52

Editor’s Picks

Of the 47 submissions to this week’s edition, these five were my favorites.

At DR. HEBERT’S MEDICAL GUMBO, we learn about an overweight patient who wants to lose weight. At THE RUMORS WERE TRUE, M. Dyspnea wishes for more effective techniques to teach teenagers about the effects of alcohol on the brain. From my very own hospital here in Bethel, visiting resident Rob at ALASKA BOY…RIDES AGAIN describes a medevac story from one of our villages. Kim over at EMERGIBLOG gives us her dream design for a new ER. And the ever-endearing GRUNT DOC describes a chief complaint of “?” when the patient is both schizophrenic and deaf.


Perspectives

Blogger William Rubin at BILLY RUBIN tells us that medicine is a life of endless learning (so true!). Tony Chen at HOSPITAL IMPACT describes the privilege of being a health care worker. At ANXIETY, ADDICTION AND DEPRESSION TREATMENTS, Dr. Mada questions where the line is that separates healthy training in athletes from disordered eating. Louise at COLORADO HEALTH INSURANCE INSIDER wonders whether we are using too much ultrasound in pregnancy?

Henry Stern at INSUREBLOG asks “can marijuana be classified as a medicine?” MY LIFE, MY PACE suggests that too often medical students are whiners. Hsien-Hsien Lei at A HEARTY LIFE gives a report of a British television show called Cardiac Arrest. The eponymous blogger of VITUM MEDICINUS tells us his ten favorite things about the first term of medical school.


Patient Perspectives

At A CHRONIC DOSE, Laurie describes making choices about which symptoms we attend to. Susan Palwick at RICKETY CONTRIVANCES OF DOING GOOD discusses sleep apnea and the importance of CPAP. Elisa Camahort of HEALTHY CONCERNS is bummed about the Cheerful Oncologist’s recommendations on how to get your doctor to listen to you. K. Weaver of LIVING WITH DIABETES offers a patient story. And Mona at THE TANGLED NEURON discusses depression and Alzheimer’s.

Clinical Practice

Rob Lamberts at MUSINGS OF A DISTRACTIBLE MIND warns about bringing work stress home. At SUNLIGHT FOLLOWS ME, blogger TSCD tells an amusing story of a patient with abdominal pain in a bathing suit. South African blogger Karen Little of MILF’S ANATOMY has a difficult day.

New blogger Scalpel of SCALPEL OR SWORD? has a painful dental experience when the doctor becomes the patient. At SCANMAN’S NOTES, Dr. Vijay Sadasivam brings us the oldest published description of holoprosencephaly. The #1 Dinosaur at MUSINGS OF A DINOSAUR tells us how s/he (making no assumptions here) puts a new patient at ease.

At UROSTREAM, Kea Girl reveals herself as the surgeon who truly hates the poke of a needle. Alice at HOME SCHOOLED MED STUDENT gives us a description of two surgical patients. Wilderness medicine specialist Dr. Paul Auerbach of HEALTHLINE describes the diagnostic dilemma of a possible spider bite. At UNBOUNDED MEDICINE, Jon Mikel, M.D. uses a Wood’s lamp to diagnose vitiligo. And Dex at A BUDDING EMERGENCIST tells a story of the importance of details.

.

Original Articles

From BORNEO BREEZES, Traveling Doc gives a description of public health efforts in Pakistan. Tara Smith of AETIOLOGY discusses the recent E. coli outbreak from packaged spinach. At INSIDE SURGERY, Dr. Lisa Marcucci educates us about nesiritide, a brain naturietic peptide.

.

.

.

Review Articles

Always Learning, the blogger of WANDERING VISITOR, reviews a recent study on the association between diet and Alzheimer’s—one more reason I’m glad we have no McDonald’s in Bethel! Amy Tenderich of DIABETES MINE comments on a study to fight obesity by having no chairs in elementary school classrooms. At THE EXAMINING ROOM OF DR. CHARLES, Aiden Charles discusses a study finding that Asian women have the longest life expectancy of any Americans.

