It's a matter of listening, something that the system doesn't allow:

This is interesting since the PAs and nurse practitioners see the 'less complicated' patients, you would think that it would be they who had only 15 minutes per patient...with their easy patients and all. And the physician would be graced with over 30 minutes per decipher the nuances of the more complicated patients, and make more difficult ...


Which brain is lying?

When the EMR goes down

The hospital grinds to a halt:

IT people that work at a hospital: yes, your department now truly influences whether patients get better or worse, and indirectly, live or die.

Panda answers this and other burning questions.

A chef and his tongue

A star chef has cancer of the tongue. Instead of the standard treatment of cutting out part of the tongue, he's opted for more unconventional treatment.

Placebo Television #5

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‘Nuff said

(via Dr. Wes)

Like Billy Walsh on Entourage, doctors have disdain for "suits". Here's why:

But now the intrepid blogger of Over My Med Body may be getting an inkling why doctors who have had years of training like this can get so upset when their dedication, knowledge, or work habits are questioned by some "suit" with a six-, seven-, or eight-figure income, a "suit" who is comfortably in ...


Medicare error P4P

Dr. RW looks further at the unintended adverse consequences, saying it will outweigh any benefits.

Pallimed looks at several recent articles discussing EBM.

As common saying goes, "A physician who treats him(her)self has a fool for a patient."

So, what to make of these numbers?

. . . a survey conducted of Michigan psychiatrists regarding their opinions toward self-prescribing. A survey of more than 500 Michigan psychiatrists showed that more than 40% would medicate themselves for mild to moderate depression and that 15% had actually done so in the past. Seven ...


Zero percent financing

Coming soon to a doctor's or dentist's office near you:

For $3,500 laser eye surgery, $6,000 ceramic tooth implants or other procedures not typically covered by insurance, millions of consumers have arranged financing through more than 100,000 doctors and dentists that offer a year or more of interest-free monthly payments.
Richard Reece comments on the practice.

Zagreus Ammon with a somewhat different take:

I don't think working forty eight hours straight is the problem. More likely the fact that those 48 hours have become as grueling and punishing as an ultra-marathon. The fact is that medical interventions have become much more intense than ever before and no patient lounges around the hospital waiting to get better. The cost-containment pressures on the health care system have ...


Any errors in medical records can hinder the chance of obtaining insurance.

Abbott Labs has an in-house employee editing various Wikipedia entries pertaining to their drugs:

As other observers have noted since the Wikipedia tool was released, other companies have edited their Wikipedia entries "” sometimes making small changes, sometimes making their entries sound more promotional "” but the Abbott case was particularly striking because it involved the deletion of a reference to safety study published in a major medical journal ...


Slate with the answer:

No. When you're sitting on the toilet, spreading your feet and leaning forward tightens the levator ani muscles that control defecation. If you're having trouble passing stools, you should take the opposite of a wide stance, and lean back. Doctors recommend this technique to relax the bowel muscles.

McArdle on Groopman's How Doctors Think. I agree with her, and continue to advocate global, evidence-based measures (which also would help the medical malpractice/defensive medicine problem) to guide clinical decision making:

Every profession resists being told that there is a standard way to do things, that a cookie cutter can cut better than their skilled hand. Journalists famously hate the "inverted U" style of writing ...


Dr. Val thinks about the hardworking residents working this upcoming Labor Day weekend:

Physicians work for 3-7 years after graduating from medical school, and are paid (on average) about the equivalent of a home health aide or a medical secretary but work about twice the hours during residency. In fact, if you calculate out the salary by the hours they work, resident physicians are paid about $9 -$10/hour ...


Don't tempt the medicine gods.

First night on call

Graham's first night on call during his medicine sub-i: "Man it sucked."

Don't worry, it gets better. An attending once told me to always look at the orders first, then the note. When it comes to things getting done, the note means nothing. This is especially true out of academic medical settings when you have several consultants and cross-covering physicians writing orders on your patient.

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