From the monthly archives:

June 2004

How the American health system is becoming more elitist

June 30, 2004

An ethics professor takes an interesting look at how elitist the US health care system is becoming. On one hand, we have concierge practices:
Now, one might wonder why it is necessary to pay a bounty to get a doctor to call you back, especially if you are already paying through the nose to belong [...]

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What discounts?

June 30, 2004

It seems the effect of the Medicare drug discounts was simply higher drug prices. The more things change, the more they stay the same.

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The myth of July syndrome

June 29, 2004

The NY Times today writes about the so-called July syndrome – the time when the new house staff start at teaching hospitals across the country. There is no data to support worse patient outcomes in July – although I can certainly remember the potential for disaster.
My very first day was being the [...]

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Practicing evidence-based medicine in real life is difficult

June 29, 2004

Refraining from testing and evidence-based testing is nice, but difficult in today’s practice environment:
In one study in which Dr. Kroenke said he examined 500 patients with physical symptoms, 70% of all subjects improved two weeks after seeing a primary care physician. While symptoms persisted in about 25% of patents, follow-up studies showed that serious diseases [...]

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Should doctors charge patients more for increasing malpractice premiums?

June 29, 2004

Seems like practices who have a liability surcharge may become increasingly common:
Physicians gathered at the AMA Annual Meeting last month explored a variety of options for immediate relief for a profession besieged by increasingly unaffordable medical liability insurance premiums.
The hottest topic of discussion: liability surcharges. The idea is that physicians would tack a charge onto [...]

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Statins and macular degeneration

June 29, 2004

One of my patients this morning wanted a statin prescribed to ward off macular degeneration. She had perfect cholesterol. I wasn’t aware of any trials connecting the two and told her I’d look into it. Here’s what I found:
A new study from UAB indicates that patients who take cholesterol-inhibiting drugs known as [...]

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Bribery

June 28, 2004

I was just in NYC this past weekend and was going to comment on this NY Times article, but Nick at Blogborygmi has eloquently summarized everything up.

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As follow-up . . .

June 28, 2004

. . . to physicians denying treatment to lawyers, Medpundit gives an insightful opinion on this desperate tactic.

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More malpractice ranting

June 28, 2004

Nothing like coming back from vacation and seeing more inflammatory articles on the malpractice controversy. Medrants summarizes some of the more recent articles.
Update:
After catching up on some weekend reading, our friend Medpundit has also chimed in on the recent ignorance by the NY Times and the esteemed Mr. Herbert.

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Response to the NY Times malpractice op-ed

June 24, 2004

There has been much discussion on the recent NY Times piece on “Malpractice Myths”, seen here at Medrants. Now comes some more criticism from the law world, highlighting the obvious ignorance of the article (via Medpundit).

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The switch to EMR

June 23, 2004

So the big deal in my practice is the transition to an EMR in the upcoming months. Finally. Our administration has chosen the HealthMatics EMR by A4 Health Systems.
The plan will be to carry these laptops into the exam room, and in an ideal situation, directly enter notes into templates while [...]

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Why PAP smear guidelines are being ignored

June 22, 2004

Stories are coming out regarding the recent JAMA article concluding that the USPSTF recommendations on PAP smears are being ignored:
Twenty-two million US women 18 years and older have undergone hysterectomy, representing 21% of the population. The proportion of these women who reported a current Pap smear did not change during the 10-year study period. In [...]

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Billing for sex

June 22, 2004

Lest I be accused of taking a continual pro-physician bias, comes a story that brings shame to our profession:
An Oregon doctor, who had sex with a patient and then charged the state about $5,000 for his “treatments,” has been jailed for 60 days and stripped of his license, officials said on Friday.
Dr. Randall J. Smith, [...]

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On mammograms

June 22, 2004

The mainstream press has gotten hold of the recent MGH study detailing that only 6% of women obtain a screening mammogram yearly during a 10-year period. With the barriers today to mammogram access, I’m not sure that improvement is on the horizon.

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