Road Trip 7: three days of Continuing Medical Education in Pittsburg


For pills the pain to abate,
Please limit the number to 8
Is there to be an excuse
For narcotics abuse?
And tobacco opens the gate

Synopsis: I’m a family practitioner from Sioux City, Iowa. I danced back from the brink of burnout in 2010, and, honoring a one-year non-compete clause, went for adventures working in out-of-the-way locations. After jobs in Alaska, New Zealand, Iowa, and Nebraska, I returned home and took a part-time position with a Community Health Center, where I worked for 3 years. I left last month because of a troubled relationship with the Electronic Medical Record (EMR) system. Right now I’m on a road trip, visiting family and friends and attending some Continuing Medical Education.

Every Family Practitioner, in order to claim the title Board Certified, has to take 50 hours of Continuing Medical Education (CME) yearly. Today I finished up a three day conference in Pittsburgh, Pennsylvania. I picked this venue so as to attend with my daughter Jesse, and her husband, Winfred.

The thrill of having my daughter and son-in-law as colleagues in this experience permeated the weekend.

The first day, Friday, I spent improving my well child checks. I found little new information, but that doesn’t mean I’ll pass the online test the first time. One of the presenters deserved the designation gifted teacher, a dynamic speaker who convinced me at every turn that I could master the material.

Yesterday a former DEA agent brought in the bad news about America’s epidemic of narcotic abuse, but more importantly told us what we could do about it. I found most interesting the fact that for new, severe pain, such as burn or broken bone, the average number of pain pills taken comes to 8; the others in the prescription hang around the medicine cabinet till some teenager pops them to see what happens. The presenter made the very good point that the doctor needs to make sure the drug prescribed goes into the right patient, whether it’s an opiate or an antibiotic.

Immediately after that I learned about the complicated new process to keep my board certification current. I still need 50 hours of CME a year, but I also need to complete three other projects every three years. An unnecessarily complicated process, the lecture took 45 minutes. I’ll be calling the helpline later this week.

And new information kept rolling in.

Human Herpes Virus 6 (you’ve heard of 1 and 2) causes pityriasis rosea, also known as the Christmas Tree rash. Acyclovir shortens duration of symptoms by 3 weeks. Three of us turned to each other in amazement; none of us had known that. Never assume that nothing changes, the lecturer said; the smartphone in this case saved the patient.

Sometimes a growing adolescent’s hip loses the growth plate, we call the condition slipped capital femoral epiphysis. To diagnose on physical exam, lay the patient supine, and passively flex the hip; if it has to rotate outwards, the patient will probably need surgery.

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