How to take care of and recover from a common but sometimes vexing finger injury.
By Mark D, Harris
Mallet finger usually results from forced flexion of the distal (most distant) part of the finger (distal phalanx – DP) during active extension of the DP. The condition is caused by a rupture of the extensor tendon (on the back of the finger) that crosses the distal interphalangeal joint (DIPJ) from the proximal phalanx (PP) to the DP. Part of the bone may also be avulsed (pulled away). Mallet finger is the most common closed tendon injury in athletes. Often, patients explain that a ball hit their partially flexed fingertip. Patients complain of pain, swelling, and an inability to fully extend their DP.
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How do we, as a society, determine how to acknowledge and reward people? Do we do it on the basis of excellence, or on the basis of equity? Can we combine the two goals? How?
By Mark D, Harris
In the March 2021 issue of The American Journal of Medicine, seven physicians, whose first names suggest that they are all female, wrote “Investigating Gender Disparities in Internal Medicine Residency Awards.” The authors began by recounting gender disparities in salary, academic rank, grant funding, and awards. They performed a multi-institutional study based on survey data from academic internal medicine residency programs starting in 2009 and extending through 2019. These physicians’ initial findings are in Table 1:
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How leaders can minimize harm in health care, in other industries, and in all areas of life.
By Mark D. Harris
“How can we change this process to prevent this error from happening again?” the senior ward nurse asked the group. It is a common question, one that I have heard thousands of times from experienced and dedicated health care professionals of all stripes.
I have worked in health care for many years, serving in positions from volunteer to emergency medical technician to senior attending physician to chief of staff at a hospital to chief medical officer of a large network. In every position, “do no harm” is a fundamental theme. This famous statement from the writings of Hippocrates encapsulates quality improvement, patient safety, access to care, and many other goals in modern medicine.
“Do no harm” can be thought of as eliminating risks that could lead to a bad outcome, such as injury or death. Occupational and Environmental Medicine physicians learn that there are four ways to decrease risk in the workplace and in the environment:
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Everything that we do, or fail to do, impacts us for good or for ill for the rest of our lives. Our teachers were right…each of us has a permanent record.
By Mark D. Harris
A little boy couldn’t resist the urge to pull the hair of the girl sitting in front of him. Across the room, a little girl couldn’t help chatting with her friend while the teacher was talking. These incidents happen every day in thousands of classrooms across the United States. Modern teachers have a variety of new techniques for dealing with such infractions, but in bygone days teachers would often respond with the same threat: “if you do that again, I will write that in your permanent record.” The children would immediately stop, at least for the moment, because everyone feared bad reports in their permanent record.
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