The Medical Joyworks Monthly


Connect to MJ's thriving community

Issue #14 (November 2020)


Dear Reader,

I've been thinking about medical ethics recently. In the three months since we launched Clinical Odyssey, I've seen a (small number of) users engage in a variety of tactics ranging from unethical conduct, to outright fraud.
A couple of the more notable incidents were:
  • a medical student masquerading as a university faculty member in order to obtain a free trial.
  • several attempts to use credit cards fraudulently (automatically blocked by our payment processor).
I keep on brooding: what kind of healthcare provider would stoop to deception and fraud? Or am I just old-fashioned and a bit too idealistic?

How does this make you feel?

Dr. Nayana Somaratna,
CEO & Co-Founder,
Medical Joyworks


The latest from MJ

  • As the COVID-19 pandemic picks up again in some parts of the world, many of our colleagues have been called back into the fray, responding to the emergency in their respective communities. We wish them the best and good luck during these trying times. We also hope to see them remain healthy and back with us soon!
  • The MJ International Medical Board is seeking specialists to join as peer-reviewers for the following specialties: general surgery; orthopedic surgery; pediatrics; obstetrics and gynaecology; neurosurgery; intensive care/critical care; psychiatry; urology; ear, nose and throat surgery; and dermatology. Join the program at  
  • Finally, in this month's edition of Meet Your IMB, we chat with Dr. Regina Hammock, attending physician and vice chair of emergency medicine at Woodhull Hospital in New York. That's it for now. Stay healthy, and curious!


International Medical Board Members

Name: Dr. Regina Hammock BS, DO, FACOEP, FAAEM
Speciality: Emergency Medicine
Designation: Attending Physician, Vice Chair of Emergency Medicine
Work institute: Emergency Department, Woodhull Hospital, New York
Graduated from: New York College of Osteopathic Medicine, USA
What attracted you to your specialty?
I was attracted by the possibility of being able to take care of any patient (regardless of their ability to pay me). I really enjoy taking care of sick people, and making them (and their families) feel better. And as a side note, I also do not have to worry about my own health insurance.

What have you learned about your specialty solely from experience?
Unfortunately, I have learned that doctors do not often communicate with their patients, nor explain what is happening to them. Just the same, patients do not feel empowered to change their healthcare providers when they are not satisfied. This is not a healthy dynamic that we must change.

On a positive note, I have discovered how much fun emergency medicine is (and the emergency department - ED - it is a unit, just like ICU). 

What is a common misconception associated with your field of study?
A common misconception about emergency medicine is that anyone can handle an emergency. Because of this, most healthcare providers view the ED physician as a resident who does the bidding of other specialists. More often than not, many healthcare providers fail to recognize an emergency within their own specialty.

What is your biggest research interest today?
Currently, my biggest research interest is COVID-19, as well as caring for those with respiratory complaints. There is so much to learn. Fortunately, we have come a long way since March 2020.

What publication/research are you most proud of?
The METRIQUE study has been a great source of pride. It was the first international study I had done in regards to FOAMed. It was an amazing experience for me. URL:

In your opinion, what is the greatest challenge in your field today?
A rather common challenge we face (in the U.S. at least) is that people perceive that emergency department physician’s work can be handled by physician extenders and nurse practitioners. That simply is not the case. PEs and NPs lack the extensive training required for ED work. ED physicians have four years of medical school, plus three or four more years of residency.

What will be a game-changer innovation in your field?
I believe a major game-changer would be giving EM/ED physicians the acknowledgment they deserve for their crucial and highly necessary service. In the U.S., earning a medical degree is extremely expensive and aspiring doctors must often seek loans to complete their studies. It would be great if these loans could be forgiven, especially for physicians who work in underserved and low-income areas. That way, they would not have to worry about the immense financial burden they face upon completing their residency.

How has MJ helped advance your professional objectives (in terms of teaching, research, management, personal development, etc.)?
Medical Joyworks has given me an opportunity to re-learn complaints I have cared for in the past, keeping my knowledge fresh. I am also better able to explain complaints to my patients, thanks to the MJ Team’s considerable attention to detail when expressing complex ideas in their learning modules. And, of course, I feel that I am more at ease when conducting research for lectures or printed publications I may be working on.


Recently released stories

Infested - Play it free online
Duncan III: It's Complicated - Play it in Clinical Odyssey
Antonio I: Under Pressure - Play it in Clinical Odyssey
Unusual - Play it free online
Conditioned - Play it in Clinical Odyssey
Unclear - Play it in Clinical Odyssey
Pertussis - Read it free online
... and 12 more.


Q&As from our user community

Clinical Sense: Shaking (Parkinson's disease)

Q: Why wasn't this patient started on levodopa? Isn't it the first-line agent?
A: What you say is correct. However, in younger patients, dopamine agonists are an alternative first-line agent; and they are often better tolerated. Please see the following article (which has an excellent infographic) for more details:
If you would like to play this scenario or join the conversation, go to the Clinical Sense app in your mobile device.

Prognosis: Your Diagnosis: Collapsed (Nonconvulsive Status Epilepticus)

Q: Will this patient require long-term anti-epileptic therapy?
A: Owing to the emergency nature of this presentation, information is limited and we cannot make a definite pronouncement in this respect.

On the surface, it seems that this was an unprovoked seizure. If MRI or EEG reveal an epileptogenic focus, long-term anti-epileptics will definitely be necessary. Even otherwise, many centers routinely commence long-term anti-epileptic therapy in all patients with an unprovoked seizure.

Conversely though, if it turns out that the seizure was provoked by an underlying condition (e.g., IV drug use), long-term anti-epileptic therapy might be avoided.

Overall, this is a complex topic; the following article discusses it in greater detail:
If you would like to play this scenario or join the conversation, go to the Prognosis: Your Diagnosis app in your mobile device.
That's all for now!

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