What has evidence based medicine done for us?
BMJ with a theme-issue on evidence-based medicine.

Malpractice Prescriptions
PointofLaw is hosting a featured discussion on medical malpractice: "This month, we're looking into medical malpractice once more. In lieu of a back-and-forth format, this month we're inviting comments from some leading thinkers on medical malpractice reform to discuss a new paper by Daniel Kessler of Stanford Business School . . ."

Wyoming med-mal study
"The Milliman actuarial firm projects what will happen if Wyoming enacts a cap on non-economic damages. According to Martin Grace's summary, the study's simulation model 'suggests that the cap [at a level of $250,000] will reduce losses and loss adjustment expenses by about 15%.'"

Playing Doctor
"Lying on a résumé isn't a crime - except when a doctor does it."

A Precarious Exchange
What an interesting article in bringing up a salient point.

To a physician, this scenario is all too familiar "” we call it "sign-out" "” but in a way, the anthropologist would be right: it is a peculiar ritual, this daily transfer of patients from one medical team to another. As I write this, at the end of a frantic afternoon, 18 residents are simultaneously handing ...

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Sleepy Interns Committing Key Errors, Study Shows
"The researchers, led by Charles Czeisler at Brigham and Women's Hospital in Boston, found that interns working more than 80 hours a week committed 36 percent more serious medical errors than interns who kept a less arduous schedule.

When it came to diagnosing illness, the sleep-deprived interns made 5.6 times more serious mistakes than their rested colleagues, the research showed."

The ...

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The Australian: Where the health system is failing us
"About 35 per cent of Australian women do not have regular Pap smears and more than 60 per cent of people visiting a GP do not receive any diet or lifestyle advice that would improve their overall health.

Patient dissatisfaction also was high, with 23 per cent of Australians surveyed saying the local health system should be rebuilt completely."


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Stomach Acid Drugs May Raise Pneumonia Risk
"The risk is not huge. But the drugs work so well and so safely -- and are advertised so aggressively -- that they're among the most-used drugs in the U.S. . . .There seems to be one extra case of pneumonia among every 100 people who take acid-suppressing drugs for one year."

The study is from JAMA and is found
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DEA Withdraws Its Support Of Guidelines on Painkillers
"The Drug Enforcement Administration has reversed its support for a set of negotiated guidelines designed to end a controversy over the arrests of hundreds of pain specialists who prescribed powerful narcotics for their patients. The agency took the document off its Web site earlier this month, less than two months after announcing it with great fanfare."

This seems to be ...

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What's Ashlee Simpson to do without talent?
Chris Rangel talks about the "reflux" explanation for Ashlee Simpson's lip-synch incident this past weekend.

Grand Rounds Five
Hosted by code blog: tales of a nurse. The weekly best of the medical blogs.

And tomorrow is Friday
A story of the doctor as a patient.

Lawyers: To treat or not to treat?
"While it might not be a bad idea from one perspective to give trial attorneys a taste of life without physicians, surely we have a higher calling"”to practice in "purity and holiness," as the original Hippocratic oath says, or with "uprightness and honor" as in "A Physician's Oath," used by some med schools today. It's risky, but the sick need the benefit of ...

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PointofLaw.com: State initiatives head to the wire
"Doctors and lawyers are battling over ballot initiatives in four states this year, with very mixed signals from the voters at the moment."

Prognosis for Rehnquist Depends on Which Type of Thyroid Cancer He Has
"Of the four main kinds of thyroid cancer, the papillary type is by far the most common. The cure rate is about 95 percent among younger people. But among older people, the cure rates for papillary thyroid cancer are often lower."

Just because it's new doesn't mean it's best
"Scenario: How do you decide whether to prescribe a new drug?

The simple answer to this question is, 'Of course I would not use a more expensive medicine to replace an effective one with no side effects.' But in fact such substitutions do occur, and frequently. The drug companies count on it."

Nabbing no-shows: What can you do when patients are absent?
Always try and show up for your doctor's appointment.

Costly medicine: A look inside Ben Taub's ER
Inadequate mental health care is another reason overburdening the ER: "When their illnesses turn into crises, the only option is an astronomically expensive visit to a public emergency room. Dr. Daniel Garza, medical director for Ben Taub's outpatient psychiatric clinic, says it's not unusual for mental patients to call 911 and be transported by ambulance — all in desperate bids to ...

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Unhappy time for medicine
"This is not a happy time for medicine. There is an increasing discordance between rising costs and the satisfaction that most patients have with the care they receive. We pay more and get less.

It's not quite true to say that all are dissatisfied. Some are quite happy with the system: CEOs of health maintenance organizations, executives of pharmaceutical companies, personal injury trial attorneys, investors ...

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Traveling physician provides old-school service, modern medicine
Shame that physicians have to rely on a "boutique" practice in order to do house calls.

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