As many know, I am a bit of a fanatic on the issue of antibiotic overuse. One of the residents in our program recently referred to me as the "antibiotic nihilist." Patient expectations play a significant role in physicians' decisionmaking regarding antibiotic prescribing choices. This month's Pediatrics has another compelling article that provides a sobering picture of what many of us continue to worry about: despite mounting evidence that antibiotic prescribing needs to be done more judiciously, most physicians continue to overuse these medications.

The CDC's National Center for Health Statistics is an excellent source for finding statistical data. I downloaded the most recent National Ambulatory Medical Care Survey (1997) dataset, which is 1.3 megabytes. Make sure that you read the instructions on how to access the datafiles before you download. The PDF version of the summary should have sufficient information for most people.

Someone was bound to come up with this: Lifeshirt. It's a battery powered vest that you can wear all of the time. "It measures 35 bodily functions, including heart rate, blood pressure and breathing patterns." Users can then upload the data to physicians.

Calculate your diabetes risk at the American Diabetes Association website.

I have a few patients with narcolepsy. One of them sent me this link to the Narcolepsy Network.

I've always enjoyed BMJ. It's got the right mix of medical information, humor and sharp editorials to keep me awake. This week's article on alien hospital linen is not to be missed.

Neurology: Diabetes may double the risk of dementia.

Another EMR product: Dr.notes. This is product that makes heavy use of templates .. with easy enrty of normal values. I keep thinking that HCFA is going to strike back against such templates. It's so easy for docs to enter a "normal" exam … and so tempting therefore to document compontents of the exam that didn't happen. I've certainly caught medical students documenting exam components that they didn't perform .. do physicians do this too?

I lost my stethoscope last week. It's not on the floor of the car .. nor under the desk .. nor under the pile of charts in the office. A Littmann Cardiology II that I've had for 10 years. I guess I'll have to buy a new one.

Lots of choices online …

Stethoscopesonline.com Has a new Littmann III for $119.
DiscountMedMarket.com. has one for $124 … and they are advertising the Littmann electronic scope (though not yet available) for $299.

The other electronic scope on the market is the HP Stethos Electronic Stethoscope which goes for about $349.

I think I'll wait a few more years to get an electronic version …