Old-school doctors

Maurice Bernstein laments the loss of the physical exam:

The old doctors had less tests and more time and more attention to the patient. Whether they could do a better job in diagnosis and treatment of the disease than more modern medicine is doubtful. But one thing is clear, they had the time to do a better history and physical and their treatment of the whole patient might ...

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Zelnorm, RIP



Zelnorm has been pulled, as there is a small association with heart attacks when taking this IBS drug:

Swiss pharmaceutical maker Novartis AG will stop selling a drug to relieve constipation after it was linked to a higher chance of heart attack, stroke and worsening chest pain that can become a heart attack, federal health officials said Friday . . .

. . . Earlier this year, ...

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Abortion in Mexico

Apparently access to this procedure is pretty good:

Practically, those who can scrape together $700 can get an abortion from a doctor. Some of them will even bill health insurance for the procedure, by coding it as a complication of pregnancy, according to the article.

John Mack goes to his doctor's office yesterday and reports on his findings.

Panda Bear just has no quit in him. The third in a series post on single payer - there's no way the American public, groomed to expect the best medical care, instantly - will stand for it:

So, it may come to pass that our country adopts a single payer system in our impossible quest to provide high quality health care for all. The result will be ...

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An editorial in the San Francisco Examiner tells it like it is:

Next time your doctor orders lots of blood tests and MRIs, you will be experiencing a slice of the estimated $124 billion annually in unnecessary costs imposed on American health care providers through malpractice and other liability lawsuits. Doctors call it "defensive medicine" when they order lots of mostly unnecessary, time-consuming and expensive tests for fear of being ...

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Remove the financial incentive, and you get what's happening in Canada - perceived doctor shortages:

Now, we have a situation where the great doctor can only bill a maximum of $450,000 per year (minus overhead and taxes). When, prior to the cap, he was happy to work for "services rendered" and billed accordingly.

However, now his $1.3 million practice is cropped at $450,000 per year. So he has two ...

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Coughing fit

An uncontrollable episode of coughing causes a girl to get kicked off a plane, even though a physician on board said she'd be ok to make the flight.

Carrot or the stick?

An economist suggests demerit awards instead of performance bonuses. With all due respect to guys like Matthew and Ezra, the problem with health policy wonks is that they base their opinions with zero clinical experience in medicine. Because of this, it is difficult for physicians put any weight into anything they say.

An op-ed in the Boston Globe:

And yet Elizabeth Edwards said at a news conference, "I don't expect my life to be significantly different." She calls herself "incredibly optimistic." About his press secretary Tony Snow, President Bush said, "He is not going to let this whip him, and he's upbeat."

Of course all people need hope: hope for a good day today, hope for a normal life, and ...

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Power of placebo

Or, an IV flush for pancreatitis pain.

A physician is about to go through a malpractice trial. His wife goes off on a tirade:

My physician husband is going to court next week, being sued by a woman whose husband died of esophagus cancer. She thinks she deserves money because someone died. SOMEONE must pay. Win or lose, the taxpayer pays and health care costs go up for everyone. Win, and tens of thousands ...

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A Texas senator wants to pay women $500 if they change their mind about an abortion after showing up at the clinic. Steven Levitt thinks about this:

Honestly, though, is it really such a bad idea? What if he left out the part about visiting an abortion clinic? Does it make sense to subsidize women who were going to give up babies for adoption? I think maybe it ...

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Panda Bear is on a roll with a follow-up missive against single-payer health care. He tries to explain it as simply as possible for those blindly support such an ill-conceived measure:

In the quasi-single payer system of Medicaid and Medicare we have today, the goverment fixes the price at such a low level that those who decide to let the dog into their practice have to run a high ...

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Bard-Parker with the revealing CT scan. Wow.

CRNA salaries

CRNAs (Certified Registered Nurse Anesthetists) make almost as much, if not more, than primary care physicians - with 2 years of college education. This post from a forum wonders how:

CRNAs make 224% as much as RNs and 156% as much as advance practice nurses (NP). According to the allnurses.com website, 58% of nurses are certificate nurses only, ie. have no advanced degree beyond a RN. It is not ...

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Isn't that the point?

That is the plan some are considering:

Democrats in the Minnesota state Senate want to give publicly insured patients $20 gift cards to stores such as Target as an incentive to follow their doctor's orders.

Sen. Linda Berglin, who leads the health budget panel, is betting that it will pay off for the state to sink $1 million into incentives for diabetics who control their blood sugar and smokers ...

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The once-promising pill for obesity is facing challenges in the FDA due to its psychiatric side-effects.

"When faced with the opportunity to read a book by someone who isn't by profession a writer, I always go for the doctor." (via DB)

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