Grand Rounds 5.35 at Healthcare Technology News

19 05 2009

healthcare technology News GRAND ROUND may 19Grand Rounds is up at Healthcare Technology News. This edition of Grand Rounds, the Best of the Medical Blogosphere, focuses on Health Care Reform.

The Grand Round begins with a stunning quote of type 1 diabetic blogger Kerri Sparling that really hits the mark with her post at Six Until Me:

“Why, Insurance Company, are you so against proactive care? Why do I need to pay more for a brace or a shot or an extra visit when you’re more content paying for a several thousand dollar surgery instead? Not enough bang for your buck? Why do you fight me tooth and nail against coverage for a continuous glucose monitoring device?* Is my life not worth the investment to keep my legs on instead of paying 100% to amputate them in a few decades? I know I’m expensive as a chronic disease patient, but I’m healthier than 85% of the people I know. I eat well, I exercise regularly, and I am on top of my disease. Yet you deny me life insurance, you won’t let me purchase a private health insurance policy, and you would rather see me on an operating table than taking up a doctor’s time in an office visit. (And it’s not like I’m taking up more than 5 – 7 minutes of a doctor’s time, because that’s about all we get, on average. Pathetic.)”

After a few more examples of the Patient and Consumer Perspective on why we do need reform, this edition continues with:

  • Providers, Prevention and Self-Management
  • Meaningful Use and Enabling Technology
  • Dollars and Sense
  • What’s Working Elsewhere?

Please read the whole edition here

Next Grand Round will be hosted by See First, Insights into the uncertain world of Healthcare.


* I saw the same problem mentioned on a Dutch Blog “Diabetesblog“, where the story was told of a patient who has hypo-unawareness: she can’t feel when her blood glucose is low. Therefore she suffers many complications of diabetes, i.e she has poor sight and has recently fainted in front of the children. The only thing which she feels would work is the (FDA approved) continuous glucose monitoring device (CGMS). The problem is that the her insurer won’t cover CGMS, as it’s efficacy has yet to be proved.

Coincidentally I’m gathering the evidence on “the effectiveness of the CGMS in the management of type I diabetes” for a Cochrane Protocol (not approved yet). However, it will take some time for the authors to finish the review after the protocol has been approved.

See the full Story on Diabetesblog (in Dutch) here

Some excerpts:

Sinds een jaar of vijf draagt ze daarom een insulinepomp die continue een klein beetje insuline afgeeft. ‘Maar dat zegt natuurlijk niks over mijn bloedsuikergehalte op dat moment’, zegt Judith. Meer baat zou de Losserse volgens haar internist hebben bij een continue glucosemeter met implanteerbare sensor, een apparaat dat is overgewaaid uit de Verenigde Staten. De sensor meet 24 uur per dag de bloedsuikerspiegel en geeft een waarschuwingssignaal als de waarde te laag dreigt te worden.

Het probleem is echter dat de zorgverzekeraar van Judith, Menzis, het apparaat – kosten: 40 à 50 euro per stuk; één exemplaar gaat maximaal drie dagen mee – niet wil vergoeden, ook niet nadat de internist van Judith daarop heeft aangedrongen. Te duur, oordeelt Menzis. En bovendien, zo motiveert een woordvoerder het standpunt van de zorgverzekeraar, ‘heeft het College voor zorgverzekeringen (CVZ) onlangs besloten de sensor niet te vergoeden’.

Ook een tweede verzoek dat de arts onlangs indiende heeft niets opgeleverd. Volgens de woordvoerder van Menzis is de zorgverzekeraar zelfs strafbaar als het apparaatje vergoed zou worden, omdat het onvoldoende getest zou zijn. Onzin, zegt Getkate. ‘Niet voor niets heeft de Diabetesvereniging Nederland een positief advies gegeven. Er zijn bovendien andere zorgverzekeraars die het al wèl vergoeden.’

En dus ligt de Losserse in de clinch met haar zorgverzekeraar. Wat haar nog het meeste steekt is ‘dat Menzis eigenlijk op de stoel van de arts gaat zitten’…..

Grand Rounds 5.34 at the Health Observatory Blog

12 05 2009

Grand Round is up at Health Observatory Blog.

Kudos to the bloggers Ivor Kovic and Ileana Lulic, for this blogcarnival on “Diversity”, which they introduced as follows:

We want to demonstrate how rich, colorful, multidimensional and diverse the health/medical blogosphere truly is. So please send us your dearest posts, the ones that genuinely reflect your style and personality, no matter the subject.

