From the monthly archives:

September 2008

Fixing Medicare

September 30, 2008

Soaring Medicare costs will soon make the recent economic troubles look like a drop in the bucket.
Maggie Mahar tries her best to address this in a recent paper, summarizing many themes from her blog. Suggestions include instituting a comparative effectiveness agency and increasing funding for primary care, as well as left-leaning suggestions like [...]

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Unusual cause of seizure in newborns

September 30, 2008
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Doctor’s lounge

September 30, 2008

Hospitals are doing away with them.
No wonder, as medical care becomes more fractionated with specialists and sub-specialists, and the pressure increases to see more patients, there’s less downtime to spend in the lounge.
It’s a shame, since it makes it difficult to know your colleagues, let alone put a face to the specialist you are consulting. [...]

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Sex addiction

September 30, 2008

I’ve almost finished watching the first season of Californication – great show by the way – and started thinking if David Duchovny’s recent tribulations could somehow be related to Hank Moody, the sex-obsessed character he plays on the show.
How real is sex addiction? Well, the WSJ has a column (via the WSJ Health Blog) [...]

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Front line crisis

September 30, 2008

Normally antagonistic to physicians, here’s a nice change from the NY Times detailing the crisis that is affecting primary care and cognitive medicine. It even takes a jab against one of it’s pet themes, universal coverage:
There is a crisis in medicine today, and it will not be fixed by any candidate’s proposal to provide [...]

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Health information on the web

September 30, 2008

Some patients find Internet-based health information empowering, others find it overwhelming.
Either way, it’s here to stay and patients are going to have to get used to the growing amount of medical information available to them.
The NY Times has a nice article giving patients suggestions as they navigate through the web:
The daily bombardment of news [...]

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Roving dermatologists

September 30, 2008

Tired of waiting months for patients to receive a dermatology consult? Kaiser has a novel way to solve this. Enter the roving dermatologist, who takes consults over the cell phone and drives to the requesting physician’s office for an evaluation or biopsy:
The roving dermatologists can provide same-day assessments and biopsies of skin lesions, [...]

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General surgeon shortage

September 30, 2008

The primary care physician shortage has been well-documented.
Now general surgeons are becoming scarce, with medical students pursuing specialty surgery for increased income and a better lifestyle.
I can see this eventually happening to medical specialties. For instance, there may soon be a general cardiologist shortage as more sub-specialize into interventional cardiology or electrophysiology.
Again, no surprise [...]

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Pfizer gives up on cardiac drugs

September 30, 2008

Pfizer, who once ruled the cardiac drug scene with Lipitor and Norvasc, is pulling out of heart medications to focus on more profitable areas like oncology and Alzheimer’s disease.
They got burned pretty badly with the HDL-raising drug torcetrapib, and their combo statin-hypertension medication Caduet is having anemic sales.
Profits obviously dictate where innovation should lie. [...]

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Cutting Medicaid payments

September 29, 2008

Medicaid payments to doctors will likely be targeted next year as an effort to save costs:
“No states like to cut provider payments,” Dr. Smith said. “But it is perhaps one of the first places states would turn to because it is a real savings.”
Idiocy. As always, the wonks take the short-sighted approach [...]

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Eliminate Internal Medicine and Pediatrics?

September 29, 2008

Well, that can happen if this family physician gets his way.

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Prostate cancer screening and the PSA test

September 29, 2008

I often talk about PSA screening for prostate cancer. The USPSTF recently did not recommend screening men age 75 or older.
PSAs have not been shown to improve mortality, and can lead to a slew of unnecessary biopsies and anxiety.
Predictably, urologists do not agree, as more PSA screenings lead to more revenue-generating workups.
The unnecessary [...]

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CRNA versus primary care

September 29, 2008

CRNA salaries are rising and slowly eclipsing those of decreasing primary care physician wages.
The Happy Hospitalist notes that nurse-anesthetists have the overwhelming advantage in today’s payment environment, that many medical students are finding out to their dismay.

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Height gap

September 29, 2008

During last week’s Presidential debate, Senator McCain pointed out the height difference between North and South Koreans.
This is likely due to malnutrition and poor living conditions:
Studies of escapees from North Korea show that those born after the partitioning of the Korean Peninsula in the North were consistently about two inches shorter than their counterparts [...]

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FACP, FACC, FACS

September 29, 2008

The increasing amount of letters after the signature signifies the fragmentation of physician into hundreds of professional societies, effectively “neuter[ing] us as effective voices in healthcare reform.”

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Medicare advice

September 29, 2008

CEOs of the Mayo Clinic and Johns Hopkins write an op-ed suggesting some common sense ideas to dealing with the runaway Medicare train.
Among the suggestions are comparative effectiveness, removing Congress from coverage decisions, and eliminating price controls.
All good ideas, will the government listen?

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