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Contest winners--Part 2.

Thanks again to everyone who submitted entries for our 2005 Clinical Pearls contest. More winning pearls will be published next month, but remember that even if you don't win a prize, your words of wisdom may be published in a future issue. Some readers may feel that the following pearls are too simplistic to warrant a prize but, in my opinion, they demonstrate exactly what clinical pearls are all about: great ideas and tips that can help you in your day-to-day practice but cannot be found in textbooks or scholarly journals.

Here is the second group of prize-winning pearls. Each of the following doctors will receive a portable DVD player with car kit.

Keep Sex Secret

No, not that kind of sex! Sarah Artman, M.D., of Hilliard, Ohio, has a neat little trick for keeping the sex of a fetus a secret. She points out that sometimes a patient does not wish to know the gender of her fetus. There are still some parents who want the surprise of hearing. "It's a boy!" or "It's a girl!" in the delivery room. But if Dr. Artman is able to determine the gender during an ultrasound exam, she wants to document it for future reference should any complications occur. Also, the patient may change her mind and later wish to know the gender.

If the information is written in the chart, there's always a chance that someone will inadvertently ruin the surprise and upset your patient. So Dr. Artman devised a code to document gender. If the fetus appears male, she writes "gender-declines," and if the fetus appears female, she writes "gender-declined." The "s" stands for "son," and the final "d" stands for "daughter."

When in Doubt, Suck It Out

Endometrial polyps frequently are encountered during hysteroscopy. Andre Saad, M.D., of Westbury, N.Y., has been dissatisfied with methods of removal described widely in the literature. Blind curettage and fishing with polyp forceps frequently miss polyps; hysteroscopic resection is cumbersome and time consuming; and a wire snare is only useful if the polyp dangles to the level of the ecto-cervix. Dr. Saad has found that using standard suction curettage equipment with a No. 7 or No. 8 suction curette will easily dislodge a polyp in the majority of cases and provides a thorough curettage specimen as well. It's quick, easy, and a familiar technique for most gynecologists. He makes a point of reintroducing the hysteroscope after evacuating the polyp to confirm that it has been completely removed and that hemostasis is adequate.

Fight Boredom With a Board

Linda Haddox, M.D., of Daytona Beach, Fla., has an interesting method of distributing information to patients. In each patient room, she places a dry erase board, and then writes helpful hints or medical information she wants to share with patients each week. Sometimes the message is humorous, sometimes encouraging, such as smoking cessation tips. Sometimes she shares the latest summary of new medical information. It's a great way to advertise something new in the practice and a lot more personal than flyers or brochures.

Just after Dr. Haddox sent this pearl, I noticed that our oncology clinic uses a dry erase board in their waiting room to share an uplifting "thought for the day."

DR. FLAMM is area research chairman and a practicing ob.gyn. at the Kaiser Permanente Medical Center in Riverside, Calif.

Send Us Your Clinical Pearls!

Please include your name, affiliation, and phone and fax numbers. Mail to:

Dr. Bruce L. Flamm

10445 Victoria Ave.

Riverside, CA 92503

Or send them by fax to 909-353-5625 or by e-mail to

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Title Annotation:CLINICAL PEARLS
Author:Flamm, Bruce L.
Publication:OB GYN News
Date:Aug 15, 2005
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