Well, it definitely isn't like it used to be:

The first question I get asked when I pursue medical treatment is who is your insurance company and the responsible party. There is no one who is willing to give you any simple advice or reassurance for fear of being blamed for wrongdoing or sued for malpractice. The doctor that I had for 25 years, all my adult life, recently quit ...

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Instant first aid

Some good tips when an ER or doctor isn't handy, like rubbing an onion on first-degree burns.

Lawyers in the ER

Are they reluctant to tell physicians their profession? GruntDoc thinks so:

The most reticent to tell me what they do are lawyers (and I'm just guessing here, but if I was a lawyer in an ED I'd worry a little that I'd get over-tested and overdiagnosed due to medmal paranoia . . .

It's causing all sorts of confusion and dilemmas:

New York City appears to be on the forefront when it comes to transgender rights. Last month, the agency that runs the subway system agreed to allow transgender people to use the restrooms of their choice. Now comes news that the city will probably allow people born there to switch the gender on their birth certificates.

According to a proposal that's ...

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Medicine has too much variability, says Aggravated DocSurg, and can't be compared to flying a plane:

Now let's compare the pilot to, oh, I don't know, a general surgeon (what I lack in imagination is made up by a complete deficiency of imagination), and that surgeon will do four operations today. The first is a laparoscopic cholecystectomy on a healthy 50 year old; the second is an incisional hernia ...

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He takes exception with the AAP's reasons for opposing these clinics. I think this physician commenter truthfully explains the cause of the fear:

The big threat to us is that they cut into our biggest financial gain - the 2-minute visit. I make way more in 10 2-minute visits than I do 2 diabetic checks. I don't want to give our "bread and butter" (when it comes to revenue) ...

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Observes someone who works at a pharmacy. It's either ampicillin or ibuprofen. The more interesting observation is that these same patients often later return with prescriptions for broader-spectrum antibiotics, prescribed by the ER.

Bloodbath at Pfizer

PharmaGossip with more on the sales force cutdowns.

TBTAM reports on the HPV test and how to convince your doctor to order tests you may not need. However, with ancillary tests bringing in revenue, doctors may not need much convincing.

A urologist reports a bizarre case, which is reason enough to read. However, when patients threaten to leave AMA, they act as if this is some kind of threat against us. Trust me, it makes no difference to the doctors if they chose the path against medical advice.

Let the conspiracy theories begin. This anti-Kaiser website suggests Kaiser is paying off Holt to be a token "blogging presence" during this PR event in the midst of their EHR debacle.

Mom microwaves baby

This news comes out the same week that a man puts a baby in the freezer. Sick.

From the WHO: AIDS, heart disease and depression.

You have to quit completely.

Rude doctors

Dr. Malpani offers some insight:

For one thing, doctors in hospitals are very busy and they often just don't have time for the common pleasantries which we take for granted in our daily life. Many of them are brusque and down-to-earth because they need to get on with their serious job of taking care of their patients, and they simply cannot afford to chit-chat with patients or their relatives. ...

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Which is why PSAs continue to be ordered in 85 year-old men.

Another nice NY Times essay. The benefits of an impersonal hospital environment, and why doctors don't cry:

Monitoring the potassium, adjusting the antibiotics, getting the latest scan result "” this is a full-time job, enough to keep a patient and family completely distracted from the awful truth. The welter of information, so much of it useless, is the accidental genius of our current health care system.

And ...

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NY Times' Abigail Zuger on giving money to patients:

I still indulge in fantasies of saving my needy patient with a solid hunk of cash, an anonymous check "” enough to buy her food and transportation; expert, consistent medical care; a few treats; and a little something in the bank.

It is an idiotic fantasy. But perhaps no more idiotic than for me to write out checks this ...

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Cover-up at the BBC

Dr. Crippen exposes some shoddy reporting, and subsequent covering of tracks, over at the BBC.

Why do you use as a placebo versus homeopathic treatment? Orac discusses the excuse of why homeopathic treatments are not conducive to double-blind, placebo-controlled studies.

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