They quite succeeded in making a grand round with great diversity. I like the style. It gives a good introduction to the posts, without being too lengthy or too short (X wrote a post Y on Z). You can read the the present edition here.

Health Observatory Blog is part of the website Health Blogs Observatory, started with the aim to conduct annual surveys of health bloggers and their blogs to gain better insights into the state of health blogging.

It is possible to submit your blog to their directory to gain better exposure and participate in their future research.
I surely plan to do that, increasing the number of Dutch blogs included from 2 to 3.

Next Round will be hosted by Healthcare Technology News.

Grand Round 5.33

5 05 2009

2366412067_3b7d038410_mGrand Round is up at Ausmed Blog (or Nursing Handover).

It is the first time Nursing handover hosts the Grand Round and I’m glad there wasn’t a theme ànd all submissions were accepted.
You can read the compilation here.

Next week’s Grand Round will be hosted by Health Blogs Observatory.

Grand Round 5.31 at Diabetes Mine: Birthday Edition!

21 04 2009

2267526122_f4376fc6bf1This weeks Grand Round is up at Diabetes Mine, the blog of Amy Tenderich. Amy celebrates her birthday today, thus we gonna sing a Happy Birthday song first:

Click here for my Twitter and Blip Birthday Message.

Read the compilation of posts here!

The next Grand Round wil be hosted by another well known diabetes blogger: Kerri Morrone Sparling of Six Until Me

Stories 3. Science or Library Work: what is more rewarding?

20 04 2009

2267526122_f4376fc6bfAmy Tenderich of Diabetesmine, will celebrate her birthday at the very same day as she hosts the next Grand Round. She has therefore chosen a very appropriate theme (see announcement):

I’m favoring any and all posts having to do with birthdays and special occasions – or anything that smacks of serendipity, perks, or gifts related to the work you all do.

First of all I would like to congratulate Amy on her birthday.

I have been hesitating whether I should contribute to this round. It is not an easy subject and a bit out of scope. However, thinking about it, many ideas came up and it even became difficult to choose one. But here it is. It is even the first post in a series: STORIES, a selection of personal stories.

Most of you will know that I’m a medical librarian by profession, but a medical biologist by education. Many years I worked as a scientist, with mice, patients, cells, DNA and proteins.3419163183_91968b96d6

I was an avid scientist. My motivation was to unravel mechanisms and understand life. I liked to ask questions: “why is this? why do I find that? how does it work?” The greatest reward you can get is: looking for explanations and finding the answer to a question. Thinking about it and discussing it with others is exciting.The more difficult a question is, the more rewarding it is to find the answer. The gift that science gives you is science itself.

In those twenty years I did have my little successes. I had a press conference at a congress (1) (because it was the only subject that was understandable for the public) and I had two papers that were frequently cited (2).

The finding that gave rise to those two publications was very serendipitous. We found a very tiny band in B cells that were used as a negative (!) control for follicular lymphoma in a PCR for the t(14;18) chromosomal translocation. This translocation is considered the hallmark of this type of B-cell cancer. If this was true, it would mean that the lymphoma-associated t(14;18) involving the BCL2 oncogene could also occur outside the context of malignancy. My task was to prove that this was true. This was not an easy task, because we had to exclude that the tiny bands in the tonsils were due to contamination with exponentially amplified tumor DNA. A lot of tricks were needed to enable direct sequencing of the tonsil DNA to show that each chromosomal breakpoint was unique. To be honest, there were quite some moments of despair and most of the time I believed I was hunting ghosts. Certainly when the first band I sequenced was from a contaminating tumor. But finally we succeeded.

And although science can be very rewarding:

  • Most ideas aren’t that new.
  • There are many dead leads and negative results (see cartoon).
  • Experiments can fail.
  • There is a lot of competition
  • It takes very long before you get results (depending on the type of experiment)
  • It takes even longer before you get enough results to publish
  • It takes still longer before you have written down the first version of the paper
  • … and to wait for the first comments of the co-authors (see cartoon)
  • … and to rewrite the paper and to wait …
  • … and to submit to the journal and wait..
  • … to get the first rejection, because your paper didn’t get a high enough priority
  • and to rewrite, wait for the comments of the co-authors, adapt and submit
  • to be rejected for the second time by referees that don’t understand a bit of your subject or are competitors
  • to rewrite etcetera, till it is accepted…and published
  • to wait till somebody other than you or your co-authors find the paper relevant enough to cite.
  • but most importantly even with very good results that make you feel very happy and content:
    • each answer raises more questions
    • most research, whatever brilliant, is just a drop in the ocean or worse:
    • it gets invalidated

I loved to do research and I loved to be a researcher. However, it is difficult for post-doc to keep finding a job and wait for the contract renewals each year. So almost 4 years ago, just before another renewal of the contract, I was happy to get the opportunity to become a medical librarian at a place not far from where I lived. In fact, after all these years it is my first permanent job.

