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The importance of continuing ed



By Dr. Jeff Daniels EBS Medical Columnist

In most professions, the learning process is continuous from the first exam at school until you hang it up for good. In a rapidly changing world, especially in the field of medicine, continuing education is critical to being a good doctor.

Doctors learn all the time: from patients, reading journals, talking to colleagues, and even from watching television commercials for all those new and expensive drugs – I know somebody will ask me if this $600 toenail fungus treatment they’ve seen advertised is right for them.

I recently attended a continuing medical education conference hosted by the University of California – San Francisco, called “Clinical Strategies in Primary Care.” You might think I used this as an excuse to visit that wonderful city, but I’ve attended several other CME events at this university, and I I’ve learned a lot through them.

This conference consisted of 24 one-hour lectures – starting early in the morning and continuing into the evening – for three consecutive days. Here’s some of what I learned from the many lectures I attended:

I discovered that not every woman over 40 needs a mammogram every year or two, and to be wary of the pitfalls of mammography, such as over-diagnosis and over-treatment of minor, non life-threatening cancers. Also, we should be doing more CT scans for lung cancer in chronic smokers, and a condition called nonalcoholic fatty liver is the most common liver disorder in the U.S., with weight loss the only proven treatment.

I learned new approaches to deal with student athletes who sustain concussions, including putting the brain at maximum rest – this means no schoolwork, TV, or video games until symptoms improve – and why some schools are discontinuing high-risk sports, like football.

A lecture on the heart inundated us with new guidelines developed from randomly controlled trials and published in scientific, peer-reviewed journals. These guidelines mainly involve targets for cholesterol, weight, and blood pressure, and most current studies validate what doctors have been doing for many years.

For women experiencing the symptoms of menopause, a supplement called black cohosh may work better than a placebo to help alleviate hot flashes. I also learned about the best and safest approaches to hormone replacement therapy.

I discovered the latest guidelines for stroke treatment using clot-busting drugs, as well as a new stroke-prevention technique for accessing and removing blood clots through blood vessels – called endovascular therapy this is the newest approach to stroke management.

In a lecture on common infections, I learned that a bug called Fusobacterium necrophorum is just as common as strep, can cause the same symptoms, but with worse outcomes if not treated properly, such as pneumonia and even death. We don’t have an easy test for this, and it’s something to be suspicious about when the illness looks like strep but the rapid test we perform in the office is negative.

There were many more lectures, and I brought back a considerable amount of information to share with my staff and the students we teach, as well as our patients. All of this came from just three days in San Francisco.

Dr. Jeff Daniels has been practicing medicine in Big Sky since 1994, when he and his family moved here from New York City. A unique program he implements has attracted more than 700 medical students and young doctors to train with the Medical Clinic of Big Sky.

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