It Was Fun While It Lasted

Today is a sad day here at AskAnMD.

Doctor D was really excited about this new blog getting nominated for "Best Medical Weblog of 2009." Doctor D was doing his victory dance and playing "Eye of the Tiger" so loud the neighbors complained because he was totally gonna win that sucka.

Alas The Man over at Medgadget didn't think Doctor D's blog should be in the finals, thus all the AskAnMD fans that couldn't wait to vote it to victory were disenfranchised. Doctor D suspects The Man is dabbling in politics again since a lot of the finalist blogs in this category look like they were written by corporations or medical schools and are about as interesting as watching paint dry.

But never fear! The Man didn't totally succeed in exterminating personality in medblogging. Our dear friend Doctor Rob from Distractable Mind slipped into the finals!

So mosey on over there and vote for Dr. Rob early and often!

Is Doctor D encouraging you to vote more than once? Naw, you must have misunderstood that.

While you are over there be sure to support the beautiful work being done by WordDoc at Medical Moments in 55 Words for Best Literary Medical Weblog.

The real competition this year comes in Best Patient's Blog. Three of Doctor D's total favorites made the list: Queen of Optimism, ∞ itis, and RheumaBlog. Doctor D is so torn, because all those blogs are excellent! I might just have to vote for all of them.

Would Doctor D vote more than once? Of course not! You guys are totally misunderstanding me.

Have fun voting!

By the way, did you notice that Medgadged totally ignored medblogging nurses? WTF? Why is The Man always trying to hold the RNs down? Medical students too!

That's it! Doctor D has to set this right:

Tune in to this week's Friday Links to Vote for Doctor D's totally unofficial NurseBlog of the Year and MedStudentBlog of the Year awards!

Feel free to say sweet and comforting things in the comments to console Doctor D in his time of sorrow. Or you can just tell him to get over it and be a man, because its just some stupid contest and he isn't 8 years old!

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?

Should I Get A Medical Alert Bracelet? (Upselling Healthcare)

A question from WarmSocks:

When should someone wear a medical alert bracelet? Nobody has ever recommended that I should consider it, but my med list seems awfully long so I'm wondering if it would be appropriate?

The purpose of the alert bracelet is two-fold:

1. To provide vital information in an anticipated emergency.
2. To make money off of people with illnesses.

Should I wear a bracelet? Do you have a condition likely to cause you to be found unconscious, and have something about you that would make your care different than the average unconscious person? You should probably carry a brief list of your medical conditions and medicines, but most of those things don't require a bracelet.

These bracelets are marketed to people with things like insulin-dependent diabetes or heart rhythm problems. The bracelet basically says, "This is likely the reason I'm unconscious and this is what to do!" I've seen a lot of diabetics and heart patients with such bracelets, but I've never seen these bracelets make much difference. Paramedics always check blood sugar and heart rhythm as soon as they find you in such situations, so in my experience people with and without these bracelets get about the same care.

The best reason I can see for a bracelet is a rare condition that rescuers aren't going to be thinking about. Diabetics need not worry—we check a sugar on everybody that's unconscious, bracelet or not. (Other reasonable situations to have a bracelet would include: severe anaphylactic reactions to medicines or if you don't want to be resuscitated if your heart stops. )

The second reason for bracelets is to stimulate the economy. The healthcare industry is massive and you—the patient—are the cash cow. If you stop consuming all the medical accessories and extras then the Healthcare economy might shrink! Proven, effective care can be a narrow margin business, but all the physical and pharmaceutical accessories that you see marketed keep the Healthcare Business healthy even in lean times.

If you call a bracelet company they will say that your daily aspirin or history of ankle sprains should definitely qualify you for a bracelet. "Let's bill your insurance, and for a bit more you can get a stylish 14 K gold band for it!"

Your doc should be able to tell you if your condition really needs a bracelet or not.

But be careful if you doc is offering bracelets or any other "value added" products in their office for your convenience! With Primary Care profit margins razor thin, a lot of doctors are going over to the darkside and letting corporations talk them into adding "secondary income streams" to their practice. If your doctor is selling something (bracelets, supplements, skin rejuvenation, etc.) other than medical care you should run the other direction. Your doctor should be an advocate for you, not the spokesperson for some product line.

Is Doctor D may be alone in his righteous anger about MDs who sell extras in their practices? D was highly offended when Little D's doctor was selling vitamin products at the clinic. Mrs. D told Doc D to quit being a pinko Commie and accept that capitalism works this way. Do you mind if your doctor makes extra by selling products?

Patient Eduction (Friday Links)

Doctor D's recent Friday Links have focused on healthcare providers. It is good for patients to hear what doctors and nurses are saying. Conversely it is useful for those of us in medicine to listen to the voices of patients. So today I bring you two patient blogs that Doctor D never misses.

These are patients who write only about one illness: their own.

• ∞ itis: WarmSocks blogs about living with Rheumatoid Arthritis. She was the first blogger who found AskAnMD and sent encouraging emails and a link from her site. I was hesitant to feature her on Friday Links because most readers don't have RA and therefore might not be interested, but the more I read of WarmSocks' practical advice, insight, and humor the more I realize that she is useful for just about anyone who is interested in medical care.

• Neo-Conduit: Even some medical people (like Doctor D) don't know much about a Urinary Diversion, but this blogger's courage after years of difficulty in the medical system is to be admired. She has some understandable frustration with medical folks, but her perspective is worth listening to. Her observations about patient suffering and frustrations are a insightful and never angry. She is on Doctor D's "must read" list every day.

For some other great patient blogs check out the "patient bloggers" section on the sidebar. And if you follow Doctor D's Friday Links for the physician perspectives you should definitely go over to Dr. Rob's site and read Top Ten Ways To Annoy Your Doctor.

Doctor D will be back soon to answer your questions and with a special post with Nurse K! Stay Tuned!