The veil of secrecy is coming down at fertility clinics. "Largely unregulated, fertility clinics have long operated under the assumption that preserving anonymity is best for all parties. But as the stigma of infertility fades, the secrecy of the process is coming under attack, both from parents like Ms. Villalba and from the growing number of adults who owe their lives to donors."

It helps to be rich if you need an organ:

To find matching donor organs, transplant centers rely on the United Network for Organ Sharing, or UNOS, a nonprofit organization that maintains a nationwide patient waiting list. Organs are then typically dispensed to the sickest patients or to those who have been waiting a long time.

UNOS maintains the list, but it's left up to 256 organ transplant ...

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The "July effect" of new residents takes place in January in Australia. "It's an oft-quoted fact that 'complications' increase in January, aided by the influx of nervous junior doctors who have yet to find out just how their new hospital works and where everything is. We've been through medical school and passed our exams, we've been floating around various hospitals for the past few years of our lives; but ...

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How an iPod can improve stethoscope skills. "The iPod or other listening device can help train doctors to use their stethoscope more and be more efficient, according to TIME. Dr. Michael Barrett of Temple University in Philadelphia, in a study published today in the American Journal of Medicine, concluded that medical students improved their stethoscope skills dramatically if they listened to certain digitally recorded soundtracks that mimic the distinctive vibrations ...

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On the Supreme Court's ruling of Oregon's Death with Dignity Act. "Any effective physician has two fundamental roles. The first is to prolong life. The second is to ease suffering. In most situations, easing suffering is part of prolonging life, as when we guide a patient through an accident or a surgery and treat pain as part of ensuring survival. Sometimes, though, our two roles collide, and a decision ...

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Australia is considering having nurses perform some physician duties. The Australian Medical Association reacts:

AMA national vice-president Choong-Siew Yong said proposals to replace doctors with "lesser-trained and lower-skilled" health workers was unacceptable.

"A doctor is a doctor is a doctor," Dr Yong said.

"Australians in the city and in the country in all states and territories want quick and affordable access to a doctor – not a ...

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Merck is striking back against the NEJM. "A current editor and former editor of the New England Journal of Medicine, which last month criticized drug maker Merck & Co. for withholding data from a published study on its withdrawn painkiller Vioxx, will be grilled next week by the company's lawyers.

The depositions, ahead of the next round of product liability trials over Merck's former blockbuster arthritis pill, will ...

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The world's first face transplant recipient is using her new lips to take up smoking again. ". . . [which] doctors fear could interfere with her healing and raise the risk of tissue rejection."

An 11-year-old girl is breathing on her own after being taken off life support. Is this meaningful? Possibly - but I'm doubtful:

Some patients with severe brain stem injuries may partially recover from a persistent vegetative state, but they rarely recover fully enough to communicate, feed themselves and live ordinary lives, Dr. Steve Williams, chief of rehabilitation medicine at Boston Medical Center, told the Globe. But he said ...

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The life of a medical student in Iceland. "As K., a 25-year-old female medical student who I met in a small rural clinic, explained: 'Icelandic students are trained to be very independent, sometimes aggressively so. Coming to the country gives you an opportunity to work on your own . . . to see what you can do when you're put in the situation.' 'Here,' she said, 'you learn by doing.'

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Submit to Grand Rounds

Kevin, M.D. will be hosting Grand Rounds next week. Please email me your entries by Monday, January 23rd, 6pm EST. Or else.

Submission guidelines can be found here.

Update:
My "Pre-Rounds" profile on Medscape is up.

Annual salary for a geriatrician: Less than $16,000. "As an internist who obtained certification in geriatrics the first year it was offered, I found your editorial on the graying of America to lack a full understanding of the problem.

No one in a practice that is not subsidized by other physicians, or has ancillary income such as lab or X-ray, can afford to be identified as a geriatrician today. ...

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"A perfect storm of medical, legal and personal choice issues." More on the record high C-section rates:

The increase in primary C-sections and decrease in VBACs continue a trend established in the mid-1990s, the report noted. In 1996, C-sections accounted for just more than 20% of all U.S. births, with primary C-sections constituting about 13% of the surgeries. At the same time, VBACs rose to about 28% of births to ...

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Meth cases are straining emergency rooms. "The problem was particularly intense in the middle of the country: 70 percent of hospitals in the Midwest and 80 percent in the Upper Midwest said methamphetamine accounted for 10 percent of their patients. Nationwide, 14 percent of the hospitals said such cases made up 20 percent of their emergency room visits."

Search engines and blogs are becoming top desintations for finding health information on the internet. "Consumers and physicians alike increasingly are turning to search engines to find health information on the Internet, rather than pointing their browsers toward specific, known Web sites." (via The Healthcare IT Guy)

A CDC physician claims that a drug error, not chelation therapy, killed a 5-year old boy. This case is well-documented. Here's what the CDC physician had to say:

"It's a case of look-alike/sound-alike medications," she said yesterday. "The child was given Disodium EDTA instead of Calcium Disodium EDTA. The generic names are Versinate and Endrate. They sound alike. They're clear and colorless and odorless. They were mixed ...

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The government is putting pressure on physician pay in the UK. "Yet for all our hard work, the government is effectively saying that we should be punished for the failure of NHS managers to balance the books."

Congratulations to the winners of the Medical Weblog Awards. "After a wonderful year of medical blogging, with so much quality writing in so many fields of medicine, it's time to announce the winners of The 2005 Medical Weblog Awards!

These awards were chosen by you, the readers -- and boy, did you keep it interesting. We thank you for your opinions and are grateful for your continued patronage ...

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DB on the Medicare reimbursement dance. "Doctors have said they will not embrace pay-for-performance without long-term payment reform, and Congress is saying it will not consider such changes without assurances that doctors will play ball on quality reporting."

And therein lies the stalemate.

One obstacle to the "potential windfall of litigation" in New Orleans - finding a jury:

More than four months after Katrina wrecked much of the city, Bruno & Bruno has filed dozens of lawsuits that reflect the rising frustration and anger among thousands of residents and business owners who lost homes, jobs and relatives in the flooding. The lawsuits' targets include the U.S. Army Corps of Engineers and local government ...

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