T****g
发帖数: 705 | 1 11. Drug abuse, alcoholic 在美国精神科病人人群中是非常大的成分。我工作的
州是重灾区，我自己就有100多这样的Active patient。我在主持一个丁丙诺非项目，
在帮助这些病人。美国人对医生99.99%是非常尊重的，所以不存在受威胁的问题。
12. 我的典型的常规工作：我只做门诊，每周40小时。有一天带PGY3住院医生，半
天也带medical student。其他时间自己看病人，要自己写note。通常第一个病人 9am
，最后一个病人一般约在3:30pm。周二开始的早一个小时。有时会加病人到4点。然后
花半个小时把note完全完成后再回家。中午休息1小时。我们是教学医院一个新病人1个
小时；通常 private practice一个新病人是 30-45分钟。
13. 申请双科的话，你的材料准备要有艺术。当被问起是否申了双科的话，Honest
，但要有讲话艺术，自己想清楚了怎么说。我见过FM 或内科和精神科一起申请的。但
病理和精神科就比较远。
14. 要看suboxone 病人，需要做addiction fellowship 吗... 阅读全帖 |
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j********z
发帖数: 423 | 6 免费的够呛。看你查什么了，药物的话，MPR（monthly prescribing reference)有免
费的, medscape也免费，还有关于asthma, immunization的免费的小程序。 |
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x****8
发帖数: 360 | 8 As reported, APNs not only make considerably more than RNs, but when the
percentage differences between what they made at the youngest and at the
oldest ages are compared, APN income increases at a greater rate over time:
15% vs 11% for RNs.
nurse
is |
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z****z
发帖数: 1037 | 9 免费的medscape，MPR， epss，uptodate, guidelines. |
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A*******s
发帖数: 9638 | 16 Recommendations on Cell Phone Use and Cancer Risk（ZZ)
Allison Gandey
Information from Industry
Think what it could it cost you not to adopt an EHR system
For office-based physician not adopting an electronic health records(EHR)
system by 2015, Medicare payments are planned to be reduced.
Calculate impact June 22, 2011 — The evidence is limited when it comes to
cell phones and cancer risk, but specialists say common-sense measures can
come into play until the science catches up with technology.
T... 阅读全帖 |
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s********o
发帖数: 3319 | 17 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: herby (小臭宝), 信区: MedicalCareer
标 题: [合集] 你有生以来做出的最佳临床诊断是什么？
发信站: BBS 未名空间站 (Thu Jun 2 00:01:26 2011, 美东)
☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的... 阅读全帖 |
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s********o
发帖数: 3319 | 18 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: herby (小臭宝), 信区: MedicalCareer
标 题: [合集] 你有生以来做出的最佳临床诊断是什么？
发信站: BBS 未名空间站 (Thu Jun 2 00:01:26 2011, 美东)
☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的... 阅读全帖 |
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A*******s
发帖数: 9638 | 19 A very good read. But it may require a password to enter.
• 65% of malpractice claims were dropped, dismissed, or withdrawn before trial;
• 25% of malpractice claims were settled;
• 4.5% were decided by alternative dispute resolution; and
• 5% were resolved at trial, with physicians prevailing in 80%-90% of those cases.
http://www.medscape.com/features/slideshow/malpractice?src=ptal |
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A*******s
发帖数: 9638 | 20 Thanks for sharing. The slides in medscape pretty much include everything.
希望大家看一看， 无论有没有类似经历， 对将来的practice是有好处的。
长在河边走， 哪有不湿鞋？ 在平时的工作中， 对病人要体贴，对同行要体谅。 这就
是我想说的。 |
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A*******s
发帖数: 9638 | 21 A very good read. But it may require a password to enter.
• 65% of malpractice claims were dropped, dismissed, or withdrawn before trial;
• 25% of malpractice claims were settled;
• 4.5% were decided by alternative dispute resolution; and
• 5% were resolved at trial, with physicians prevailing in 80%-90% of those cases.
http://www.medscape.com/features/slideshow/malpractice?src=ptal |
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A*******s
发帖数: 9638 | 22 Thanks for sharing. The slides in medscape pretty much include everything.
