THE EXPANDING UNIVERSE OF BLOGGERS—people who post personal commentary on the Internet—now includes a galaxy of medical professionals. Dozen of sites are being composed by physicians, nurses and hospital staffers who regularly rant on topics from public policy to the top 10 “Worst Intern Duties.” Here, passages from the blogs of three noteworthy practitioners.

Hospital Innovations That Do Not Exist…Yet

Adapted from an Oct. 21, 2005, posting on, a blog written by “Maria,” a resident physician in psychiatry

Instead of donning a gown and a pair of gloves for every patient who is on contact precautions, physicians and nurses would walk through an antimicrobial force field in the doorway of the patient’s room. It would be like a thin waterfall tumbling from the ceiling to the floor. People would automatically become “drenched” in this force field and protected against infectious diseases. And somehow, when the person walked out, the force field would be removed and the entire system would disinfect itself. Maybe with continuous magnetic or electric pulses. Or something…

More Thoughts on Supply and Demand

Adapted from an Oct. 25, 2005, posting by “rcentor” on, which sounds off on public policy and medical news

The concept of our reimbursement system is bankrupt. If you pay me for a unit of care, regardless of how much time I spend, I will look for ways to decrease the time of that unit of care. If I can see seven patients rather than six in two hours, I have increased my gross income by 17% without significantly changing my overhead! But I also had to decrease each patient visit by approximately three minutes.

Those three minutes matter! They allow the physician to ask a few more questions and answer a few more questions. They improve the doctor-patient relationship. Without three minutes, we may leave out something important from the visit.

Tips for the Emergency-Department Drug Seeker

Adapted from an Oct. 9, 2005, posting on, a blog analyzing top medical stories daily, by “Allen,” a Texas emergency-medicine doctor and former Marine doc, also known as a “grunt”

Tonight a patient reminded me there are limits to drug-seeking behavior in the emergency department (ED). I’d like to pass on some words of wisdom. Don’t:

• start screaming for another doctor 30 seconds after being told “no pain shot”
• ask the nurse, “Is taking seven Darvocet like taking one hydrocodone 7.5?”
• think “the only drug that works for me starts with a D…” isn’t going to make us less wary…
• ask, “Is Doctor X on duty?” (knowing the names of the ED docs is never a good sign)…