The Year In Review (Friday Links)

Doctor D will take this first day of 2010 to reflect on this last year...

In May of 2009 a young physician decided to name his alter ego "Doctor D" and become a medblogger.

He hadn't even read medbloggers before, but he really wanted to frankly discuss health and medicine so he opened a blog and put up some random post asking people to send in questions to some anonymous MD who was willing to spill the beans.

Doctor D just ignored the blog for 3 months, expecting a readerless blog to magically generate interesting questions his email box.

In August Doctor D finally decided he really wanted to do this, so he started posting answers to random questions that popped into his head.

Thankfully, a blogger named Magda stumbled across Ask An MD and asked the first question: about finding a new doctor. D was so thrilled he answered it in a 4-part series.

Since then the questions have been rolling in!

Along the way Doctor D has met some really amazing people on the web. The first person to show D the medblogging ropes was WarmSocks. She blogs about her experience as a patient and she explained to Doctor D how to make a blog like this helpful to people navagating the healthcare system. Later D met other cool patient-bloggers like Neo-Conduit, Queen, Wren, Helen, who really are must-reads for medical folk who want to understand the suffering and strength of a lot of the patients we care for every day.

Doctor D also wants to thank the inspiring patients he has met over email. Many readers don't have blogs, but have shared their experiences with him. D wishes the whole world could hear your stories.

Nurse K was the first and still the awesomest medical-worker blogger to welcome Doctor D to the net! Even though her ER blog is now on hiatus K has always been D's webcrush and he still reads her twitter religiously. Ask An MD has also been visited by such great medical bloggers as Nurse Maha, Nurse Lee, Doctor Rob, Ell the med student, and the hilarious Dr. Grumpy.

So Doctor D has met some very cool people, answered a lot of questions, and had a lot of fun. Ask An MD is getting hundreds of visitors each day and it's really only a few months old. Keep those questions coming!

Thank you all for a great 2009!

So what do you think? What have you liked and disliked about the blog this year? What direction do you think Doctor D should take the blog in 2010? What sorts of questions do you think Doctor D should be selecting from the mail bag in 2010?

The Battle Against Incompetence

A while back Nurse K asked a really good question:

How do doctors deal with colleagues that they know are incompetent? Keep your mouth shut? Frank discussion with the medical director? Anonymous letter?

Doctor D has two ways of answering this question. One makes him look really awesome, and the other exposes him a part of the problem. Doctor D will start out all the heroic stuff and then tell you more in the next week:

Doctor D once worked at a place called Crayzee Clinic, because he really wanted to practice primary care in an underserved community. (What a saint! Let's give Doctor D a Nobel Prize or something!) Unfortunately the clinic came with a partner we shall call "Crayzee Colleague."

Now Crayzee Colleague was pleasant enough, but the medicine she practiced didn't even remotely resemble proper standards of care. Doctor D, being the totally nice dude that he was, thought maybe Crayzee Colleague was just behind the times and hadn't heard of the cool new stuff doctors have been doing for these last fifty years. D mentioned his concern in the gentlest possible way, but would you believe it, Crayzee went nuts! She called D a "young doctor who doesn't know shit."

So Doctor D printed out some info for Crayzee Colleague on how medical care is done in this century to prove that he isn't the only one who believes in things like vaccines, mammograms, and such. Unfortunately nothing changed about Crayzee Colleague's incompetent care.

Doctor D was worried because he shared patients with Crayzee Colleague and the stuff she did wasn't exactly safe. From time to time he sent her pleasant little notes reminding her about sensible medical care as he was cleaning up her disastrous work. After a few months of this our hero realized Crayzee Colleague had no interest in changing anything.

Since Crayzee Clinic was federally funded, Doctor D figured he should go up the ladder and speak to "The Man." The Man isn't a doctor, but he has a fancy title, sits behind a big desk, and supervises a whole lot of doctors. D figured his colleague would surely listen to The Man. So D informed The Man that he was very worried about Crayzee Colleague's care. The Man said "Doctor D you are right. Crayzee should step up her game."

And then nothing happened.

Crayzee Colleague kept providing downright dangerous care, ignoring D's still friendly but increasingly firm reminders to at least try to practice something resembling primary care.

Finally, Doctor D had enough of Crayzee Colleague doing dangerous shit to his patients. He blew the whistle as loud as he could. He warned every healthcare bureaucrat he could find, "Look, if Crayzee Colleague keeps doing this stuff that endangers patients I will resign from Crayzee Clinic and tell every patient I see on my way out that I'm leaving because the care here is a treat to public safety!" And still nothing happened.