And it is a far more rewarding job than I ever had before, although perhaps not as challenging as research.

  • Results are more immediate.
  • Answers are clearcut (well mostly)
  • People (doctors, nurses, students) are very happy when you learn them how to search (well generally)
  • they are also happy when you do the search for them
  • or when you help them doing it
  • It is very rewarding to develop courses, to teach, to educate
  • the job has many facets

The rewards can vary from a happy smile, a hand shake and “a thank you” to acknowledgments and even co-authorships in papers. Sometimes I even get tangible presents, like chocolates, cookies, wine or gift tokens.

Last week a patron suddenly said when seeing the presents gathered: “Is it your birthday?”
Presumably it is about time to drink the wine I got.Cheers!


Photo credits (Flickr-CC):

Grand Round 5.30 at Pharmamotion

14 04 2009

pharmamotionThis week’s Grand Round is up at Pharmamotion, the wonderful Pharmacology blog of Flavio Guzmán. Flavio is a MD who works as a teaching assistant at the Department of Pharmacology of the University of Mendoza in Argentina. The aim of his website is to offer a better understanding of pharmacology, by gathering freely available educational resources, like animations and videos, and drug information of reliable unbiased resources.

But this week Flavio is host of the Grand Round. Read his selection of submissions here.

The last two weeks, the Grand Rounds had very specific themes on very interesting subjects.

If you haven’t done so already, you might enjoy reading:

“Reflections on the way life used to be” by Leslie Michigan of Getting Closer to Myself (April 7). the theme was prompted by the fact that Leslie was diagnosed with lupus and rheumatoid arthritis for almost a year ago.

“I think about the way life used to be, I automatically think about change, and the myriad ways in which my life has changed over the past few years.”

“When things go awry” by Dr. Paul Levy of “Running a Hospital”. Paul Levy compiled (personal) stories about incidents or medical errors (March 31). His theme draws on the desire to encourage greater transparency in the delivery of clinical care.

It is a pity I didn’t have time to contribute to these rounds, because these subjects really strike a personal cord. Indeed, life has changed the first years after I got Sheehan syndrome, because things “got awry” at the hospital.– It is good to read these often personal stories.

Next edition will be hosted at Diabetesmine.

Latest News: Grand Round at ACP Internist

17 03 2009

shutterstock_1387084-786145-latest-news Latest news, hear the latest news: Grand Round is up at ACP Internist, a newspaper serving internal medicine!

This time literally a newsworthy and noteworty round. According to ACP internist:
“We’re paying tribute to the daily newspaper. Read on for the latest headlines, opinions, features and even the funnies.”

There was no theme, all medical/health head news was included. Please enjoy reading all headlines here

The next round will be hosted by Codeblog, tales of a nurse.

Email/RSS feed to the MedLib’s Round and other Medical Blog Carnivals.

5 03 2009

There are several noteworthy medical blog carnivals (Grand Rounds) around, but it is difficult to make (and thus take) an email/RSS feed to these carnivals, because the editions are hosted by different bloggers each time.

Recently Walter Jessen of the Highlight HEALTH Network has managed to make a feed to all important medical blog carnivals (based on bookmarks).

I’m very pleased that Walter also took the initiative to make a feed to the MedLib’s Round. You can subscribe to it by clicking this link. This is a superb way to keep up to date with the latest MedLib’s Round.


It is also possible to take one subscription to all medical blog carnivals at once by clicking here.

Alternatively you can take RSS/email feeds to individual blog carnivals at Walter Jessen’s Highlight HEALTH Network:

Presently the following 10 carnivals are included:

  1. Grand Rounds Blog Carnival
  2. Encephalon Blog Carnival
  3. SurgeXperiences Blog Carnival
  4. Medicine 2.0 Blog Carnival
  5. Change of Shift Blog Carnival
  6. Cancer Research Blog Carnival
  7. Health Wonk Review Blog Carniva
  8. Gene Genie Blog Carnival
  9. MedLibs Round
  10. Palliative Care Grand Rounds

Thanks Walter for this initiative.


