2014 Archive

Stanford Medicine 25 Blog

  • Slow Medicine And Fast Medicine

    As we watch medicine unfold, there is a lovely debate emerging around slow versus fast medicine. It would seem that emphasis on the bedside falls very much in the category of the former.


  • The Flipped Patient

    Many of us in the Program in Bedside Medicine are deeply involved in the medical students pre-clerkship curriculum. Each week the students interview hospitalized patients, perform physical exams, give presentations, followed by a written H&P note. These students enter the patient room with only pen and paper, as they have not yet gained access to the Electronic Health Record (EHR). By the end of the year, our students are able to obtain medical history from patients with complex medical problems on their own and able to communicate their findings concisely and effectively.


  • Tripe Palms

    A patient’s hands may reveal much about them. Fingers, nails and palms can all tell their own stories of habits, occupations or disease.


  • An Image For A Day

    This interesting image raises all sorts of questions. What was Frida trying to say? Was it a comment about presence or about lack thereof? Was it a way of sanctifying the doctor? We know he operated on her many times and she thought he had saved her life. What does this evoke for you? What other observations might you make as an art critic and medical person?…


  • 10 Osler-isms to Remember in Your Daily Practice

    William Osler’s life and work remains so instructive. Here at Stanford we invoke his name often, and have something we call an “Osler Evening” to honor him; these are evenings where we interview a faculty member on stage, getting to know a bit about their life, the journey they made to get where they are.


  • Erb and Westphal

    Wilhelm Heinrich Erb of Bavaria, an internist interested in neurology, was a professor in Heidelberg, Germany. He is most known for writing about the importance of deep tendon reflexes to the neurological exam in the January 1875 issue of Archiv fur Psychiatrie und Nervenkrankheiten.


  • Clinical Medicine Article by Dr. Andy Elder

    A member of our Stanford 25 team, Dr. Andy Elder, recently published his thoughts about his visiting professorship to Stanford last year.


  • The Birth of Percussion

    Leopold Auenbrugger was a physician, but he was also a composer who wrote an opera for an Austrian empress. However the coming together of music and medicine had its origins in watching his father tap on the side of wine barrels to determine their contents.


  • The Internet: The Elephant in the Examination Room

    Peter Conrad, a sociologist at Brandeis University, spoke of the rise and fall of the medical authority in the doctor patient office encounter in his many scholarly articles. With the internet becoming the “elephant in the doctor’s office,” the dynamic of medical authority has certainly changed…


  • Abraham Verghese Interviews with Medscape’s Eric Topol

    The leader of our Stanford 25 program, Abraham Verghese, recently sat down with Medscape’s Editor-In-Chief, Eric Topol. This interview was part a number of popular videos for a Medscape’s One-On-One series that is newly published today.


  • Stanford-25-Website-Passes-One-Million-Visitors!

    With over one million unique visitors (and over 1,360,000 total visits) to our website alone, we want to thank everyone for their support.


  • Interview with Dr. Eric Topol (editor-in-chief of Medscape)

    The editor-in-chief of Medscape, Dr. Eric Topol, visited Stanford to sit down and do an interview with our Dr. Vergese for the Medscape One-on-One online video series.


  • Do You Know How to Measure an Ankle Brachial Index?

    The ankle brachial index (ABI) is a common and useful exam in the outpatient setting to detect peripheral arterial disease. ABI’s should be measured in all people over the age of 50 if they are a diabetic or a smoker. It should also be checked in patients over the age of 60.


  • The History of Bedside Ultrasound: From Submarines to Sub-Interns

    Among the myriad of modern diagnostic tools, few can claim the certainty, consistency, and intimacy of ultrasound. In contrast to other dominant types of medical imaging characterized by large, foreign machines and uncomfortable noise and positioning, this sound-based imaging technique is one of the least intimidating and widely-used exam method, applied in fields ranging from Pulmonology and Gastroenterology to Obstetrics and Gynecology.


  • The Babinski Sign

    Among the key players in the neurological revolution of the early 19th Century, few may claim as much lasting relevance as Jean-Martin Charcot. Lending his eponym to phenomena such as Charcot’s Joint (diabetic arthropathy), Charcot’s Triad (acute cholangitis) and most notably Charcot’s Disease (ALS), the French physician is widely considered to be a progenitor of modern neuroscience and psychology.


  • On Chekhov: The Marriage of Medicine and Literature

    Anton Chekhov, Russian physician-playwright from Tagranog, must have written about more than a hundred physician characters in his literary career.


