Just ask this question.

Should the mentally ill be allowed to vote? Shrink Rap has issues with this:

Can I cringe long and hard now? The mentally ill shouldn't vote? What's a mental illness? Anyone who's had an episode of depression or mania? Obsessive Compulsive Disorder? How about those panic attacks? And we can't figure out at what instant someone with dementia becomes unsafe to drive, how do figure out the instant at ...

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ICU woo

Homeopathy in a reputable medical journal. retired doc and Dr. RW do not approve:

The Journal does a disservice to its readers when it presents a homeopathic jargon filled discussion as if a scientific discussion is taking place. There was no editorial explaining the reasoning behind publishing such an article. One of the characteristics of science is its coherence.The sciences of pharmacology,physiology and toxicology build upon and are ...

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Snakebite

Great case from #1 Dinosaur.

A JAMA study suggests the variability of standard of care in malpractice cases:

The locality rule was a 19th century concept intended to protect rural physicians from being held to the same standards as physicians working in urban areas or at academic institutions, the authors said.

But, they note, modern communication has removed barriers to standardization -- no place is more than a phone call or a mouse click ...

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Drug seekers

Panda on the two philosophies when dealing with drug seekers, as well as ditching his PDA.

I stopped using my PDA as well a few weeks ago. ePocrates was nice, but the database kept corrupting and it wanted to sync all the time. I went back to Tarascon, which I haven't used since medical school. I never remembered it being so thick.

Paris Hilton's psychiatrist is apparently a Doctor of Osteopathy, and the press doesn't quite understand what the degree means:

Sophy is actually a D.O., or Doctor of Osteopathy. Though osteopaths are still considered licensed doctors in America (not, however, in Europe) and Sophy serves as the legitimate medical director of the L.A. County Department of Family and Child Services, he does not seem eager to tout his full credentials"”perhaps because ...

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Arnold Kling views Sicko and talks about an end of life care example the film brings up:

The case was of an African-American man who died of kidney cancer. His weeping wife had been told by a doctor that there was hope from a bone marrow transplant, but the insurance company denied the treatment. You were left to conclude that the decision was based on profits or racism.


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Apparently, the life support machine was too loud:

After the perpetual noise of what would prove to be his neighbor's life support machine "got on his nerves," he proceeded to simply unplug the device without precaution in order to ensure that "he got his peace and quiet."

The more doctors that treat a patient is not necessarily better. It's time to change the carrot:

Despite seeing many doctors, few patients get the treatments that are recommended for them, and few have their chronic diseases well-managed. For example, fewer than 30% of people with high blood pressure have it adequately controlled, according to the agency's most recent analysis of health-care quality. No surprise, really. Fee for ...

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He did it under his parents' watch:

The 15-year-old son of two doctors performed a filmed Caesarean section birth under his parents' watch in southern India in an apparent bid to gain a spot in the Guinness Book of World Records as the youngest surgeon.

Instead, the boy's father could be stripped of his licenses and may face criminal charges, officials said Thursday.

Dr. K. Murugesan showed a ...

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The NEJM is surprised that not every doctor follows EBM like gospel, again showing the disconnect between academic medicine and the real world:

"What we learned from this is that evidence-based medicine is easy to talk about but hard to implement," editor-in-chief Dr. Jeffrey M. Drazen said in an interview.

Maria gives us a somewhat bizarre psychiatry consult.

It is often positive and one-sided, and often fails to show very serious consequences:

But the media owe us more than just cheering, gushing and cooing when reproductive technologies create babies in numbers that do not occur naturally and, more seriously, that carry tremendous risks.

In the case of the Masches, the mother went into life-threatening heart failure right after the births. Too much blood was in her body ...

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The priority is disposition, not diagnosis.

Edwin Leap with some powerful writing.

#1 Dinosaur stirs things up about the controversy surrounding circumcision:

I don't have a problem with anyone disagreeing with me. I would just like to see some intellectual honesty brought to the discussion, with a response like, "I understand my little boy (and his sex partners) will be at higher risk for some health problems later in life as a result of this decision we're making for him, but ...

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Cool in the OR

Sid Schwab explains why operating rooms are so cold.

Hospital employment

It's back in style, writes Richard Reece:

Today, it is specialists and sub-specialists and hospitalists, who are hot when it comes to physician employment. For hospitals, salaried specialists fill a void "“ in-house patient coverage, ER coverage, and prestige in the community.

For the physician, other factors are at work "“ a predictable 40 hour week, which fits the life styles of young or burnt-out physicians, a refuge ...

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A study suggests the obese may have a better prognosis after a heart attack. Dr. Crippen with his own take on the study:

The life time risk of heart attack is predominantly a function of the hand of cards you are dealt at birth. The fatties may have been lower risk at birth, but have brought the disease prematurely upon themselves. The thinnies were probably always high risk ...

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