Year: 2009

Do patients really need their complete lab and radiology reports?

Most prefer the bottom line, sparing them the raw data.

Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.

So, borrowing this image from Dr. Rob, I’m not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):

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A doctor in Cuba becomes a nurse in the United States

When physicians in other countries come to the United States, they often become nurses or lab technicians, rather than re-taking rigorous board exams to remain doctors.

One example includes doctors from Cuba. According to this story in The New York Times, “6,000 medical professionals, many of them physicians, have left Cuba in the last six years.” Cuban doctors, who often earn $25 per month, find it significantly more …

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Robert Ricketson and the surgical screwdriver medical malpractice case: The medical records revisited

Robert Ricketson is a spine surgeon who was involved in a high profile 2003 medical malpractice case in Hawaii where a surgical screwdriver was implanted into a patient’s back. This is his account of the ordeal.

by Robert Ricketson

I am writing today out of frustration and anger, as I am frankly quite tired of passively going along as my name appears year after year in malicious “medical blogs” and …

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How soon should patients receive their test results?

And should you assume that no news is good news?

The answer is no. According to a study in the Archives of Internal Medicine, 7 percent of abnormal test results from primary care offices were never reported to the patient. And in a large, unnamed, academic medical center, that number ballooned to 23 percent.

That’s almost a quarter of abnormal test results from that center that patients were never …

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Did Demerol cause Michael Jackson’s cardiac arrest and death?

Michael Jackson’s death continues to consume the news cycle.

There is currently no clear explanation. Some have speculated that it may be related to the narcotic pain drug, Demerol. According to this report from the UK’s The Sun, “An Emergency Room source at UCLA hospital said Jackson aides told medics he had collapsed after an injection of potent Demerol …

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Steve Jobs received a new liver, and the ethics surrounding his transplant

Orac, a general surgeon who blogs at Respectful Insolence, writes the most comprehensive entry I’ve seen thus far on Apple’s Steve Jobs’ liver transplant.

For those interested in the medicine behind the transplant, go and read his post in its entirety. I’d like to highlight some of the potentially questionable ethics surrounding the case.

For one, there is the question why Mr. …

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How much time do doctors spend on paperwork?

A common complaint is that doctors these days are spending more time doing clerical tasks.

Examples include filling out pre-authorization forms, talking to health plans for pre-certifications on imaging studies, and spending time jumping through bureaucratic hoops. Generally, you do not need a medical degree to do these tasks.

Bob Doherty points to a study that gives some numbers to back up the claims. Primary care doctors spend about 3.5 …

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Is House M.D. bad for medicine?

A few days ago, we talked about how Scrubs was a relatively accurate portrayal of medical life.

Let’s talk about the other end of the spectrum, namely, Fox’s House M.D.

As an emergency physician notes, the doctors in the House-universe seem super-human. Indeed, “the docs on that show are not only walking encyclopedias of rare diseases, but they are …

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Can you really kill a man by gluing his anus shut?

A recently reported method of torturing gay men in Iraq sounds horrifying.

Andrew Sullivan points to an article that spares no graphic details: “. . . anti-gay Shiite death squads are sealing their anuses with a powerful glue, then inducing diarrhea, which leads to a painful and agonizing death.”

But, can someone really die from this novel form of torture?

Emergency physician Shadowfax has his doubts. …

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Nighthawks, dayhawks, and the demise of the American radiologist

More hospitals are resorting to so-called “dayhawk” radiology services to read their x-rays.

It’s modeled after the “nighthawk” model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.

Now, the phenomenon is happening during business hours as well, which according to radiologist Giles W. L. Boland, means that “some radiologists can no longer assume long-term …

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Should the MCAT grant extra time for students with learning disabilities?

A recent California court denied extra time for aspiring medical students with dyslexia and attention deficit disorder when taking the MCAT.

The body that administers the test has to straddle a delicate line, in granting extra time to a broadening definition of the disabled student versus maintaining the overall fairness and integrity of the high stakes test.

Despite the ruling, three of the four plaintiffs have gone …

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Did the Canadian health system fail Natasha Richardson?

Would Natasha Richardson be alive today if she had gone skiing in the United States instead?

I don’t think it would have made a difference.

To recap the tragedy, Ms. Richardson died from an epidural bleed, after she fell while skiing. Her presentation was somewhat classic, with the well-described “lucid” period before she deteriorated.

According to Canada’s Globe and Mail, “ambulance workers were not …

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Why do I need a rectal exam, and what can doctors find with the gloved finger?

Have you ever wondered why doctors have to perform a digital rectal exam?

Well, look no further, as primary care doctor Rob Lamberts gives us the answers discerning readers demand.

Simply by looking at the rectum, which by the way, indeed “takes some getting used to,” can lead to significant diagnostic findings. Furthermore, does tight sphincter tone matter? And should you be worried about the large hands …

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Relative value units, and how the RVU payment system doesn’t allow doctors to practice good medicine

For those who don’t know, every piece of work that a doctor performs is quantified and measured.

The base unit of physician work is known as the relative value unit (RVU). Most physician salaries are determined by the amount of RVUs a doctor produces in a given year, and in most cases, can range between$35 and $45 per RVU in primary care, depending on geographic location and …

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Ways you can die from having sex

Cosmo Magazine, that bastion of reliable medical advice, declares, “An orgasm almost killed her.”

Intrigued, gynecologist Amy Tuteur reads further, and finds its about case where a woman developed stroke-like symptoms after intercourse, and was diagnosed with an embolic stroke.

The patient was taking the birth control pill, which can raise the risk of blood clots. In this case, it was also combined with the presence of …

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How many babies can one woman carry?

That’s a question I was asked more than once, in light of this week’s story about the birth of octuplets.

For the answer, I’ll refer to this article in Slate. The largest reported number of fetuses in a single womb is 15.

The limit is not so much the number of fetuses, but the combined size and weight. As Christopher Beam explains, “once the total …

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Her hands and feet amputated, a Brazilian model dies from Pseudomonas aeruginosa sepsis. What happened?

Mariana Bridi da Costa, a 20-year old Brazilian model, tragically died early Saturday morning from Pseudomonas aeruginosa urosepsis.

How can this happen?

Miss Bridi da Costa initially presented on December 30th, and was diagnosed with kidney stones. An ultrasound, plain film, or CT scan likely would have been done to confirm the diagnosis. I assume that a urinalysis was also performed, and if …

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