From the monthly archives:

August 2006

NEJM on primary care

August 31, 2006

A must-read article on the challenges facing primary care today:
No serious proposals to narrow the income gap between primary care physicians and specialists are on the national agenda. Fee-for-service payment rewards quantity rather than quality, fostering the rushed visits that underlie primary care’s shortcomings. Pay-for-performance programs appear to be insufficient to make a substantial difference; [...]

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Hospital CEOs are raking in the bucks

August 31, 2006

Most of the major non-profit Boston hospital CEOs are making in excess of $1 million.

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Delay in diagnosis suit: Refer early

August 31, 2006

The jury sends a clear message to a PCP in this case of hematuria which turned out to be bladder cancer:
“They realized, in a man over 50 years old who has blood in his urine, it is bladder cancer the majority of the time,” said Gregory Patton, Doniger’s Santa Ana attorney. “The doctor decided that [...]

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Plastic surgery and summer break in China

August 31, 2006

Many college students in China are going under the knife during the summer:
Like a growing number of students in China, Pan Ou will spend her university vacation going under the knife in a plastic surgery procedure she hopes will boost her chances of getting a good job after graduation . . .
. . . [...]

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More medical top 10 lists

August 31, 2006

Another medical top 10 list - this time, the most likely misdiagnosed diseases.

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Big surprise, liability concerns are deterring medical students from OB/GYN

August 31, 2006

According to a recent survey in Florida:
Of the students who considered ob/gyn but decided against it, 32 percent ranked “fear of malpractice” as the first or second deterrent to entering the field, compared to 21 percent who never considered ob/gyn. Nearly 27 percent of students who considered ob/gyn ranked “fear of being sued” as a [...]

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The President of Uruguay is also a practicing oncologist

August 31, 2006

He spends a morning a week in clinic:
At the clinic, which is affiliated with the country’Â’s best-known private hospital, Dr. Vazquez wears a white smock with his name embroidered on a pocket. His colleagues, men and women alike, greet him with a kiss on the cheek, as is the custom here, and address him as [...]

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"Rising medical costs have been largely justified"

August 31, 2006

Cutler with a policy piece in the NEJM. Matthew Holt dissents.

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Segregating medicine along religious lines

August 31, 2006

More religion-based OB/GYN practices are popping up:
The center is one of a small but growing number of practices around the country that tailor the care they provide to the religious beliefs of their doctors, shunning birth-control and morning-after pills, IUDs and other contraceptive devices, sterilizations, and abortions, as well as in vitro fertilization. Instead, doctors [...]

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Flea chastises an ER doc for overtreatment

August 30, 2006

Flea must be quite the intimidator to make an ER doc cry.
I’m going to side with the ER doc on this. Over the phone, you can’t make an accurate assessment of the patient and thus, it’s tough to call the shots on what tests should and shouldn’t be ordered. If something happens [...]

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A call to ban fertility treatments for the obese

August 30, 2006

Can this ever fly here?
The British Fertility Society is recommending women with a body mass index of 36 and over should not be allowed access to fertility treatment.
Underweight women and those classed just as obese (BMI over 29) should be forced to address their weight before starting treatment, the society said.

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Medicine is simply a revenue-driven business

August 30, 2006

Many offices are starting to charge for administrative requests in this time of declining reimbursement. Hey, that’s what you get in a fee-for-service system:
Doctors - particularly primary care doctors - are increasingly billing for services that patients have long expected to get gratis: prescription refills, photocopies of medical records, phone consultations, family medical leave [...]

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Pay primary care by the hour

August 30, 2006

The physician/author, Robin Cook, explores this idea in the NY Times:
As it is now, insurance companies “” following Medicare’s lead “” pay primary care doctors according to the number of patients they see. Each patient visit is generally reimbursed at a flat rate of slightly more than $50. The payment is the same whether the [...]

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Should American doctors offer their services to Al Qaeda members?

August 30, 2006

Fox News explores this question during this interview regarding a physician accused of treating Al Qaeda members.

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"Medicine uses science, but it is not science"

August 30, 2006

Reasserting that there are no certainties in medicine:
Montgomery tells us it is important to realize medicine is not a science. We imagine if it’s a science, its conclusions and recommendations are certain. They’re not, as any honest doctor would tell you.
And curing ourselves of this false quest for an impossible certainty is step one toward [...]

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