So Doctor D did exactly as he had threatened he would.

At the end of our story The Man's bureaucracy remained intact, Crayzee Colleague was still at the clinic, and Doctor D had all his principles but no job in the middle of the Great Recession.

...but Doctor D is still proud he opened that can o' whoopass on medical incompetence as well as The Man and his Crayzee Clinic.

Please feel free to praise the fearless Doctor D in the comments section! Get his ego good and inflated because next week he has to make some confessions that will disappoint you.

Friday Unlinking

It is a sad day in the medblogging world! Nurse K has pulled the plug on her blog again!

We can only assume that the illustrious Nurse K had renounced blogging out of shame! She had been promising to do a guest post for Doctor D for like a month now and never got around to doing it. Poor K! Her guilt at letting down Doctor D must have driven her to despair. And now she has closed her blog and assumed a life of quiet contemplation in order to do penance for her transgressions.

Nurse K, all is forgiven! I never really thought you'd do that guest post anyway. I knew the topic was too dull for your tastes! I forgive you the guest post you owe me. You are free to return from your seclusion. Your readers need you in these dark times!

Actually Nurse K is still cool, but her blog is down for the near future. She is missed, but Doctor D will keep her link on the sidebar, ready for her triumphant return. Until then you can get your dose of ER Crayzees at this site.

The Triumphant Return of Nurse K!

Yes, it is 3 a.m. and Doctor D should be sleeping since he is still getting over his viral infection, but some news just can't wait:

The world's greatest medblogger has returned! Nurse K is blogging again and as brilliant as ever. Who knows how long the cynical goodness will last? So head on over there and laugh till you wet your undergarments!

By the way, this is by no means lessens my endorsement of Tex and Nurse Lee yesterday, but heck, Doctor D would recommend Nurse K over even his own blog.

The Curse of Doctor D (Friday Dead Links)

Be afraid! Doctor D is the kiss of death for really great medical blogs!

Just when Doctor D says to himself, "This is my favorite blog on the whole frickin' internet!" the blog suddenly disappears. Not just stops updating, but disappears completely into password protected oblivion!

First came Crass Pollination by Nurse K. Doctor D laughed so hard reading those wild tales from Nurse K's ER! It closed just a few weeks after Doctor D found it. Coincidence?

Then just this week Doctor D was reading Journey to MD and said to himself, "I really enjoy Ella's witty commentary and stories from medical school. I think this is my favorite medblog of all!" And suddenly it's gone... without even a "Hiatus" post!

This is some dangerous stuff! I am desperately trying not to love Dr. Grumpy lest I inadvertently destroy his blog as well. But in case I don't succeed, you should read the post about drunk doctors, the story of Mr. Jackass, and the time Happy Hospitalist got schooled by Grumpy right now!

Doctor D's new found blog-killing power really should be harnessed and used for good! Feel free to let Doctor D know in your comments which medblogs should be spared and which should be destroyed.

Ella and Nurse K if you are out there, please come back! I promise not to annihilate your blogs again.

*UPDATE: So just a few hours after I posted this Ella's Blog reappeared! WTF? Was she just messing with Doctor D to see if he missed her? Welcome back Ella! Now we just need to figure out how to do the same for Nurse K!

Should I Have My PSA Checked? (Friday Links)

Okay so no one sent in this question, but a lot of people have asked Doctor D over the years.

Doctor D is using this question to introduce a new feature of "Ask An MD" Friday Links! There are a lot of great medical blogs by patients, doctors, nurses, and med students , so each Friday Doctor D is going to share some interesting reading from the medical blogsphere with you. I'm still answering a couple reader questions each week so keep emailing them in.

Should I have my PSA checked?

Tricky question! Unfortunately the answer isn't as simple as "Yes" or "No" and there are a lot complicated issues in healthcare tied into the controversy surrounding this simple blood test.

Doctor D wouldn't be brave enough to tackle that question, but Doctor Rob (at Musings Of A Distractable Mind) wrote a fascinating piece on the business of prostate care. The debate in the comments is where it really gets interesting.

Read it Here: An Intuitive Reasoning For Rising Health Care Costs

On a side note: It is a sad day for the medical blogsphere. Nurse K has temporarily closed her blog. She says this is a temporary hiatus. Hopefully she will be back soon, but you can still get a taste of her thoughts on Twitter. Nurse K is the funniest, toughest, most wise-ass ER Nurse on the planet and her blog was always a joy to read. I'm sure the Happy Hospitalist will cry himself to sleep every night until Nurse K is back.

Did you read (or write) a great medical blogging this week? Post the links in the comments!