From the Philippines, Dr. Emer of PARALLEL UNIVERSES bemoans the improper use of statistics by the Department of Health. At HEALTHLINE, Dr. Enoch Choi reviews recent FDA information about the proper way to take your daily aspirin. Orac of RESPECTFUL INSOLENCE is happy about a recent study which finds that the age of your surgeon doesn’t matter until the surgeon is really old.

At INTERESTED-PARTICIPANT, blogger mj pechar discusses a statement from the British Medical Journal that the “morning after” pill has not reduced the abortion rate. At STRAIGHT FROM THE DOC, Gloria Gamat reviews a study suggesting that green tea and its extracts may slow the progression of Huntingtons disease. She reviews another study at CANCER COMMENTARY regarding a combination drug which inhibits the growth of aggressive tumors in prostate cancer. Dr. Joel Fuhrmann of DISEASE PROOF gives a review of the questionable benefits of alcohol consumption.

ALERT! Late addition--somehow one fell between the cracks! Sincere apologies to CLINICAL CASES AND IMAGES BLOG who reviews the new once-a-year drug to treat osteoporosis.

.

.

.

Health Biz

Dr. David E. Williams of HEALTH BUSINESS BLOG comments on the real reasons behind a company’s opposition to electronic medical records. And Bob Coffield of HEALTH CARE LAW BLOG reviews an article on non-profit hospitals.

.

.

Summary

So there you have it. I hope you enjoy this week’s compilation of the best of the medical blogosphere.

.

Next week’s Second Anniversary edition of Grand Rounds will be hosted by Dr. Enoch Choi at HEALTHLINE. You may email your submissions to him at enochchoimd-thoughts at yahoo dot com.

.

And if you haven’t yet participated in the Healthcare Blogging Survey sponsored by Envision Solutions and The Medical Blog Network, please do! Click here. The survey ends on September 29th.

Photo credits:

1. Mt. McKinley, known to Alaskans simply as "Denali"; North America's tallest peak. From a post card, photographer unknown.

2. Bethel from the river at sunset, by The Tundra PA.

3. Float plane on Naknek Lake, from Beautiful America's Alaska by George Wuerthner. www.wuerthnerphotography.com

4. Arrigetch Peaks, Brooks Range, ibid, by George Wuerthner.

5. Grizzly bear, ibid, by George Wuerthner.

6. Musher and sled dog team competing in the Yukon Quest, from Mushing Alaska 2003 Calendar, photo by Jeff Schultz.

7. Bald eagle. From a postcard, photographer unknown.

8. King salmon. From www.lamedialodge.com, photographer unknown.

9. Caribou bull, from America's Beautiful Alaska by George Wuerthner.

10. Alaska mountains, by Dutch (Mr. Tundra PA).

11. Polar bear kiss, by Thomas D. Mangelsen, www.mangelsen.com.

Grand Rounds Vol. 2 No. 46

...is up at Mexico Medical Student. The host is an American going to medical school in Guadalajara, and his "focus" (not exactly a "theme") is cultural convergence. The top honor went to Borneo Breezes, the new blogger I recently welcomed here. I am really pleased for her; the post she wrote is excellent. The new twist in this week's Grand Rounds is the addition of music. Our host has added a number of mostly classical selections which play in pop-up windows when clicked on. It adds another layer to the Grand Rounds reading experience which I found very enjoyable. As always, there is plenty of great reading there... (and my post on Home Remedies made third place! I'm jazzed!)

Grand Rounds Is Up!

It is Tuesday and Grand Rounds is posted at Inside Surgery. A nice collection of reading this week. (How did I become Tundra Medicine Man?)

One extra benny of living in Alaska: I get to read Grand Rounds before going to bed on Monday night!

Enjoy...

GRAND ROUNDS is up

For some delightful, engaging, thought-provoking reading, check out this week's Grand Rounds, Vol 2, No. 44, at Medical Humanities blog. I am honored to have been included in the weekly compilation of the best of the medical blogosphere. The hosts have done a marvelous job of creating a garden in which to do your reading. Enjoy!