Most are unhappy with penis-enlargement surgery. "Experts said spam e-mails and advertising were giving men unrealistic expectations about penis surgery."

Many stroke patients miss out on clot-busting drugs. However, consider what is going through the minds of ER docs when deciding the use the drug:

I abhor TPA. I too am a Board Certified ER Doc. Now if a patient comes in having an acute stroke, I can be sued for giving TPA ("He didn't explain the risks well enough") I can be sued for delayed treatment with TPA ...

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intueri brings us the Valentine's Day edition of Grand Rounds. Come get the best of the medical blogosphere, personal-ad style.

In doctor's office, it's hurry up and wait. Mitch Albom waits 47 minutes for a blood draw:

Forty-seven minutes. I am led inside. They stick the needle. I press the cotton. I put on my coat. I exit the office. The faces don't look up, but I know what they are thinking. They are thinking, "How long?" They are hating every minute of it.

ER overuse - "the crisis is near":

The number of Central Florida hospital beds, meanwhile, has grown just 13.7 percent during that time, from 4,278 in 2000 to 4,865 last year. And even if there are empty hospital beds, there are not enough nurses and doctors to treat patients in those beds.

The issue is compounded further by the state's medical malpractice insurance crisis, which has resulted in fewer ...

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An editorial to restore Wisconsin's malpractice caps:

At stake is whether Wisconsin will remain a place where patients have good access to doctors, or whether Wisconsin will become a state that doctors flee to escape high malpractice insurance costs.

The risk is real. A 2004 survey in Illinois, by Northern Illinois University, found that 44 percent of respondents living in the southern part of that state had lost ...

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Pediatricians aren't listening to a recent Cochrane Review regarding the efficacy of flu shots in infants. (via Health Care Renewal)

A possible reason why there are less women than men in the developing world: hepatitis B.

Meet the doctor who made the diagnosis on Michelle Kwan, forcing her to pull out of the Olympics.

More useless screening tests designed to bilk you. For $3,400, you get the "The Biophysical 250", a blood test that screens for hundreds of conditions.

What happens when there's no primary care? You get bounce-backs and "yo-yo" admissions:

Researchers said repeat admissions from these people were costing the NHS £2.3bn a year and the situation was set to get worse as the population aged in the next few decades.

Fetal-pain bills are being pushed, despite the lack of evidence:

The most recent study on fetal pain, published by the Journal of the American Medical Association, concluded that it was unlikely that a fetus could feel pain before the third trimester, and that an anesthetic would pose an unnecessary risk to women.
Some however, have more common sense:
"I trust doctors, not the legislature, to make medical judgments," Doyle said ...

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Dr. RW points us to a dermatology add-on for Google Image Search.

29% of radiologists said they would not choose medicine if they could decide their career paths all over again. Not sure what they have to complain about. With all the defensive medicine being practiced, radiologists stand to benefit the most.

Good luck to Orac at his new web address.

Crusader, no. "Strong advocate", yes. Meet Eric Topol's replacement at the Cleveland Clinic:

In an interview Sunday, Nissen said he prefers to "stick to the science" in debates about drug safety. The characterization is an apparent allusion to Topol's condemnation of Merck, maker of Vioxx, whose behavior he called "repulsive" and "appalling" during a federal trial over whether the drug contributed to a Florida man's death.

The ...

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Criminal gangs are targeting hospitals, stealing expensive medical equipment to sell on the black market abroad.

Want to work at a hospital where malpractice caps are too low? Try Oregon Health and Science University:

The Oregon Medical Association is a doctors' group usually on the opposite side of what malpractice attorneys have to say. But in this case, even OMA president Dr. Robert Dannenhoffer agrees that the Oregon Legislature should review OHSU's $200,000 cap.
(via This Makes Me Sick)

Novel idea - an ENT takes an ad out in a Bermuda newspaper, looking for malpractice insurance:

Familiar with the Bermuda market, Dr. Shea took out an advertisement in The Royal Gazette yesterday, seeking coverage between $1 and $3 million with a $10,000 deductible.

Contacted yesterday, the 81 year old explained the rationale behind it.

"I've never paid a malpractice claim and so what I thought, because I've ...

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This should be music to Lunesta's (and Ambien's) ears:

CONCLUSION: This multicomponent, nonpharmacological intervention conducted by trained research staff had no effect on nighttime sleep in this sample of nursing home patients.
(via Notes from Dr. RW)

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