Stanford Medicine 25 Blog


This has been a heady month for our group. After an enormously successful Bedside Symposium bringing in 120 faculty from 11 countries to learn and teach bedside skills, I was so thrilled to see our work so prominently mentioned in the INSTITUTE OF MEDICINE’S report titled, “IMPROVING DIAGNOSIS IN HEALTH CARE.” Having preached for so

Stanford Medicine 25 Skills Symposium Hosted by Program of Bedside Medicine

This week, the Stanford Medicine 25 hosted its first skills symposium for educators by educators focusing on clinical skills in a effort to bring together some of the world’s leaders and educators in medicine. Doctors from various specialties, who have a passion for medicine at the bedside and teaching the physical exam, came together for

What’s the diagnosis? Patient presents with chronic sinusitis and this finding…

What’s the diagnosis? Answer Below…       Answer: Granulomatosis with Polyangitis: aka, GPA. Diagnosis is based on the saddle nose deformity in a patient with severe sinusitis. What conditions are associated with saddle nose? 1. Granulomatous Disorders: a) Granulomatosis Polyangitis b) Infection (Mycobacterial, Leprosy) c) Sarcoidosis 2. Neoplastic Conditions, i.e. EBV Associated Nasal Lymphomas

What is the name of this sign?

Figure 1. From (1) with permission. In case you didn’t spot it here is another example: Figure 2. Same patient with more obvious example on left ear. Answer Below…       Answer: Diagonal earlobe crease (DELC). 1. What eponym is associated with this sign? Answer: Frank’s – named after Dr Sanders T. Frank observed

What Is The Specific Cause of This Patient’s Clubbing?

Figure 1. Obvious clubbing in patients toes. Note the relative severity in the toes compared to the hands. From (1) with permission. The causes of clubbing are a favourite bedside question on rounds. They can be divided into: Pulmonary (commonest – think neoplasm until proven otherwise). Bronchial carcinoma Mesothelioma Bronchiectasis Cystic fibrosis Interstitial fibrosis Cardiac

What’s the Mass in the Neck?

A 21 year old Japanese male is presenting with a mass in his neck he finds incidentally. The mass is best seen on the right side of his neck when he turns his head to the left. The picture denotes a change upon swallowing. What is his diagnosis and workup? (Scroll down to see answer)

Can you Diagnose this Common Rash in Young Adults?

A 31 year old male with no significant past medical history presents with a new rash over both his legs, arms and trunk. The rash (shown in the picture below) is described as multiple small scaly areas, and is only mildly itchy. Your patient states to have recovered from a “cold” about one month ago.

The Jugular Venous Pulse – Circa 1957

In 1902 Sir James Mackenzie published a book entitled “The Study of the Pulse. Arterial, venous, and hepatic and of the movements of the heart” that described his studies on the jugular pulse using what would later and famously be known as the “Mackenzie polygraph”. He was the first to make recordings of the arterial

Announcing the Stanford 25 Skills Symposium

Calling all physician educators! Join John Kugler and Abraham Verghese and our core Stanford 25 team with guest faculty Dr. Steve McGee and Dr. Andrew Elder as we provide a 2-day course for physicians who teach or are interested in teaching at the bedside. Attendees will return to their institutions more confident at the bedside

Slow Medicine Versus Fast Medicine

As we watch medicine unfold, there is a lovely debate emerging around slow versus fast medicine. It would seem that emphasis on the bedside falls very much in the category of the former. This debate also is reminiscent of the work of David Orr and his lovely books, THE NATURE OF DESIGN and DESIGN ON