希望大家看一看， 无论有没有类似经历， 对将来的practice是有好处的。
长在河边走， 哪有不湿鞋？ 在平时的工作中， 对病人要体贴，对同行要体谅。 这就
是我想说的。 |
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L****n
发帖数: 12932 | 23 Divorce rates among physicians have been reported to be 10% to 20% higher
than those in the general population.[20]（which is well published 50%）
Furthermore, those couples that include a physician who remain married
reported marriages that are more unhappy.
http://www.medscape.com/viewarticle/410643_2 |
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d****y
发帖数: 2180 | 24 UW 题目里面列了肌注和皮下注射，然后选了肌注，说是肌注起效快。我觉得这题目真
是坑爹啊。（ 另外还有一个怀疑Cushing syndrome到底是先做Dexamethasone
overnight suppression test 还是先测24小时cortisol的也是很让人抓狂。传统的是
先做Dexamethasone overnight suppression test， 然后Mayo Clinic 是推崇先测24
小时cortisol的。考试如果碰到这两个同时出现的，到底选哪个？ 肯定要晕了。 ）
另外我从Medscape 找到的：
The pros and cons of epinephrine administration through various routes are
summarized in Table 2.[1,8•,12–18,19•,20•] Intramuscular
injection into the mid-anterolateral aspect of the thigh is recommended as
t... 阅读全帖 |
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s******t
发帖数: 579 | 25 抛砖引玉：
幻听属于精神分裂症的阳性症状，用classical neuroleptics 都应该可以吧？国内应该是有的。病人可能也没好好吃药。
Risperidone是 atypical neuroleptics，也可以试试。
用一种药如果不够，需要联合用药来增加效果，还有其它方面的治疗，你可以从下面的
文章看看：
http://www.medscape.org/viewarticle/738924
还有，许多病人的幻听从来就没消失过，如果病人的自知力存在，知道这个是不存在的，这个幻听并不干扰病人的生活，也可以接受。 |
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d****y
发帖数: 2180 | 26 冤枉，我没有这个意思啊。你看A++认为是E，你认为是A， 麦地也是两个答案都有选的
，都有道理。所以要specialist出来解惑啊。
这个form我也是online 做的，form 1没有expanded feedback， 所以是不可能知道自
己的对错的，除非form 4 也有同样的题目。
心包填塞，我看medscape那里说就是临床诊断，超声当然是最好的诊断方法。问题是这
个病人是不是情况比较紧急，需要马上穿刺积液减压呢？急诊穿积液可能并没有超声啊。
如果不算很紧急，那当然就选A了。 |
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A*******s
发帖数: 9638 | 27 一个不常见，容易忽视的诊断。
Subclavian stenosis disorder is a relatively rare disorder. There are only
about 2% in today’s population and about 7% of the clinical population that
suffer from subclavian stenosis. On most cases, SSP or subclavian steal
phenomenon is only incidentally found during sonography conducted in the
vertebral system. About 2% to 5% of those who are examined are discovered
this way. Of all these incidents, only 5% of the patients actually
manifested symptoms of subclavian stenosis syndr... 阅读全帖 |
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d**o
发帖数: 618 | 31 I'm not sure what are the points you try to clarify.
1. At this point there is no alternative that is proven better than tPA.
http://www.medscape.com/viewarticle/778998
2. You may say the pt is a little too old for hemicraniectomy, but it is not
excessive.
"Patients with malignant MCA territory infarction should be enrolled in
randomized controlled trials of decompressive hemicraniectomy if this option
is available. In the absence of clinical trial availability, and given the
dire prognosis asso... 阅读全帖 |
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b***u
发帖数: 746 | 34 From Medscape:
Michael J. Sacopulos, JDDisclosures
December 30, 2013
Patient Not Warned to Avoid Physical Exertion; Dies During Threesome
A Lawrenceville, Georgia, jury awarded $3 million to the estate of William
Martinez. Mr. Martinez was 31 years old in 2009, when he entered his
cardiologist's office. There he complained of chest pain that radiated into
his arm.
His cardiologist found that Mr. Martinez was at "high risk" of having
coronary disease and ordered a nuclear test to be performed. Th... 阅读全帖 |
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b***u
发帖数: 746 | 37 According to Medscape's 2014 Compensation Report, the average family
physician earns roughly $176,000 annually after expenses, but before taxes.
To most folks, that kind of money is pretty enviable. But for many doctors,
it's simply not enough.
How is it possible to have trouble paying bills on $175,000 a year?
Young MDs and DOs, especially, may be weighed down by medical school debt:
Graduates of the class of 2013 owe $169,900 on average, according to the
Association of American Medical College... 阅读全帖 |
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r*****1
发帖数: 805 | 39 dextromethorphan HBr and quinidine sulfate 20 mg/10 mg capsules (Nuedexta;
Avanir Pharmaceuticals, Inc) as the first treatment for pseudobulbar affect
(PBA).
http://www.medscape.com/viewarticle/731783
不知道是不是A大眼里的新药
这病和病人年龄有关系吗？这病从neuroanatomy角度分析很有意思～ |
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