Neurology Notes

Worth the Subscription

I subscribe to the online edition of The Lancet Neurology. The 2007 Round-Up was worth the subscription price itself. I need to keep up very broadly and these are the kind of overviews that help me the most.

Also in The Lancet Neurology:

The Lancet Neurology: “We used a unique response-conditional crossover design to provide rescue treatment if needed, and patients who showed an improvement in inflammatory neuropathy cause and treatment (INCAT) disability score during treatment were re-randomised into a 24-week extension phase.

I’m reading this both to gain some insight into immunologic treatment successes, but I’m trying to figure out how useful the trial’s design might be. I’ve been skeptical of enrichment designs in the past, but this may be a more clinically relevant way to study the reality of clinical responses.

Memories

I did my MD, PhD training as well as my medical internship at Emory School of Medicine in Atlanta. I’m sorry, but not surprised that it may close.

A Safety-Net Hospital Falls Into Financial Crisis – New York Times: “Once admired for its skill in treating a population afflicted by both social and physical ills, Grady, a teaching hospital, now faces the prospect of losing its accreditation. Only short-term financial transfusions have kept it from closing its doors.”

When I trained, Grady was a resident’s hospital. Care was provided by residents under the direction of Chief Residents who had completed training and were often specialty fellows continuing training and a group of incredibly knowledgeable teachers who ran the services and provided checks on care through morning rounds. There were teaching attending physicians, but their function was to teach and supervise, not provide care.

After I left, medical reimbursement rules changed so that the attendings had to provide care and sign off everything if the school was going to be able to bill at all. Having to switch from resident care to medical faculty care kicked a big prop out from under academic medicine and was one of the forces that eventually led me to my career in industry.

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