  • Pathognomonic Signs and Metaphors of the Gynecologic Exam

    Here we share memorable metaphors and pathognomonic signs, some of which are fruit and cheese metaphors in their own right. This is not mean to be an exhaustive list, but rather a reminder of the many interesting observations that can be made during a physical exam…


  • Cultural Competence at the Bedside

    A clinician will encounter patients from all socio-economic strata, who speak foreign tongues and understand disease in ways that stand apart from the clinician’s own conceptions of disease etiology.


  • Dr. Ahuja Leads a Stanford 25 Session on the Oral Exam

    In our last Stanford 25 session, Dr. Neera Ahuja led a session on the oral exam. In this session, she talked about important findings of the oral exam for the internist that include abnormal findings of the tongue, buccal mucosa and salivary glands.


  • What Can Doctors Learn from Narrative Medicine?

    Patient-centered care is an important aspect of the National Strategy for Quality Improvement on Health Care. As such, healthcare institutions are strongly focusing on the patient-physician relationship and the patient experience.


  • Dr. Barry Teaches the Exam of the Foot and Ankle

    Dr. Barry trained in Rheumatology at Yale and now serves as the Director of the Johnson & Johnson Global Health Scholars Program at Stanford. Please read below for some take-home points of the foot and ankle exam from Dr. Barry.


  • Teaching Humility at the Bedside

    Humility is an underappreciated skill in a time of global budgets, evidenced based approaches, and cost-containment. The bright, well-read, talented medical students who may lack humility are not uncommon.


  • Art and Observation: Stanford 25 Trip to the Cantor Art Museum on Stanford Campus

    Humility is an underappreciated skill in a time of global budgets, evidenced based approaches, and cost-containment. The bright, well-read, talented medical students who may lack humility are not uncommon.


  • Dr. Singh Teaches the Exam of Low Back Pain and Hip Pain

    Dr. Singh is the Clinical Chief of the Stanford Internal Medicine Clinic. Below are some take-home points for the session.


  • What’s the Cause of These Nail Findings?

    This patient has Beau’s lines. They are usually caused by severe stress to the body.


  • Dr. Neil Schwartz Teaches the Neuro Exam

    Dr. Neil Schwartz is a Stanford neurologist and the Program Director of Stanford’s Neurology Residency Program. Dr. Schwartz is an excellent teacher within the Stanford community and led this week’s Stanford 25 session on the neurology exam.


  • Dr. Rosenberg Teaches the Lymph Node & Spleen Exam

    Dr. Saul Rosenberg was first recruited to Stanford in 1961 and was involved in the creation of our hospital’s first lymphoma program. Today, Dr. Rosenberg shared his years of experience to lead our Stanford Medicine 25 session on the lymph node and spleen exam.


  • Dr. Mindie Nguyen Provides Advice on the Abdominal Exam

    Thank you to Dr. Mindie Nguyen, one of our wonderful Stanford gastroenterologists and liver specialists, for teaching our last Stanford 25 session on the abdominal exam. Dr. Nguyen focused on practical methods of diagnosing liver and spleen enlargement. She provides us with some follow-up tips when conducting the exam of the abdomen…


  • What’s in Doctor Verghese’s Lab Coat?

    We’re sure you must be wondering: what does Dr. Verghese carry in his white coat when attending on rounds?…


  • Abraham Verghese wins the Heinz Award

    Congratulations to our own Dr. Abraham Verghese for receiving the 2013 Heinz Award for the Category of Arts and Humanities. The Heinz Award is widely considered to be one of the largest individual achievements in the world and includes an prize of $250,000.


  • Stanford 25 Session: Shoulder Exam with Mark Genovese

    Dr. Genovese emphasized technique and the importance of the exam of the shoulder over imaging. He says the following: “Visualize, palpate, active range of motion, passive range of motion, assess rotator cuff against resistance, assess for impingement. Value of the shoulder exam is far more important than standard or advanced imaging.”…


  • Stanford 25 in Okinawa: 10 things learned about this beautiful island

    The residency program (called the Muribushi Okinawa Project) consists of 8 hospitals throughout Okinawa. This Stanford-Japan exchange program is organized by Dr. Haruko Akatsu (Stanford Department of Endocrinology)…


  • Dr. Neil Gesundheit Teaches the Thyroid Exam this Week

    Thank to our endocrine specialist, Dr. Neil Gesundheit, for leading our Stanford Medicine 25 session this week on the thyroid exam! Read below to learn some tips about the thyroid exam directly from Dr. Gesundheit.


  • Lymph Node and Spleen Exam with Dr. Beth Martin

    Dr. Beth Martin led this week’s Stanford 25 session by teaching our residents how she exams for enlarged lymph nodes and an enlarged spleen.


  • Stanford Medicine 25 Faculty Training session at Western SGIM

    In this session, we shared our experiences with teaching the physical exam at the bedside. Our participants got into groups and came up with their own bedside teaching example to share with everyone.


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