The reason I love grand rounds is that it offers me the opportunity to see stuff that I might normally overlook.

No themes here, per se.  Just some good stuff from around the web.  The response was great and all offered something unique.  I have chosen, however, to select some of the best material for your reading pleasure.  Rather than generate a massive dung heap of disconnected links that no one can practically manage, I have made the administrative decision to focus on some of the more compelling content.  I’ve also tried to place an emphasis on new, potentially understated blogs that might not otherwise see the light of day.

Buckle your seatbelt and keep your arms inside the vehicle.

Tweeting the meeting – Why and How.  This post by Dr. Vinny Arora is a sign of the times.  I remember not even 2 years ago practically tweeting to myself at the American Academy of Pediatrics National meeting.  While the stream that I created all by my onsies was actually pretty good, I realized we had work to do.  But Twitter integration appears to be becoming standard of care at many national meetings.  Each of us should be adapting a post like this for our respective organizations.  All of us should see ourselves as leaders in this evolving medium.

Portfolio careers.  As a physician with wildly varied interests I found this post from BMJ on ‘portfolio careers‘ really interesting.  I think this has been something I’ve been striving for but really never knew.  For the uninitiated, portfolio careers have been known in medicine since at least the 19th century, when Anton Chekhov combined his medical practice with writing plays.  Medicine no longer has to be a doctor’s sole occupation or a job for life, and today it is common for consultants and general practitioners to diversify into other areas.  My plan is to create a new breed of dog based on a cross between the dachshund and the poodle:  the weinerdoodle.

Do Patient Empowerment & Squeamishness Mix.  How does someone who can’t stand nipple rings function as a breast cancer patient?  Read and learn from the one and only Jackie Fox on Dispatches from Second Base.  And don’t stop there, read Why Cancer is Better Than New Year’s Resolutions.

White Coats.  I love love love finding new medbloggers and Jennifer Middleton, MD MPH came to my in box touted as “one of the next superstars for 2011.”  Her post White Coats suggests that the lab coat may play a surprisingly important role in helping define health care players.  I don’t wear a white coat and I introduce myself to parents with my first name.  But I love Jennifers voice and well-defined sense of professional self.  Her posts are short, focused, opinionated and with plenty of white space for my tired eyes.  Keep ‘em comin’ Jen.

Featured By from Nicholas Weaver.  Grand Rounds wouldn’t be complete without some mention of the future physicians of America the world.  Nicholas Weaver is curating some of the best health related content with an interface that’s easy on the eyes.  He breaks it down into sections for physicians, patients, nurses and administrators.  Put your feet up and spend a little time seeing what’s out there, or in there as the case may be.

Who Writes Clinical Guidelines? While I typically don’t have the attention span for blog posts over 500 words, I had to make the exception when I got the word on Dr. Rich’s clinical guideline thinking.  As more elements of physician decision making are slowly stripped from our hands, we can seek solace in the fact that clinical guidelines here to keep us on the straight and narrow.  Dr. Rich addresses the issue of clinical guidelines in an animated way that’s worth a peek.  And if the evolving administrative regulation of how you hold your otoscope is too much, his peripatetic rambling on physician career decisions will offer an element of comic relief.

And if you’re in the mood for more cerebral input from cardiac electrophysiologists mosey on over and visit Wes Fisher and John Mandrola.  Real insight from real doctors.  John’s recent post, Choosing Option A, concerning a physician’s decision to do nothing is worth a read.

Unskilled vs. Professional Nurses.  The Muse RN was a welcome surprise and her post the on the divergent paths of the skilled and unskilled nurse is compelling.  It opened my eyes to the ways that nurses can potentially see themselves professionally.  The principles here can be extrapolated to other medical professionals.

If you’re in the market for more great nursing content have a peek at SaraBethRN.  Her post over Christmas, Is That Nurse Texting, caught my eye and got me thinking about iPhone attribution error.

Dearest Thyroid.  Apparently few can resist Jody’s charm and generosity.  Jody’s blog was suggested by two readers who coincidentally commented on her ability to write.  I can’t disagree.  And she happens to be one of the most generous and curious patient advocates in the twittersphere.  Her letter to the thyroid sets a light tone for Thyroid cancer awareness month.  (Note to self:  blog posts written as ‘letters’ to parts of your own body are endearing and constitute a novel means of making a point.)

The Healthcare Hype Circle.  When I want my brain to hurt I can always turn to Phil Baumann at Health is Social.  Phil’s a nurse and brings his medical expertise together with hard-edged insight in technology and social media.  Here Phil thinks healthcare is stuck in a hype circle and I can’t disagree.  E-Patient Dave chimes in down in the comments.  What say you?

Pass Protection for Patients.  Here’s a writer you should have heard of:  Carolyn Roy-Bornstein.  She’s an RN-turned-pediatrician writer from Massachusetts with a post inspired by nothing other than the New England Patriots’ most recent loss to the New York Jets.  The issue of patient hand off can never get too much attention.  Put Carolyn on your list and let her know I sent you.

