From the Director
Hi Team! Seems fair to mention the “instant classic” Duke win in the Weekly Updates, made all that much sweeter by a night out at MotorCo to watch the game. Despite having JARs
Ann-Marie and
Joel Boggan mis-identified as law students in the Herald-Sun, a great time was had by all. Fun during the week carried on with another “instant classic” Trivia Bowl prepared by Chiefs
Eileen Maziarz, Tony Gutierrez and
Juliessa Pavon. This led up to Intern Day Off, with a priceless scene of surprise in Grand Rounds when it was announced…thanks to all who helped keep our teams running on Friday. We also heard excellent SAR talks from
Jennifer McCarty Gutierrez and
Ed Coverstone.
We are moving ahead to plan many of the events and activities of the second half of the year. Be on the lookout for
MaestroCare (Epic) training and
How To Be a JAR appearing on your schedules, as well as opportunities to meet and greet with fellowship directors, applications for the Faculty Resident Research Awards and how to help out with the charity auction and humanism night.
This week’s Pubmed from the program goes to SAR
Jason Lappe…
Red cell distribution width, C-reactive protein, the complete blood count, and mortality in patients with coronary disease and a normal comparison population. Lappé JM, Horne BD, Shah SH, May HT, Muhlestein JB, Lappé DL, Kfoury AG, Carlquist JF, Budge D, Alharethi R, Bair TL, Kraus WE, Anderson JL.Clin Chim Acta. 2011 Nov 20;412(23-24):2094-9. Epub 2011 Jul 27.
Have a great week,
Aimee
What Did I Read This Week (by Jane Gagliardi, MD)
[box]Sources of Regional Variation in Medicare Part D Drug Spending; Julie M. Donohue, Ph.D., Nancy E. Morden, M.D., M.P.H., Walid F. Gellad, M.D., M.P.H., Julie P. Bynum, M.D., M.P.H., Weiping Zhou, Ph.D., Joseph T. Hanlon, Pharm.D., and Jonathan Skinner, Ph.D.; N Engl J Med 2012; 366:530-538
February 9, 2012 [/box]
As an internist/psychiatrist who practices solely in the inpatient setting, I encounter a lot of patients who do not take their medications…frequently due to issues of access.
Just yesterday I had a patient pull me aside to ask about the medication our team had prescribed for him and how much it cost, as he has no insurance and limited income. In the Department of Psychiatry, Dinesh Benjamin, a recent graduate, worked with Dr. Marvin Swartz on an “academic detailing” project emphasizing how to use older, generically available medications (like the first generation antipsychotics); this initiative was accompanied by availability in the Duke pharmacy of 2-week supplies of medications, free of charge to patients leaving the hospital, that can be found on the $4 formularies at large-chain department stores and supermarkets. They used the clinical database to determine patterns of prescription and found that generic prescriptions increased over the time period the academic detailing was conducted (a finding borne out in my own clinical practice).
This Special Article in the New England Journal of Medicine highlights drug spending variations that turn out to be related in large part to provider prescription patterns (generic vs. non-generic). As a proponent of Evidence-Based Medicine, I will admit that there are not always many articles demonstrating the benefits of generic medications over brand-name ones. My fondness for EBM includes at least in part a passion for uncovering sources of bias, coupled with a drive to bring the best applicable evidence back to the patient, considering his or her values, preferences, and issues of access to care. While we should always strive to prescribe the medication with the best available evidence to treat the problem our patient has, the only benefit from an inaccessible medication is theoretical at best.
[hr]
[divider]
From the Chief Residents
Grand Rounds
| Date |
Topic |
Division |
Topic |
| 2/17/12 |
Reidel |
Oncology |
Sarcoma |
Noon Conference
| Day |
Date |
Topic |
Lecturer |
Time |
Vendor |
| Monday |
2/13 |
Pulmonary Hypertension |
Dr. Fortin |
12:00 |
Rudinos |
| Tuesday |
2/14 |
Business of Medicine |
|
12:00 |
Dominos |
| Wednesday |
2/15 |
Nephrology |
Dr. Kovalik |
12:00 |
The Pita Pit |
| Thursday |
2/16 |
Clin Pharm |
|
12:00 |
Papa John's |
| Friday |
2/17 |
Chair's Conference |
Chiefs |
11:00 |
Moe's |
Note - Chairs Conference will be held in 2003 conference room
Trivia Bowl
Thanks to everyone who provided us with stories to tell (there are so many more!) and congratulations to the Housestaff for yet again rocking trivia (next week's noon conferences will cover Duke bball and Coach K as these are your deficiencies, thank goodness they are not on the ITE!). For those of you who were unable to be there, we will post the slides up for you to enjoy.