You may also want to read:

Grand Round is being served at The Blog That Eat Manhattan.

24 02 2009

grand-rounds-menu-523Come enjoy the wonderful menu that is being served today at The Blog That Eat Manhattan, that is run by Margaret Polaneczky, MD who introduces herself as follows:

I practice medicine, cook and wax prolific in NYC.
You can call me Peggy. Or Dr P.
Just don’t call me late for dinner.

Grand Round nr 5.23 is being served as a full course dinner, so take care not to consume it at once, because this will surely cause indigestion.

Next week’s Grand Rounds will be served payed off hosted at Health Business Blog.

Grand Rounds 5.22 – Napoleon’s Dynamite – GOSH!

17 02 2009

ndmacheckyestEver heard of Napoleon’s Dynamite? Ever seen Napoleon’s Dynamite? According to nurse Kim it is “pretty much the coolest movie ever made” and therefore chosen as theme for the Grand Round she hosts today at Emergiblog.
And Gosh what an excellent Grand Round she compiled. And Gosh am I relieved that I just got 10 submissions for the first MedLib’s Round (she had to deal with 45 submissions or so). And Gosh
am I glad she announced the Grand Round as follows (LoL):

“No theme, and I’m not doing anything that has to do with Presidents or Valentines, so send in any and all topics!

I will say this: “It’s Grand Rounds, what do you think! GOSH!”

Thank you Kim, for this wonderful round, and for including all submissions, including mine.

I have to admit that I have never seen Napoleon’s Dynamite, but reading Kim’s Grand Round I probably should.

Next Grand Round will be hosted by Dr. Peggy at “The Blog that ate Manhattan.

Grand Rounds 5.20: Anniversaries and Blogosphere Scam

3 02 2009

Number OneThe latest edition of Grand Rounds is now up at Not Totally Rad.

This edition coincides almost exactly with his anniversary as a blogger.

So first of all a happy anniversary to samurairadiologist!

For this Round, he chose a loose anniversary theme, asking contributors to write about something cool or important that they had learned in the past year.

The lead-off post is written by Val Jones: How the Health Blogosphere was Scammed — Last two weeks the health blogosphere was buzzing with outrage about the fact that Wellsphere was sold to HealthCentral. Why were people pissed off? In the past, hundreds of health bloggers had received a flattering offer of the SEO of Wellssphere asking them to contribute to Wellsphere, “a free online community where regular people, enthusiasts and professionals can connect, inspire and educate each other about health”. (uh not really). This offer included the republishing of the content of their blog on the Wellsphere site. About 1700 bloggers accepted the offer, probably because they taught this would increase the traffic to their blog or because they wanted to contribute to Wellsphere or be part of its community. Those bloggers often did not realize that they in fact gave away the entire contents of their feeds for nothing. And herein lies their pain: Wellsphere made a good financial deal out of the transfer, but the bloggers who provide content for Wellsphere got no revenues at all. Some people consider this scraping, others consider it legitimate since the bloggers agreed to it.

In my view it is not really “stealing”, compared to the ripping off RSS feeds without informed consent or even knowledge, as discussed in previous posts (see here, here and here).

But you could call the recruiting Wellsphere campaign misleading and unpleasant at least. Furthermore, according to many former Wellsphere employees the Wellsphere management team behaves rather unscrupulous in general.

At least this big incident uncovers the vulnerability of the web 2.0 world and the bloggers: the concentration on traffic and getting links on the one hand and the poor protection of the intellectual property of bloggers on the other hand.

For further information look at the introduction at Not Totally Rad, the posts he refers to, i.e. the above mentioned post of Dr Val and a post of Dmitriy of the Trusted.MD blog. But there are a lot of other good posts on the subject, i.e. on the blogs of the Wall Street Journal, a psychiatrist, an athlete and patients (see here; some warrnings were already written in July 2008).

But apart from this specific theme there are many others worth reading: Anniversaries, lessons learned, Diabetes blogs and Other Chronic Diseases, Humor in Medicine, Ethics and Other Delicacies.

Next Round will be will be hosted by The Health Care Blog

Grand Rounds 5.16: On Profit in medicine and other cool stuff!

6 01 2009

3046846192_fb1aed3ccbEdwin Leap has the honor to host the first Grand Round of 2009. The theme of this week is profit in medicine.

“The value, or detriment, of financial profit in health-care. From doctors to pharmaceutical companies, universities to insurers and everything in between; is profit good or bad?”

