From the monthly archives:

January 2008

Military medical malpractice

January 31, 2008

CBS News with a piece wondering if military and VA physicians should continue to be protected from medical malpractice under the Feres Doctrine.

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Was Glaxo tipped off to the Nissen crusade?

January 31, 2008

The GSK mole: “Why I sent it is a mystery. I don’t really understand it. I wasn’t feeling well. It was bad judgment.”

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A bigger carrot

January 31, 2008

Someone gets it. To make a difference about quality, you have to make it worthwhile for the physician.

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Bob Wachter: “The growing teleradiology trend, driven by the fact that the same technology that allows me to read my films without going to the radiology department also allows a radiologist in Banglaore to read a film as easily as a radiologist in Bangor. The Indian radiologist earns one-tenth of what the U.S. radiologist earns. [...]

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The stoned 6-year old

January 31, 2008

Great case from the Stanford ER.

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Taking aim at P4P

January 31, 2008

Dr. Wes: “But perhaps a better word for this incentive program is not a reward, but a bribe to do more testing and mindless documentation. Worse, maybe this money is really a kickback scheme to reward the large hospital-owned primary care physician groups (with whom they have contracts); the same groups who already have electronic [...]

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Vaccine-autism link, not

January 31, 2008

Another study debunks the myth. Hear that, Eli Stone?

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Paying to remain uninsured

January 31, 2008

My opinion on individual mandates is “evolving” (as they say in politico-speak). I previously supported an individual mandate approach to universal care, as practiced in Massachusetts. At the time, it was a preferred alternative to the other solutions, such as single-payer or Medicare-for-all. The focus on personal responsibility and encouraging the consumer [...]

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How the deck is stacked against patient apologies

January 31, 2008

A doctor apologizes to the patient, and gets reamed for it:
I can’t see where the legal system has helped medicine that much. I’m certainly dismayed to work in an environment where I can’t say I’m sorry without first considering the legal ramifications of doing so. Lawyers have succeeded in sucking the notion of [...]

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Universal coverage or cutting costs

January 31, 2008

Choose one or the other, because you can’t have both:
Universal health care has a basic and fatal flaw, you can’t simultaneously reduce the cost of a service and increase access to it. If you have universal access, you have to find a way of paying for people to get that access, which raises costs. If [...]

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HRC and Barack, are you listening?

January 31, 2008

AAFP: “The Massachusetts Health Care Reform Plan addresses one critical component of health care reform — insurance coverage. Without an adequate supply of primary care physicians, however, the plan cannot guarantee timely access to care, creating a gap between coverage and actual provision of services. As a result, waiting times to see a primary care [...]

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Doctoring by email

January 30, 2008

A variation on Jay Parkinson’s practice, this physician eschews insurance for an internet-based approach to primary care. Wave of the future, or a niche market?

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1 physician: 60 inpatients

January 30, 2008

That’s freakin’ scary.

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EMTALA and "social admits"

January 30, 2008

Scalpel: “‘Social’ admits to the ‘no-doc’ admitting staff are usually about as welcome as a fart in an elevator. Particularly when they are unfunded midnight weekend language-barrier system-abusing complicated social admits of questionable medical necessity.
When patients like you get admitted, you tend to be challenging for the hospitalists to discharge too, so you end up [...]

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