Are rising malpractice premiums related to economic downturns and stock market losses?
"Trial lawyer advocates often repeat the silly assertion that medical malpractice premiums spiked in recent years because insurance companies had to recoup bad stock market investments. It's an argument refuted often enough before . . ." (via PointofLaw.com)
May 2005
All Stories
Over 90 percent of physicians admit to practicing defensive medicine
"A total of 824 physicians (65%) completed the survey. Nearly all (93%) reported practicing defensive medicine. 'Assurance behavior' such as ordering tests, performing diagnostic procedures, and referring patients for consultation, was very common (92%). Among practitioners of defensive medicine who detailed their most recent defensive act, 43% reported using imaging technology in clinically unnecessary circumstances. Avoidance of procedures and ...
"Stop misleading the public. Tell the truth."
Simple, yet difficult to enforce, in direct-to-consumer advertising. The FDA made this bed, it's their mess to clean up. Easier to ban DTC advertising outright.
Grand rounds is up this week - Da Vinci style
Come get the weekly best of the medical blogosphere.
151 people were wrongly given a diabetes drug, instead of simethicone for stomach complaints
The diabetes drug was a sulfonylurea. Simethicone is given for bloating and gas. Death from hypoglycemia can occur with the diabetes medication.
Attorneys are furiously filing medical malpractice lawsuits in Cook County to beat damage caps
With caps coming, Illinois' lawyers are racing to chase ambulances
"Down the stretch they come.
Attorneys are furiously filing medical malpractice lawsuits in Cook County in a race to beat Gov. Blagojevich's signature on a bill that caps awards in such cases.
Since legislative leaders announced a deal on caps last Wednesday, 58 medical malpractice lawsuits have been filed in Cook County -- three to four times ...
Is giving Viagra to a sex offender akin to giving a gun to a convicted murderer?
This sex therapist says no: "In my clinical experience, healthy sexual encounters are actually a key part of a sex offender's successful recovery. They teach the sex offender to refocus his desire on an appropriate subject. Some convicted sex offenders have been in treatment for decades, with no recidivism. To deny them access ...
Do patients want doctors who are on time, but rush appointments?
Reading these comments got me thinking - Where in the spectrum of waiting are you?
Are you, fellow physicians, the type who is always on time, every 15 minutes? Or do you spend as much time as it takes with each patient?
Do you, as a patient, want a physician who runs on time, every time? Or do you mind waiting 1 hour for a ...
How HIPAA is interfering with health care quality
"In a paper published in the Archives of Internal Medicine, researchers from the University of Michigan Cardiovascular Center report how their research on heart attack care has been hampered by the national medical privacy regulations under a law known as HIPAA, which took effect two years ago last month.
In all, they write, the changes needed to comply with HIPAA ...
Malpractice caps: Both sides can show data that they're right
Illinois is the latest state to enter the cap fray: "Now that Gov. Rod Blagojevich and state lawmakers have agreed to try caps to contain the rising costs of medical malpractice insurance and keep doctors in Illinois, even the most optimistic say there is not much to do but hope for the best."
A surgeon had his certification revoked after he sold test answers on eBay
"The Philadelphia-based board, which has certified tens of thousands of surgeons nationwide, found out last summer that 86 questions used on its 290-question multiple-choice exam were listed on eBay. Questions used on the exam are rotated from a large pool each year."
Why retail clinics will fundamentally change primary care
More people are using walk-in clinics for primary care
"'People are much more consumerist today,' Dr. Lo said. 'No one wants to wait two weeks to see a doctor. In fact, no one wants to wait an hour in my waiting room. People are much more concerned about getting things done on demand, and they have difficulty finding a primary care doctor who will see them promptly.'"
Sounds like primary care physicians are going through the same pains in Canada
"Family medicine is a tough sell. Patient needs are more complex than ever. They're older and not coming through their doctor's door with one ailment. Some have diabetes and heart disease. Others have had a stroke and are now battling cancer. These aren't patients that can be seen and sent on their way at the end of ...