To summarize Edwin’s view, here is his concluding remark:

“Until we re-discover Hippocrates, and what he was saying all those years ago, we’ll just have to do one of two things: keep paying people lots of money, or learn to do without care. That’s the way I see it, anyhow!”

Although not everyone sticks strictly to the topic (or interprets profit like ‘value’, as I did) it has become a very interesting round again with many posts touching the theme in one way or another.

Next Round will be will be hosted by Barbara Kivowitz at “In Sickness and in Health“.

Foto Credit: Adrianclarkmbbs – Flickr CC

Old Year/New Year Dutch Grand Ground – Grote visite 1.10

31 12 2008


Welcome to the OLD YEAR/NEW YEAR edition of the ‘grote visite’ or Dutch Grand Rounds.

The theme of this Grand Round is past (what has been, history), present (hot news) and future (what to expect, wish, foresee).

We ring out the Old Year with two excellent posts of the dedicated bloggers and initiators of the Dutch Grand Round Jan Martens of and Dr. Shock of Dr Shock MD PhD

Jan Martens writes about Transcranial Magnetic Stimulation Historical Research. As some of you might know (I didn’t) Jan is conducting a historical research about the use of electricity and magnetism in psychiatry. Here he is focussing on video’s of Transcranial Magnetic Stimulation. He searched Youtube with “transcranial magnetic stimulation” and only found a handful of interesting modern videos, but no old videos of guinea pigs in a magnetic stimulator -which he had hoped for. He would be most obliged if you could help him out with historical videos or other information about TMS.
Dr Shock has already responded to his request, but has found no older video’s. Perhaps youtube is to young for historical video’s, but I can also imagine that researchers are reluctant to show guinea pig experiments to the general public.

Dr Shock MD PhD presents Dr Shock’s popular posts from 2008 and a look ahead for 2009. Dr. Shock wonders whether the popularity of his two most popular posts this year (at least according WordPress Blog Stats), i.e. Sex, Video Games and the Brain and How much Chocolate is Good for your Health? is mainly based on the title and keywords (or the picture? -see his post). He also gives an overview of other top posts and the posts he found the most pleasurable to write. This was a post about empathy in the doctor patient relationship, part of a series about patient doctor relationship and it’s different aspects such as education, self-disclosure to name a few as well the post Why do psychiatrists like detectives?
I share his idea that the most popular posts are not always the posts you enjoyed yourself the most and vice versa. I often wonder why some posts become popular and others don’t.

Dr Shock intends to focus more on the developments of health 2.0 and medical education in the coming year 2009. He made a first step this year to become member of the tweeple community at twitter. A useful community, isn’t it @DrShock?

Dr Shock also asks us which of his posts we enjoyed the most. I think the unanimous answer is: “We like them all, it is the mix”.

Please visit Dr Shock’s blog to read more.

That concludes this edition. Or perhaps it concludes the Dutch Grand Round…….

I took a look at the carnival submission form, but found no new rounds planned, perhaps because a new scheme is still to be made, or perhaps because it will end here and now….

I do hope the Dutch Grand round will be continued, because there are enough good Dutch medical bloggers around. The question is why just few of them actively contribute to this round? Hopefully 2009 will bring a change.

Photo credit: loesenlodewijk Flickr Creative Commons

Grand Round 5.15 at Moneduloides. At the interface of evolution and medicine.

30 12 2008

The theme for the old year/new year Grand Round was not an easy one: “At the interface of evolution and medicine“. This theme was chosen to celebrate the coming bicentenary of Darwin’s birth, and the 150th anniversary of the publication of On The Origin of Species.


“Coming from the perspective of an individual who conducts medical research in evolutionary genetics, I have found that very few people outside of the world I work have been exposed to all of the ways evolutionary biology interfaces with medicine. My hope is that with this edition of Grand Rounds those who have not yet been exposed to this topic become, at the very least, sufficiently intrigued.”

Although there are less submissions than usual, the subject has been well covered by several bloggers. It has certainly triggered me to learn more about evolutionary biology and the implications on (clinical) medicine.

You can read the elaborate summaries at Moneduloides post here.

Interested in what Moneduloides means: it is derived from Corvus moneduloides, a crow species and the only non-primate animal known to invent new tools by modifying existing ones. Want to get a glimpse of Moneduloides, then read this article (“Evolutionary Biology Offers Glimpse Into Medicine’s Future”) in today’s Medscape Today!

Next Round is at Edwin Leap’s site.


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