Intern Day Off
Thanks to all of those who covered in order to keep this important tradition — all the
GM residents and attendings at Duke, VA, DRH; George Cheely, DRH ACR; Mandy George, Lisa Vann, Denise Duan-Porter, Jason Lappe, David Lofthus, Brian Kincaid, Eric Chu, Kristen Dicks, Anna Teeter Dolgner, Andrea Shaw, Lauren Gratian, Brett Goodwin, Newton Wiggins, Nick Wisnoski and the consult fellows for allowing us to move people around for coverage! Thanks also to our stellar intern reps to the Residency Council who not only planned an awesome day at Frankie's Fun Park, but who kept their lips sealed so that most of your class were surprised…great job
Jeremy Halbe, Laura Caputo, Armando Bedoya and Chris Hostler.
Other Updates From The Chiefs
Duke-UNC game – Thanks go out to Dr Klotman for sponsoring Wed night's game and for all who attended. Go Duke!
Match Day - is coming soon! Keep on the lookout for plans for the celebration. Thanks for everyone's hard work, keep your spirits up (interns, your replacements are around the corner!)
ACP meeting – for residents with posters at the NC ACP meeting on Feb 24, please start working now with the Chief at the site you are on to make arrangements to attend the poster session.
Charity Auction
Save the date for the 12th Annual Duke Medicine Residents' Charity Auction, supporting
Durham Senior PharmAssist and the
DOC patient fund!!
Friday March 23rd at 7pm, at the Durham Arts Council Building. See attached powerpoint slide for details. If you would like to support our cause, please contact Tian at
tian.zhang2@duke.edu."
12th annual Charity Auction save the date
From Your ICGME Reps (Be Mindful of How You Use Social Media)
The pertinent highlight of this month's ICGME meeting focused on professional conduct within social media. The NC Medical Board recently wrote an article describing a Rhode Island physician who posted de-identified patient information on Facebook, but was thereafter fired and reprimanded from her state board. The NC Medical Board states that physicians are held to a higher standard in social media, and that there are ethical and professional obligations to the patient beyond the exam room. Lessons to take away:
- 1) Do not post patient-related information on social media - even de-identified information can be manipulated for patient identification
- 2) The medical board can reprimand physicians who post patient related information on social media; this can affect future licensing.
- 3) This applies to international medical mission trips - patient information from abroad (particularly pictures of disfiguring cases or rare disorders) should not be posted within social media.
The Duke Health System will be coming out with a Policy on social media conduct in the near future. Please refer to the article found at the following link:
http://www.ncmedboard.org/articles/detail/practicing_medicine_in_the_facebook_age_maintaining_professionalism_online/
The Picker Institute offers grant funding in support of initiatives to incorporate patient-centered care into graduate medical education. The Graduate Medical Education RFP is now open. Check out the following attachment regarding this opportunity -
Picker Institute
Humanism in Medicine
Friends, colleagues,
Armando Bedoya, lend me your ears! It's my pleasure to announce that the annual Humanism in Medicine Night will be taking place on May 5th. It's a night to celebrate the Humanities - come play the guitar, read some poetry, do an interpretative dance (I'm looking at you,
Brett Goodwin). And now, a save-the-date haiku:
Save the Date: May 5th
Bring your guitar, drop some rhymes
Humanities, yeah!
Please contact
Chris Hostler if you're interested in either helping to organize this wonderful tradition or if you'd like to participate in the night's festivities.
[divider]
From the Residency Office
BLS BLITZ - DO NOT MISS THIS OPPORTUNITY
This is an announcement worthy of repeating - DO NOT MISS SIGNING UP FOR THE BLS BLITZ - if yours will expire prior to the end of the academic year. If your certification does expire the options to renew are both limited and costly (typical $400). When is this scheduled? April 16 - 19, 2012, offered in 2 hr sessions. Our office will have BLS Manuals available for residents on a first come basis, and must be returned the same day. The following attachment gives you all the information that you need. Register NOW so that you can get your pick of the session that best fits into your schedule.
Blitz registration April 2012
UpToDate
In case you missed the recent announcement,
UpToDate can be accessed by clinicians, staff, and learners within Duke University Health System using the following link:
www.uptodate.com/online<http://www.uptodate.com/online
Call Rooms
Reminder regarding call room cleaning and security -
Rooms are expected to be cleaned daily - if you find a room that has not be cleaned, please call house keeping. If the problem is not addressed, let our office know and we will follow-up with GME and also with house services
Security - if you find the call rooms occupied by anyone other than house staff, or you have any concerns regarding who is in the area - call security immediately.
February - Month to Celebrate GME
Please join Duke GME Leadership and staff in celebrating our GME community and the contributions made towards making this a terrific year of GME. The month of February has many events scheduled. We encourage you to take advantage of some of these opportunities during the month. GME Month 2012 - Calendar of Events<
https://gme.duke.edu/sites/medicine.duke.edumedicine.duke.edudefault/files/files/GME%20Month%20Calendar%20of%20Events%201-18-12_0.pdf
Dates to Add to Your Calendars
March 23 - Charity Auction
May 5 - Humanism in Medicine
June 2 - Annual SAR Dinner
(invitations only)
June 13 –Resident Research Event, 5-7pm
Opportunities
Michigan Derry, NH
WI and MN Phoenix, AZ
Useful links
