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Re: Bye bye BluesFrom: mark decker (mdecker@nconnect.net)Sat Jul 13 07:57:04 2002
i love reviewing literature.. i have to go over the acog compendium and precis at least 2 times a year and i review the green journal each month - and i keep track of the articles that impact on my practice and review them. i also use ovid - medline and download and read articles from that source. 200 in the last 2 years. i do specific office question reviews - i review trend in vbac breech episiotomies etc. any "question" i have.. it is FUN and STIMULATING - keeping up and learning new science that helps me in my office and surgical practice really is a blast - it turms me on and is its own reward. several times a week or at least several times a month i do something better - make a dx quicker - find the right solution quicker and miss less because i read . i memorized the 2000 and 2001 compendiums 6 times for written boards - so i tripled my usual review. and i picked up something "new" each time that sticks in my head longer each time and i get to use that more frequently in my day to day practice more often because of reviewing it so much. hell, i have an iq in the mid 130s they tell me but there is too much to keep in my waking brain so review always helps - and it gets easier each time i go through it. i keep the compenduium in the back of my car to read at lunch time - when i get lunch - i try to make a habit of it. i also read it when i am stuck in l and d. and i try to read every weekend - it goes fast because it is review. i am not trying to be holier than thou - it was a chore at first to get started but it is so easy now and easy to keep with it - and it has its rewards. it gets me more patients too - can't tell you how many positive comments - and family members and co workers i get for patients from people who tell me they were glad i could reference current science - current protocols - they like it when "we" keep up and can demonstrate we actually think through the science. it really is fun - it makes life more interesting in the office instead of the same ol stuff <i learned in residency 15 years ago or so>.. tough to get into the habit but well worth it- hell i even downloaded and studied bob wooley's EXCELLENT articles on episiotomy after he totally pissed me off on tb protocols for anyone around long enough to remember that exchange .. he did some very detailed work to compile the evidence on epis and thought it through very deeply - a lotta effort and a high quality set of articles bob. anyway - it is fun to keep learning. i pick up a lot of vwf with the ristocetin cofactor thanks to lit from last winter - it is helping menorrhagia pts with life long histories and makes me more aware for surgical risks - i am doing a hyst next week on a pt i screened with life long hx of menorrhagia that has severe pain issues - will use ddavp - i would have missed that a couple years ago if i quit reading after residency.. and i use the thrombophilia lit - expert review from feb 2002 green journal and related lit from the last year or two to pick up a lot of previously unexplained severe iugr and pih pts from past deliveries of mine and i can now offer them hep and baby asa and a reason for more optimism the next time around <acla and lac - pts from before> hell - i had a severe iugr on a gdm mom delivery 3 months ago - unexplained class 3 head bleed - delivered by cesarean - mom mthfr positive hx...had peds check the kid - homozygous for mthfr - explains the placental infarcts etc - i haven't seen any lit that says check the kids blood but it makes sense to me to check kids in these dramatic situations - you get to test mom and dad and the effect on this delivery in question that way. too winded - sorry anyway it is fun - it helps - and good didactic interchange keeps us all current and honest - makes us better at what we do mark
At 07:48 PM 12/19/2001 -0600, you wrote:
>of comprehensive gender specific internal medicine OTJ.
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