Paradoxical instructions?

In an ultrasound exam, when I prompt patients in their bed to lie on their back - this usually happens in a moment where they lie on their right or left side or when they sit - more than half of them turn around on their belly. This is a funny paradox. It happens to my colleagues as well. I don't know why, maybe patients think: well, I am already on my back but the doc wants me to change my position, so it must be the other side he's talking about. I suppose they try to cooperate, so when they don't know what to do, they do the thing that seems to fit best. "Lie down!" works better. But say "Lie down on your back!" - and they will be on their belly.

Hygiene - hospital acquired infections

An age old problem: nosocomial infections. Death through the hands of the helpers. Germs that jump from patient to patient via the contagious hands and instruments of nurses and doctors. They should wash their hands, but they don't. Countless attempts of hygiene commissions have failed in establishing a safer conduct. After a campaign, old habits sneak back, the germs follow.

Maybe the appropriate approach should be to have the patient and his family exerce the control. A large sticker on the inside of the rooms' doors with an inscription like: "To the relatives: A doctor who doesn't wash his hands is a killer." It would remind the personnel of their duty when they leave the room, because in their back they'd feel the eyes of patients and relatives who have seen the sticker before, and they care.

As long as they see the sticker.

Patients and drugs' names

It is astonishing, how few patients know their medication by name, not to talk of their drugs' purpose or function. The only thing they remember in the emergency room setting are informations like "small, white, round or lengthy" pills. -- Imagine them in a restaurant where they wish to taste again the excellent same wine from last month's dinner. Will they order "the dark green bottle with the sparkling red liquid" in it...?

Obesity in the US

No wonder there are so many obese people in the United States. There is a simple reason you never hear anybody talk about: this need to define the quality of your service by serving the largest portion. It's a virtue. Who invented the expression "all you can eat"?
In a country where everything tends to be supersized, the distances, the cars, the amount of money you can make, it is a natural consequence that people get obese. They are just trying to finish their plate.