MedStaff Update: April 2016

Autopsies Illuminate Medical Diagnosis and Care
While some clinical services, such as most transplant teams, routinely ask a patient’s next of kin for permission to perform an autopsy, other services, particularly those that encounter fewer patient deaths, are less likely to take advantage of the insights that an autopsy offers. Andrew Connolly, MD, PhD, associate director of Autopsy Services, would like to change that.

The Conundrum of Opioid Use
Few news stories are garnering as much national attention as the burgeoning opioid and heroin epidemic in the United States. In the last 13 years, there has been a fourfold increase in heroin overdoses in the U.S., fueled in part by the large number of prescriptions for opioid painkillers. Physicians today face a conundrum. How do you treat pain while at the same time prevent misuse and abuse of these powerful drugs?

The Importance of the Physical Exam
Featured Guest Contributors: Abraham Verghese, MD, the Linda R. Meier and Joan F. Lane Provostial Professor; and John Ioannidis, MD, a C.F. Rehnborg Chair in Disease Prevention and Professor of Medicine.

Oversights in the physical examination are a type of medical error not easily studied by chart review. They may be a major contributor to missed or delayed diagnosis, unnecessary exposure to contrast and radiation, incorrect treatment and other adverse consequences. John Ioannidis and Abraham Verghese were key investigators of a multi-site study, which collected vignettes of physical examination oversights to capture the diversity of these incidences.