Straight TalkA weekly update from management on the issues that matter most. Feb 8, 2018 Grand Rounds are an institutional tradition at academic medical centers. Now at NCH, we too have Grand Rounds every Thursday at 7:30 AM in the Telford Building on the Baker Hospital campus. Well over one hundred colleagues attend, including 3rd and 4th year medical students, Internal Medicine Residents, Pharmacy Residents, senior clinicians, medical professors, nurses, non-physician practitioners, pharmacists, and even some lay folks—all with the shared purpose of learning. This month’s topics and presenters are: “ENT for the Internist”—James Hadley MD “Breast Cancer, 2018”—Adam Riker MD FACS, Chief Section of Surgical Oncology Professor of Surgery, Louisiana State University “Case Records from NCH”—Rachael Pyngolil MD, MS – CMR NCH Medical Residency “Myelodysplastic Syndrome”—Alan List MD, CEO Moffitt Cancer Center Last month Dr. Sajan Rao, who did his cardiology training and fellowship at Washington Hospital Center/Georgetown University, shared an outstanding presentation—“A Practical Approach to Congestive Heart Failure.” As our Chief Medical Officer Dr. Frank Astor and I left the auditorium, I commented that Dr. Rao would have been well received at Columbia University’s College of Physicians and Surgeons in the City of New York where I trained. Dr. Astor shared similar thoughts about Cleveland Clinic where he trained. Another equally educational Grand Rounds featured Dr. Doug Harrington, Critical Care Program Director, who conducted a learning session for first year medical residents and a review for all with the intentionally provocative title, “Do we need to examine ICU patients?” The answer, of course, is an emphatic “Yes.” Dr. Harrington began with a summary of historic icons in medicine: inventor of the stethoscope René Laennec, father of modern medicine Sir William Osler, and all-time most skilled practitioner of auscultation (listening) Dr. Proctor Harvey. Bedside examination, which can be life-saving in the setting of critical illness, is a core competency in post graduate medical education. Sharing the advantages and disadvantages of various physical diagnostic techniques including the most modern—bedside ultrasound—helps everyone learn. One of our new academic Hospitalists, Dr. Ricardo Franco, an expert with bedside Point of Care ultrasound (POCUS), is teaching our internal medicine residents at the bedside how best to utilize this technology. As the crowd dispersed, a few of us older clinicians reminisced about some of our great physical examination findings from decades past. Now, the next generation will be even better prepared, as we help everyone live a longer, happier, and healthier life.