COMING OUT OF THE COLD
October 7, 2015
This has been a heady month for our group. After an enormously successful Bedside Symposium bringing in 120 faculty from 11 countries to learn and teach bedside skills, I was so thrilled to see our work so prominently mentioned in the INSTITUTE OF MEDICINE’S report titled, “IMPROVING DIAGNOSIS IN HEALTH CARE.”
Having preached for so many years on the importance of not missing the low-hanging fruit, on how phenotype matters as much or more than genotype, it is lovely to see theIOM highlight how critical the bedside exam can be and to cite four of our papers. And even more special for them to mention the Stanford 25!:
“Physicians at Stanford have developed the “Stanford 25,” a list of physical diagnosis maneuvers that are very technique-dependent.”
For me personally, it has been gratifying to see the word “bedside” used in the context of “improving diagnosis.” For too long diagnosis has meant some new advance in imaging or molecular detection of proteins, while the Horner’s syndrome, the shingles rash, the stigmata of chronic liver disease are missed, let alone the slightly more exotic diagnoses that we think internists should make or suspect more often at the bedside. Our paper on things missed on the physical exam and consequences of such misses can be found at this link (abstract only)—the full paper is released in December.
I personally am so proud of the young faculty who have taken up the baton, because that is the only way the art (and it is art, make no mistake) can be passed on. We are part of a chain and we cannot let it break. Please visit our web page for the listing of all the wonderful people who make what we do possible, but I want to in this newsletter single out John Kugler MD and Errol Ozdalga MD. Their tireless efforts (with John in the lead) made our bedside symposium a great success, and the vibrancy of our website with 5,000 hits a day has everything to do with Errol’s unceasing efforts. In addition to these two charter members, I am incredibly fortunate to have a growing team, each of whom is taking ownership of one aspect of this craft and making it their own—please click here to meet them. And without Stanford, without a vibrant Department of Medicine and my enlightened Chair, Bob Harrington, without the support of the Dean’s office to put on this symposium, none of this would happen. I feel blessed.
And most of all, thank you, our readers, our colleagues who share the faith and our well wishers. We would love to hear from you. Please join us today in celebrating a big milestone. We have come out of the cold.
A 46-year-old Vietnamese female with history of Churg-Strauss syndrome was seen for a flare-up and had the above skin changes. Based on the characteristics pattern can you diagnose the cause of this skin rash?…
37 yr old male with a history of these lesions on his the back of his hands for the past two years. Notes no other medical issues. No weakness, fatigue, fevers or rashes anywhere else on his body. He works as a chiropractor and is concerned about his patients seeing his hands. Use of various over the counter treatments such as topical steroids and moisturizers did not improve the lesions.