A reader writes:
This was the chief complaint of a 45-year old female. She's been doing this for several months, but worse over the past several days. She would go into the freezer and nibble on ice cubes and ice chips constantly throughout the day. No other complaints, and does not have any other abnormal food cravings. She does report more fatigued than usual, but denies nausea, vomiting, shortness of breath, ...
Grand Rounds 10
Come get your weekly best of the medical blogosphere.
Why Good Friends Don't Always Make Good Doctors
"Even when someone is quite ill, the doctor can't worry about hurting the person or the person's feelings. Sorry, but the next biopsy or the next surgery or the next awful test must be done. Trying to soften the blow in the name of friendship invites disaster. Stated another way, a better question to ask your doctor is: 'What would you ...
Backing off of VBAC
I was going to blog on this story from the NY Times today, but Bard-Parker writes an excellent commentary regarding this.
A nation of hypochondriacs?
"The ads routinely urge consumers to consult their doctors. But they also encourage them to ask for specific drugs. Doctors are trained as medical experts, but they are also trained to empathize with patients. When a patient demands a specific drug, doctors can experience significant conflict if they refuse to prescribe it. Some patients are known to change doctors if their requests are refused."
Should we allow direct to consumer advertising of prescription medications?
"Even though I have been an advocate of free markets in the business of health care, I have not thought that direct to consumer advertising (DTC) is such a good idea. In my opinion, DTC of prescription medical products is inherently problematic. It is way too easy for these ads to be misleading and quite often they are."
Chris ...
MRI backlash: Crackdown on costs of imaging
"Harvard Pilgrim Health Care, based in Wellesley, Mass., started a preauthorization program in July. Practices are required to submit information to National Imaging Associates, a radiology utilization management firm based in New Jersey, before ordering a test. About 10% of the time, doctors end up having to discuss the case with a National Imaging Associates representative, who may suggest a different ...
Rising costs force hospitals to end use of midwives
Another casualty of rising malpractice costs.
Doctor: Illinois Would Do Well To Follow Wisconsin's Example
"Wisconsin has drawn six obstetrician-gynecologists (Ob-Gyns) from LGH. These doctors have reportedly fled Illinois to practice medicine under cheaper insurance premiums. In Wisconsin, Ob-Gyns pay $23,677 in yearly medical liability premiums, while the same doctor in Cook County pays $230,428 annually. . .
Because Illinois has eliminated punitive damages from medical malpractice suits, many doctors in Illinois, including Narasimhan, believe ...
What's the problem with medicine from Canada?
"If you listen to drug companies such as Pfizer or Merck, or to Bush administration health policy officials such as Tommy Thompson or Mark McClellan, or to congressional leaders such as Bill Frist, you will hear that it is absolutely necessary to ban drug imports from Canada to protect Americans from adulterated or poisoned medicines.
They are lying."
Q&A: Doctor examines drug companies' role in care
An interview with Dr. Jerome Kassirer, former editor of the New England Journal of Medicine, talking about the relationship between physicians and the pharmaceutical industry.
CSI Medblogs: A Death in Error . . . What happened to Mary McClinton?
Another excellent installment by CodeBlueBlog, this time discussing a recent case where a patient was mistakenly injected with chlorhexidine.
Florida Passes Three-Strikes Malpractice Law
". . . the lawyers 'trumped the doctors' with the three-strikes amendment, because lawyers will rush to sue in the hope that doctors will settle to avoid a 'strike.'"
Many See Hope in Parkinson's Drug Pulled From Testing
"If a company stops developing a drug for safety or efficacy reasons, is it obligated to continue supplying it to patients from its clinical trials?"
DoctorMental has given out his contact information to submit Grand Rounds articles for the upcoming week. Deadline is this Monday, November 29th, 9pm. Prior weeks are archived here.
Thanksgiving from the Atlantic shore of Maine.
Courtesy of the Thanksgiving Doctor.
Woman dies, hospital `can't apologize enough' for error
"A woman who underwent surgery for a brain aneurysm was mistakenly injected with a highly toxic antiseptic solution and died, hospital officials have admitted."
Citing Cancer, Chief Resigns at McDonald's
"The Australian-born Mr. Bell, the youngest chief executive and the first non-American to lead the company, was given his diagnosis a month after being named chief executive. He has been treated with surgery and chemotherapy."
The diagnosis is colorectal cancer, which is the second leading cause of cancer death. Approximately one-third of people who develop it die of the disease. ...
Grand rounds #9
shrinkette hosts this week's collection of the best of the medical blogs. To all my new Blog Explosion readers, this is an excellent opportunity to sample what various health professionals have to say, "behind the scenes". DoctorMental hosts next week.
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
I've only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case...
Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to...
One of the things I love about family medicine is that I get to care for people of all ages. I almost...
I just finished reading George’s recent post on Evelyn Lauder, who recently passed away from ovarian cancer, and am still stirred by...
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
One morning this May, I woke up with a stiff neck. I applied hot and cold therapy all day and took an...
Visiting someone who is dying or critically ill is an experience many of us will have in the course of our lives....
A guest column by the American Medical Association, exclusive to KevinMD.com. This week, I’m joining hundreds of physicians and medical students in Washington, DC...
Everyone in the world is talking about “value-driven health care.” Or so it might seem if you pick up a medical journal...
CNN recently posted an article titled "Doctors Going Broke." It described several cases of independent physicians who are near bankruptcy although they once...
One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate...
As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going...
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively...
Paul Conslato, MD, director of clinical affairs for Lancaster General Medical Group, recently was quoted in the PAMED Better Health Network eZine...
Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and...
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
