Sunday, September 24, 2006


This story made recent headlines. A woman apparently presented with classic signs of heart attack and was placed in the ER waiting room for 2-3 hours where she died. The case is being handled as a potential homicide...yes homicide! None of the articles I've read about this event give any details as to what was happening in the ER at that particular time (how busy it was, who was being triaged into the ER ahead of her, etc.). I agree that some large errors were probably made; however, is this homicide? The American College of Emergency Physicians (ACEP) president Rick Blum, MD, gave an address on Sept 18, 2006, concerning the event and gave this quote:

"... emergency physicians and nurses go into emergency medicine to save lives. To criminalize their efforts would be a terrible mistake and have a severe chilling effect on people going into the medical field."

Read the information about this event and let me know your opinion. Should the triage nurse or ER staff be charged with homicide?

Friday, September 15, 2006


There are many outside the medical profession who do not vaccinate their children, because for some reason they feel the vaccines are potentially dangerous or may cause unwanted reactions.

I've got two things to say to these people: SMALL POX and POLIO

Now, this wasn't a big argument, but I don't think it should be. I know you love your children and it is fun to feel trendy. But, for those of you out there not vaccinating your're idiots.

Disclaimer: some patients should not get certain vaccines due to prior medical problems. If you are one of these people, this blog entry doesn't apply to you.


Quality control is a good thing, especially in healthcare.

For those out there concerned about "medical misadventures" (aka medical mistakes), I have two comments. First, medical errors, although rare, will always happen. Healthcare is not perfect, so don't expect it to be. Second, there are many quality control measures in place within a hospital or clinic setting to ensure medical mistakes don't occur.

Some examples:
- All prescriptions and medications ordered for patients in a hospital are filled through a pharmacist. The pharmacists are trained to pick up on doctors Rx mistakes and are quick to correct the problem. Unfortunately, if a pharmacist makes a mistake in the med they then give or the dosage of that med...good luck.

- All labs are viewed by lab personnel, and if a lab is abnormal, it is usually flagged in the system. Critically abnormal labs (those that need to be dealt with immediately) are called directly to the MD or nurse taking care of the patient.

- All radiology images performed in a hospital or clinic setting (at least for MDs) are looked over by a professional radiologist to ensure nothing small or large was missed by the primary doctor.

Now, read then next entry...


Apparently, I pissed off some chiropractor with my previous entry on chiropractic medicine. I wanted to post his message and my response here so that people could send in their thoughts on the issue.

Chiropractic Comment:
To each in their own opinion, however i thought it might be helpful in your condemnation of chiropractic schools to get the facts correct. A chiropractic student must complete a 5 year program at an accredited college. They must take the board exams which consist of 4 parts taken over a period of 3 years, the last part of which is an oral/practical exam. Students take 270 hours of Radiology (as opposed to the medical counterpart who recieves 30 hours of training). To round it off, chiropractic students take 585 hours of Anatomy, 75 hours of Biochemistry, 345 hours of Physiopathology, 120 hours of microbiology, 525 hours of Diagnosis, 75 hours of Clinical Lab Diagnosis, 1,320 hours of Internship.... and many more not worth mentioning. No, Chiropractors cannot treat pathological problems, but they are taught to recognize them so when the patient comes in complaining of back pain the DC can differentially diagnose if it is or is not an emergency which should be referred out. I would advise not stereotyping a profession in which you obviously have the facts incorrect. Im sure you would agree that there are many MD's out there riding that subtitle for unethical reasons. Dont forget that healthcare is for the patient, and the best thing for the patient is for all health professions to work together.

My response:
Points well taken. I fully agree with thoughts on unethical MDs, and the team work approach to healthcare. However, your facts, just as mine, are a bit off. I will address only one here simply for the sake of time and because right now, I don't care.

Concerning your quote on radiology hours in training. It seems to me that an extremely large part of your practice as a chiropractor involves the use of xrays. So, in your 5 years of training, you undergo 270 hours of radiology. Then, you are practicing in the community reading thousands of xrays yearly as a fully functioning chiropractor - with no professional radiologist over reading these xrays looking for things you've missed. Basically, chiropractic care, at least in the realm of radiology, has no quality control.

Here's the big difference. You were wrong on the idea that MDs only get 30 hours of radiology. To make it simple (like finding a pulmonary nodule on a portable chest xray), I'll break it down for you. Med students go through 4 years of med school, in which they see xrays throughout, but much more their 3rd and 4th years. All typically take a rotation in radiology during their 4th year where they sit with practicing "radiologists" (those who are professionals in radiology) and learn the basics of how to read the different modalities of imaging, xrays or other. Now the good part, after med school, MDs have to do a residency! That's another 3 to 5 to 10 years depending on how crazy they are. No matter what field or subspecialty they go into, they will be reading xrays, CT, and maybe an MRI or two the entire time on all their patients. Plus these are over read by professional radiologists so that things aren't missed. Medical doctors have a quality control system in place.

So the breakdown stands as such,

Practice nearly revolves around the use of xrays and they get 270 hours of radiology. Then they're reading them on their own - without radiologist over read.

Little formal radiology training, but spend nearly 4-8 years reading xrays every day and having them over read by professionals before they are out in the community. Plus, once out in the community, the xrays are still read by a radiologist.

You do the math.