A physician in Colorado writes an open letter imploring physicians to think about upcoming health reform:

Although I completely agree that there are genuine problems with the current system, more government interference in medicine can only make things worse, not better. One basic principle we all learned in medical school was, "First, do no harm". This applies as well to politics as it does to clinical practice. Most of the ...

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Roy Poses wonders whether pay-for-performance should also apply to hospital CEOs.

John Dickerson in Slate has his doubts. (via Health Care BS)

WebMD with a takeoff from the Fox show. A sample question:

If you eat just one candy bar a day in excess of your calorie needs, in a year you will put on:

1. 15 pounds
2. 26 pounds
3. 52 pounds

An article in JAMA suggests that most back pain is just normal aging, not caused by working. However, despite this finding, some don't expect much to change:

Still, I am skeptical that anything will happen from this exposé, as too many professionals benefit from the system, including doctors, lawyers and chiropractors. Insurance companies also benefit from this dysfunctional system by collecting a percentage of the cost distributions as ...

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Some want a NHS-like system here Stateside. A look at how sciatica is treated in the UK.

It will be more helpful if Robert sees the physiotherapist. The physiotherapist is clever enough to order NHS MRI scans. She will spend about 90 seconds with him, and then order the scan. There is currently a two-month waiting list for MRI scans. Once Robert has had the scan, he will ...

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Why can't medical devices look more like iPods? (via MedGadget)

Do my eyes deceive me? A responsibly-written cancer screening article? From major media? Maybe there is hope after all. Needless to say, this is a must-read (emphasis mine):

. . . if you really want to find as much cancer as possible, we would suggest whole-body CT, MRI and PET scans every month. But that would be absurd. Why? Because the goal is not to find ...

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Many have been promoting ePrescribe as a savior for medication errors. The Angry Pharmacist cuts through the hype. I use ePrescribe occasionally, and his concerns are bang on.

The NY Times with an obituary article on this doomed drug:

Nearly 9 of 10 doctors had "medium" or "high" awareness of the drug, the survey found. But more than half said they were concerned about Exubera's safety. They were also concerned about its price and the bulkiness of the Exubera inhaler.

Because many doctors seem to have made up their minds about Exubera, Mr. Grofik said, Pfizer will face an ...

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I'd argue no, since doctors are trained to provide the best medical care for the patient, without cost being a factor. So, I'd say that this study suggests that physicians are doing pretty well in that regard:

Your doctor may be expert at diagnosing and treating your physical ailments, but if you think he's going to keep a watchful eye on your wallet as well to prevent financial injury, ...

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Freakonomics points to the BMJ suggesting the worst jobs for a doctor, using this criteria: "[T]hese are jobs that seriously compromise ethical and moral standards, are difficult to justify to your children, and are likely to be a source of regret on your deathbed."

Cost stops the proposal dead in its tracks:

Without a cost affixed to it, the so-called single-payer plan was approved 12-7 by the legislature's insurance committee last month. It is awaiting action by the House of Representatives and the Senate.

The legislature's nonpartisan Office of Fiscal Analysis estimated the costs at $11.8 billion to $17.7 billion, depending on variables. Gov. M. Jodi Rell has proposed a state budget of ...

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A piece detailing the historical efforts resisting reform. Although current polls allegedly seem to support it, "the other side has not yet begun to fight." (via a reader tip)

Treatments for rare diseases are not profit generators for Big Pharma, so research is funded in part by patients:

Last May, Lee Hollett received an unsettling letter.

He had been taking an experimental drug as part of a clinical trial for patients with a fatal degenerative disease called amyotrophic lateral sclerosis, or ALS. But the trial's supply of the drug was running low, the letter warned, and there ...

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The threat of physician fines stemming from the UnitedHealth's LabCorp decision has hit the WSJ:

The strategy threatens to backfire. A backlash brewing among physicians and regulators is creating a public-relations mess as the company continues to struggle to recover from a stock-options backdating scandal. It also comes on top of a series of rancorous contract negotiations with doctors and hospitals in California, Colorado and other parts of the ...

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Applying never ends

Maria details the application journey from high school to fellowship.

Single payer myths

A pseudo single payer system has already been tried in the US - it was called HMOs, and look how that debacle turned out:

The United States has tried something roughly equivalent to the private insurance version of a single-payer system. Health Maintenance Organizations (HMOs) were designed to keep health care costs down by restricting certain types of treatment. However, it quickly became apparent that HMOs were not the panacea ...

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The WSJ had an op-ed last week on the incentives driving American medicine, provoking some thoughtful discussion.

Dr. Rob:
While I applaud the overall approach to the problem, I think there is an important component missing. It seems the main reason Mr. Goodman gives for innovation is to become more efficient (i.e. to save money). The primary focus of any reform, however, should be in that of ...

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Ed Silverman and Peter Rost are keeping the pressure on this exploding affair.

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