One of the new initiatives in healthcare reform is called the Affordable Care Act (ACA) which requires that all participating hospitals and clinics be reimbursed by Medicare based on the quality of care they provide.
According to live tweets and images sent from ophthalmologist Dr. Kris Held, nearly all doctors had walked out in protest and disgust of Obamacare implementation talks at a prominent national health care meeting. Typically, The American Society of Cataract and Refractive Surgery Government Relations session is a well attended, formal business conference where brilliant minds in medicine convene. This year was a different story. With talks of Obamacare implementation and compliance underway, doctors left and right had left the auditorium.
Scientists have been mystified by thepinealgland for centuries. As the brain and central nervous and endocrine systems were progressively unravelled by the anatomists, physiologists and biochemists, the pineal gland resolutely refused to yield up its secrets. Until recently the scientific community regarded it as having no function in man, being but a vestigial remnant from an earlier stage in evolution. However, in the last few years interest in the gland has reached a climax when no fewer than ten national and international conferences devoted entirely to unravelling the secrets of the mysterious pineal have been held around the world.
Physically, the pineal is perhaps the smallest organ of the body. Such a minute structure has rarely, if ever, caused so much curiosity and commotion. It is a tiny grey white structure approximately inch long, weighing about 100 milligrams, and shaped like a pine-cone. It is located directly at the top of the spinal cord within the brain at the level where the head and neck are joined. It lies attached to the roof of the third ventricle (fluid filled canal) of the brain directly in line with the point between the eyebrows. It is the only structure in the brain, apart from the pituitary gland, which is not bilaterally symmetrical, lying right in the midline. This means that, except for these two glands, the two halves of the brain when it has been cut from front to back, are mirror images of each other, with each structure being duplicated, one for each half.
It is interesting to trace the scientific history of the pineal gland to the present day.
Medical residents are universally lauded for their mastery of “delayed gratification,” and no one can fault them for wanting to play catch-up once the money starts rolling in. But, the transition from medical student to MD is laden with some unique financial challenges that, without the tools to confront them, could postpone life’s ultimate gratification (retirement) well into the future. Beginning a career ten or twelve years late with six figures of debt can place an enormous burden on new physicians who aren’t prepared to manage their finances with their future in mind.
Caught between the temptations to step up their lifestyles and to quickly pay down their debt, new physicians can find themselves running out of money without any consideration for savings. But then, they’re only at the beginning of their income potential and there will always be time for savings, right? Wrong. The most powerful resource we all have for building wealth is time. You really don’t have control over how much money you will make, but you do have control over how much time you have to save what you do make. The more time you have, the more opportunity you have to build wealth.
In the Emergency Department, we treat a wide variety of patients, so you must learn how to harmonize with everyone from CEOs and celebrities to blue-collar workers, alcoholics, drug dealers, criminals, feisty old folks, exhausted parents, defiant teenagers, babies, and everything in between.
As a first year resident in Emergency Medicine — I have had many colleagues ask me one simple question, “What about burnout?” To be honest, I never quite understood why so many non-Emergency Medicine colleagues seem to think burnout is more likely to occur in Emergency Medicine than in other specialties. Perhaps because Emergency Medicine is so appealing, that it must be too good to be true!?
But let’s be honest, working as an ER doc is probably more stressful than you imagine — but a career in Emergency Medicine is also vastly more rewarding than you likely realize. You will have some people wrap their arms around you and not want to let go, but you’ll also have other patients who will want to rip your spleen out and eat it. At the end of the day — saving lives is arguably the most important and rewarding job in the world. As an Emergency Physician, no other specialty will give you so many opportunities to help so many people in so many ways.
Ketamine, also known as “Special K” in some circles — produces effects similar to phencyclidine (PCP) and dextromethorphan (DXM), but it is also has many powerful treatment options.
Ketamine is primarily used for the induction and maintenance of general anesthesia, usually in combination with a sedative. Other uses include sedation in intensive care, analgesia (particularly in emergency medicine), and treatment of bronchospasm.
Let’s get down to the specifics..
Ketamine is a noncompetitive N-methyl D-aspartate (NMDA) receptor antagonist that blocks the release of excitatory neurotransmitter glutamate and provides anesthesia, amnesia, and analgesia by virtue of decreasing central sensitization and the “wind-up” phenomenon.
To the consternation of young physicians, the general public perception is that all medical practitioners are wealthy, which may be the reason why we hear so much grumbling over the cost of health care costs. What is largely lost on the public is that the vast majority of physicians begin their careers deep in a hole both in terms of money and time. It is difficult for the average person to fully gauge, let alone appreciate the monetary and time commitment that goes into preparing for the profession. Even before they confront the lifelong challenge of building personal wealth from a medical practice, new physicians are lined up well behind the starting line for a number of reasons..
The findings are based on more than 170,000 interviews of U.S. adults conducted last year, and measure well-being in terms of physical health, emotional health and fiscal health.
In terms ofphysical fitness, people who work in the farming, fishing or forestry industry scored the highest on exercise, with 65.5 percent of them saying that they worked out for a minimum of a half-hour for three days (at least!) the week prior. Doctors were the next highest, followed by construction workers/miners, business owners and nurses.
For healthy eating, nurses had all the occupations beat with 64.8 percent saying they had five or more servings of fruits and vegetables for at least four days of the prior week. They were followed by K-12 teachers, business owners, and then doctors.
As far asunhealthyhabits are concerned, transportation workers were the most likely to be obese, with 37.1 percent of them reporting being obese. Manufacturing or production workers had the next highest obesity rate — at 29.6 percent — followed by installation and repair workers, and clerical or office workers.
People who work in construction or mining had the highest smoking rate in the report, with 32.4 percent reporting smoking. They were followed by installation and repair workers, then transportation workers, then manufacturing or production workers.
For a look at which jobs scored the lowest and the highest foroverallwell-being, see below..
If you’re finishing up residency or fellowship, you’ve spent the last 4, 5, 6, 7, maybe even 8 years being paid about 18 cents per hour. Now you’re out there looking for your first “real” job. So when someone comes along and offers you a 6-figure salary, it’s tempting to accept it, no matter how unfair the offer actually is. Unfortunately, some employers are anxious to take advantage of young physicians who are desperate to take any job that will help them begin to pay off their enormous student loans. So many times young physicians wind up accepting compensation under their physician employment agreement that is not up to par with market standards. After all, it’s hard to know what the market standard is when you don’t have access to national physician compensation benchmark data. Before you accept a physician employment contract offer, be sure someone is looking out for your financial and legal interests.
Many physicians, especially those fresh out of training, are hasty about accepting the first job offer that comes their way because they have enormous student loans to pay off, and they haven’t yet endured a horrific employment experience that has taught them to tread carefully into any given employment arrangement. After all, when you’re out there looking for your first job, the potential employers are great salespeople- reassuring you that your wants and needs will be met.