What Your Medical Office Can Learn from Norman Rockwell.  Brandon Betancourt snags the coveted title of the week award on KevinMD.  Or maybe it was Kevin that dreamed up this saucy, worm-on-a-hook of a title.  But the post lives up to its promise and suggests 4 steps for success based on the old master.  Check it out.  Wish my gramdma were alive to read it…

Life with CP from A-Z.  Erin Breedlove’s blog, Healthy, Unwealthy and Becoming Wise, offers unique insight into the challenges of life with cerebral palsy.  Her post this week illustrates just one of the countless hurdles she has overcome on her path to higher education.  Erin’s dream is to become a pediatrician and I have no doubt she has the gumption to get it done.  Take time and peek around at what she has to say.  Most importantly, read between the lines.

The Injustice of Immunization Interviews.  Coming off the fresh BMJ sequence of reports reinforcing the fraudulent lunacy of Andrew Wakefield we find a lovely post from our own Wendy Swanson (alias Seattle Mama Doc).  One point here I love: Despite the damage that this man has done, what we remember after his interviews is the myth.  Seth Mnookin calls her post ‘one of the most level-headed, clear-eyed, forward-thinking discussions of this issue I have ever read.’  That’s an endorsement.  Seth’s new book, The Panic Virus, is at the top of my list.  I’ll get to it after I finish Deadly Choices – How the Antivaccine Movement Threatens Us All. (full and unadulterated disclosure: those are affiliate links you just glossed over)

A pediatrician mom passionate about art.  Speaking of pediatricians with talented voices, you need to meet Kate Land.  She writes MDMommusings.  I go here to relax, quite honestly.  Sometimes I get a little weary of health care reform rants and it’s nice to know that there’s a physician passionate about something different.  Here’s Kate’s bio:

I am a pediatrician (4 days a week) and mother of three kids (24/7). I enjoy thinking and writing about parenting, health and art.  There is after all much art to being a good doctor and much beauty to be found in the daily work of parenting.  Art is certainly a metaphor for our endeavors as parents and doctors, but in the literal sense I am also passionate in my contemplation of art. My children (a boy, then a girl and their younger brother) are subject to many dinner conversations about art and its greater meaning.

I don’t know about you but that made my pulse quicken.  Refreshing.  I love it.

5 Things Physicians Can Learn from Pilots.  This comes to us courtesy of MedCrunch, a new web magazine targeted to the slowly growing population of digital doctors.  I had initially read this post but it was brought to my attention this weekend.  This issue of cross-industry sharing of best practices has legs.  Reminds me of the time the guys in the OR at Great Ormond Street brought in a Formula One pit crew.

Requiem for a Crazy Lady. Dinodoc is clearly on the edge.  But there’s nothing wrong with that, really.  Check out Requiem for a Crazy Lady.  While I was initially thinking, ‘this is why I’m in pediatrics,’ I realized that this woman is me in about twenty years.  Thank God there are will be someone like Dinodoc left in the world to deal with the likes of me.  The post reads nicely.  Funny.  Wonder how he protects the privacy of his patients or does he change the facts to protect the innocent…and himself?

Should Docs be allowed to ask patients about gun ownership? GruntDoc is the original cool cat of the medical blogosphere.  You should read his blog constantly.  This post raised alot of eyebrows – it seems there’s a law under discussion that would prohibit physicians asking about gun ownership.  Understandably the pediatricians don’t think this is a good idea – and this seems to be independent of what you think about firearms.  We report, you decide.

The Blood Test Gets a Makeover.  I had missed this.  Wired magazine crushes the traditional lab result sheet in favor of a user-friendly version.  Amazing really what some expertise in design and user experience can come up with when they put their mind to it.  And, uh, when can we expect those high flutin’ reports on the bottom?

And the best of the rest in under 60 seconds.  Look for a nice overview of code status discussion from Lyle Fettig on Pallimed.  If you need solid advice on how to avoid a toxic work environment with special reference to the EMT, be sure to check out You Bet Your Life by Steven Whitehead.  This essay from the other Julia Roberts on Kidneys and Eyes captures beautifully the lows of parenting complex health kids but hints that resilience will be the winner (Should be required reading for pediatric residents).  Speaking of kids the Pensive Pediatrician offers a cute post on biting in children (or how to prepare for that first hickey).  And this entry, Boobs & Coffee, from Shawn Finch DVM was the only suggestion submitted for a Vblogger – a bit of a tear jerker and what I might expect from a vet.  There’s a new gastroenterologist in the blogopshere you should check out: Ryan Madanick.  And for the uninformed Rob Lamberts pulled the plug on Distractible – He’ll be sorely missed but I don’t think we’ve seen the last of him.

Thanks to all for your wonderful suggestions.  Thanks to Nick at Blogborygmi for seeing to it that this forum stays on track.  Look to HL7Standards for next week’s Grand Rounds.