" /> Family Medicine Notes: April 23, 2002 Archives

« April 20, 2002 | Main | April 28, 2002 »

April 23, 2002

Benevolence in business?

In a report on the radio this morning, I heard mention of a John Steinbeck quote:

"It has always seemed strange to me," said Doc. "The things we admire in men, kindness and generosity, openness, honesty, understanding and feeling are the concomitants of failure in our system. And those traits we detest, sharpness, greed, acquisitiveness, meanness, egotism and self-interest are the traits of success. And while men admire the quality of the first they love the produce of the second."

Cannery Row by John Steinbeck

It is compelling to me that the features that are synonymous with success in business are in fact the "negative" traits outlined above, and yet the values that we admire in healthcare (and other professions, in fact) are the "positive" ones.  Indeed, our primary goal in healthcare is to enhance the quality of the lives of others.   Perhaps this is why "business" skills & personalities in healthcare sometimes feel & taste like oil in our water.   Yet we can't balance our checkbooks with compassion & generosity.  Finding the balance between good business and simple good-ness is the challenge.   Those of us bred and motivated by the generosity and benevolence so prevalent in healthcare will likely revert to these instincts ... while those bred and motivated by the power, control, and "success" measures so prevalent in business and governmant may fall back into these patterns.  We both need to understand each other to work productively toward our common goals. 

High cost of prescription drugs

Heard today on NPRThe high cost of prescription medications for Medicaid patients has led to a showdown between drug companies and the state of Michigan.

Ambulatory Morning Report

In this paper, a few internists discover that the spectrum of cases in an ambulatory internal medicine practice is broad.   Let them spend a day in a family physician's office.  

 Today:

  • neonatal jaundice
  • normal pregnancy
  • sarcoid exacerbation
  • new dx - rheumatoid arthritis
  • asthma
  • allergic rhinitis
  • depression
  • knee pain
  • new patient - new dx HSV ("oh I just thought they were cold sores")
  • knee pain, back pain (ACL tear, DJD)
  • MVA - soft tissue injuries
  • depression
  • new patient - teenager (outgrew the pediatrician)
  • 9 month well-baby
  • CHF, HTN
  • HTN, hypercholesterolemia
  • URI
  • Diabetes, HTN
  • 1 year-old: Otitis Media

Johns Hopkins Division of Infectious Diseases Antibiotic Guide

"Antibiotic Treatment of Acute Bronchitis in Smokers: A Systematic Review [Linder JA and Sim I. J Gen Intern Med 2002;17:230]: "  Another study confirms what we knew in nonsmokers applies to smokers as well ... antibiotics don't help. (click title for commentary from Johns Hopkins)

The Internet Medical Journal

"The Internet Medical Journal Primary Care Pearls" is another weblog on medicine.  Looks like it's done well.