A doc in Canada gives up - and lets us know all about it
"You start to realize some patients don't give a s---.They don't
appreciate you or what you have to go through. I'm busting my butt, working all hours and getting called at 4 a.m. I have people crying on my shoulder and I have to stick my finger up people's butts -- and for what? . . ...
Blindness and Viagra
"The Food and Drug Administration said yesterday that it had received reports of partial vision loss in 38 men taking Viagra, the impotence drug, and among 4 men taking Cialis, a newer competitor."
It has long been known that Viagra can affect vision in 1 to 10% of cases - mainly color changes, or blurred or increased sensitivity to light. Blindness caused by Naion ...
Some patients and lawyers are using the subjective findings of postconcussive syndrome to their advantage
"The vast majority of postconcussional syndrome symptoms -- like headache, dizziness and memory loss -- are subjective, which makes it hard for doctors to distinguish feigned or dramatized complaints from legitimate injuries . . .
. . . 'It's a tool for lawyers basically,' he says. 'Patients think they will get a pot ...
How malpractice premiums can close physician practices
How skyrocketing malpractice premiums can shutter physician practices
"To illustrate the mathematics, Al-Aswad disclosed his personal finances: His practice earned about $830,000 last year. Out of that came his insurance costs, rent, utilities, staff salaries and, lastly, his own salary, which was in 'the low $200,000-range.'
He hasn't had a payout for a malpractice claim in 15 years, yet his insurance costs are high — just below what obstetricians ...
A doctor banned "Dr. Death" from operating on his patients
I've never quite heard of anything like the stories that are coming out down under: "Miach said that around June or July 2003 he decided to ensure that his patients never received surgery from Patel. He said he told Patel he was banned from operating on his patients. Nurses kept vigils over patients to ensure Patel performed no procedures ...
The BMJ suggests a "money-back guarantee" for medications
"A large percentage of all prescribed drugs do not have the desired effect on patients' problems. The many influences on this poor outcome include wrong choice of drug, genetic factors, interactions, non-compliance, and poor drug quality.
A no cure, no pay approach can counter these problems by optimising the effect yet still making the treatment economically feasible. If the drug ...
Kevin Pho, MD
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How I approach ovarian cancer screening with patients
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
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Why more primary care doctors are referring patients to specialists
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
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Should Google censor anti-vaccine claims?
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
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Radiologists who cheat on their board exams: Who’s to blame?
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
Physician
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Why an anesthesiologist would be needed for organ donation
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...
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5 ways to avoid a misdiagnosis
Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to...
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Benefits of the Medicare Adult Wellness Visit
One of the things I love about family medicine is that I get to care for people of all ages. I almost...
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Cancer has a way of teaching us poignant life lessons
I just finished reading George’s recent post on Evelyn Lauder, who recently passed away from ovarian cancer, and am still stirred by...
Patient
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In love there is a life giving force
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
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How to get ready for death
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
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The long term cost of a pain in the neck
One morning this May, I woke up with a stiff neck. I applied hot and cold therapy all day and took an...
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Preparing for your visit with someone in hospice care
Visiting someone who is dying or critically ill is an experience many of us will have in the course of our lives....
Policy
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AMA: Advocating for Medicare, military and fiscal responsibility
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...
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A critical look at value driven health care
Everyone in the world is talking about “value-driven health care.” Or so it might seem if you pick up a medical journal...
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Surviving the new landscape of physician reimbursement
CNN recently posted an article titled "Doctors Going Broke." It described several cases of independent physicians who are near bankruptcy although they once...
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Doctors lobby Congress to repeal the SGR
One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate...
Tech
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There is a patient attached to that implantable defibrillator
As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going...
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The pitfalls of email communication with patients
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively...
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Why adoption of EHRs is a transformational event for physicians
Paul Conslato, MD, director of clinical affairs for Lancaster General Medical Group, recently was quoted in the PAMED Better Health Network eZine...
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Why EMR is a dirty word to many doctors
Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and...
Social Media
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Using Twitter to deliver health improvement messages
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
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Addressing comments on your medical practice’s Facebook page
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
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The Internet is where patients go for pre-visit consultations
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
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5 ways doctors can benefit from professional connections
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
