When does death occur? I wish I knew honestly. In cases of medical futility, it’s always heart-wrenching to be faced with a patient in whom medical interventions amount to maintaining the status quo which is already not good. A patient whose family members don’t seem to understand that there is no going back to better […]
When Grandma/Grandpa Cannot Go Home
I was consulted on an elderly patient who had developed an infection after surgery. The infection required intravenous antibiotic therapy for a long period. The patient required rehabilitation after discharge from the hospital. The intravenous antibiotics were given there. On follow-up in the office three weeks later I determined the patient still needed intravenous antibiotics. […]
Sepsis Drug XIGRIS withdrawn from worldwide markets for lack of efficacy
In what is breaking news today in the field of medicine, the pharmaceutical company Eli Lilly announced that activated drotrecogin alfa (XIGRIS) is to be pulled off all markets including the United States. This drug, intended to treat severe sepsis, has been shown in the new PROWESS-SHOCK trial to be no better than placebo in […]
Medical Bureaucracy
I get to attend a lot of meetings in my current role, meetings that medical school nor residency nor fellowship prepared me for, meetings with people who don’t have a clue about medicine but either control the money, make the policies, or care solely about the hospitals image. Meetings about value based purchasing or outcome […]
JCAHO Descends Upon Us
Sometime in the past couple of months JCAHO paid an unannounced visit to my hospital. I should have known something was up when I saw our Chief Medical Officer up on one of the medical floors talking excitedly to an old man in a suit. My naïve self assumed he was interviewing a new physician…no […]