Lyme disease can certainly be a pickle. Some doctors are accused of not using antibiotics aggressively enough. Now, this one under fire for using extended-term antibiotics:

Lyme disease is a bacterial infection usually transmitted by a tick bite. In North Carolina, the number of reported cases has risen from 47 in 2000 to 111 in 2004.

Symptoms include fever, headache, fatigue and a characteristic "bull's eye" ...

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A woman is suing after being misdiagnosed with breast cancer. This seemed to be a particularly difficult pathological diagnosis:

He added that breast pathology like Ms Fizelle's was difficult to interpret, and that her particular case was a difficult one.

"Even if we had all the pathologists in the world, there's nothing to stop this sort of thing happening again," he said.

How to spot a potential plaintiff. One strategy for protection - obtain defensive referals, like this case of simple hypertension (emphasis mine):

Sometimes a patient wants a second opinion, but won't actually come out and say so. In such cases you have to read between the lines, and suggest that he see a specialist as soon as possible. A family physician learned this lesson the hard way when a ...

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Firecracker exploding in hand. Not for the faint of heart.

The downturn in pharmaceutical advertising has claimed BMJ USA. (via Notes from Dr. RW)

Bizarre non-medical news of the week: Japanese bride flatulence data. (via Boing Boing)

Bard-Parker and Dr. Wigton talk about the WSJ's report on "revirginization".

Sexual harrassment by patients is quite common in hospitals. "Nursing organizations say that if harassment from a patient continues, nurses can ask to have a second nurse stand by in the patient's room, refuse to care for the patient, ask that the patient be transferred to another floor, or report the behavior to a superior. Doctors and administrators are sometimes called in to talk to the patient."

Disclosing HIV and STDs via an e-card. "The site allows users to choose one of six free e-cards to send to their sexual contacts, either unsigned or with a personal message that avoids awkward face-to-face disclosure.

'It's not what you brought to the party, it's what you left with,' says one e-card featuring a picture of a bare-chested man. 'I left with an ...

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Malpractice premiums killing are going to kill specialites. "We've got a double-edged problem. We are price-fixed as far as what we get in reimbursement and we're price-fixed, literally, on what we have to pay out in overhead. There is no other profession that I'm aware of in the United States where, as the years go on, by one means or another, we're making less money, with an overhead that's ...

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SoundPractice.Net continues its medblogger interview series with Notes from Dr. RW.

The Alibi Network can fake doctor's visits. "Well, blowing off work is an easy one. Anybody can do that. Not a real popular service, we certainly can call in for you. We can provide excuses. For instance, doctor's call from the doctor's office, with the actual doctor's office on the caller I.D.

... If they choose to call to verify, we could make the ...

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This patient is fed up with waiting at the doctor's office. "Yeah, time is short and you'Â’ve only got a few minutes. Their time is precious and yours seems frivolous as you've got several minutes or possibly hours that you've robotically waited.

Your visit is classified a class 1-2-3-4-5 level. Yes, this tells someone else what to charge you for their time. Not yours. Yes all this robotic hustle ...

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Maria presents a collaborative literary medblog story. "Many of us who maintain sites that have been nominated for 'Best Medical Literary Weblog' for the 2005 Medical Weblog Awards (courtesy of Medgadget) agreed to channel our creative (and snarky) energies into a collaborative effort (and to assert our literary solidarity... or something).

These were the rules: Each story must begin with the same prompt. The total word count must be ...

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Barbers are giving AIDS education in India. "Vishwa Deepak, who is supervising the project, says FXB has trained the barbers in communication skills to raise the topic of sex, which is still a taboo subject in India.

He says the barbers are told to encourage their customers to use condoms and also try to convince them to go in for HIV tests and refer clients to appropriate centres ...

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Something different for malpractice reform - how about a "tort formulary"? "Create a 'tort formulary' that specifically lists actionable negligence by the doctor, such as intoxication, removing the wrong organ, etc. These would be subject to unlimited damage claims. The flip side is practice guidelines, like those implemented in Maine in 1992. It would be a defense for the doctor that he went by the guidelines, or had a clear ...

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From your friendly malpractice lawyer - 5 Holiday Tips To Keep You From Being an Emergency Room Malpractice Victim. Here's one:

If you have x-rays, an MRI scan or a CAT scan, ask whether the attending radiologist has read the films. Do not rely on the radiology resident in the emergency room to read the films. "Oh, but the attending isn't in now, he reads it the next ...

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WSJ: Ghost-writing and medical journals. "It's an example of an open secret in medicine: Many of the articles that appear in scientific journals under the bylines of prominent academics are actually written by ghostwriters in the pay of drug companies. These seemingly objective articles, which doctors around the world use to guide their care of patients, are often part of a marketing campaign by companies to promote a product ...

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A boy with a 4.4-pound thyroid tumor.



"Singapore doctors have successfully removed a two-kilogram (4.4-pound) tumour from an Indonesian boy's neck and chest, a member of the surgical team said.

Lukas Wahangara, who turned 13 on Wednesday, is recuperating well after the rare operation to remove the thyroid tumour measuring 20 centimetres (eight inches) in diameter, almost as big as an adult human's head."

Instapundit on Vioxx: "Risk / reward here is asymmetrical: If excessive litigation causes people to die because treatments are taken off the market, there's nobody to sue. Something's broken." (via PointofLaw.com)