Scalpel eloquently continues:

I want my patient to have a liter of normal saline intravenously. If the patient is stable, I really don't care if it goes in over 10 minutes, 30 minutes, or an hour. Just give them the dang liter and re-assess them for me please.

Dick Cheney’s leg

Dr. Wes speculates on why the Vice-President's leg is still causing problems.

Do Americans really want universal health care? Matthew Holt analyzes the recent NY Times survey:

But if you ask people as Harris finally does at the end of its survey - which pre-dates the Times' - if they're wiling to see a "substantial" increase in taxes to help the less fortunate, then support for the whole idea falls off. It's worth noting that the Times poll only asked about ...


Or is it?

The Veterans Affairs' vast network of 1,400 health clinics and hospitals is beset by maintenance problems such as mold, leaking roofs and even a colony of bats, an internal review says.

ADA on Exubera

Doesn't look good for the insulin-bong:

"I think Pfizer will wish they had never gotten into this. I doubt they'll regain their investment," says Dr. John Buse, president-elect of the American Diabetes Association, who participated in Exubera's trials. "There is no advantage to Exubera and there may be a safety risk. I see it as my job to talk people out of (using) it."

OnThePharm with 3 prescription mysteries. I got the first two, the third one eludes me. Finally got the third one after viewing it from a distance. Kind of like those magic 3-D pictures.

Interesting study from New Scientist. Human surrogates only get it right 68% of the time; could a computer do better?

The data suggested that most people want life-saving treatment if there is at least a 1% chance that following the intervention they would have the ability to reason, remember and communicate. If there is less than a 1% chance, people generally say they would choose not to have ...


John Edwards

Why he is so despised within the medical community:

John Edwards, being neither a woman nor a racial minority, isn't doing especially well in his campaign to become the Democratic Party's candidate for the U.S. presidency. Alas for him, if he were half as successful in campaigning for America's top job as he was as a trial lawyer, he might be sworn in tomorrow. Edwards won, according to Lawyers ...


The newest trend in the hospital construction boom. Dr. Wes with his take:

For it is the woo, not "evidence-based" design, with its attractive architecture, pleasant lighting, etc., that patients demand "“ and hospitals, after all, are entering a period of unprecedented competition between centers to attract well-to-do patients with money (and insurance). In this era of declining revenue, and increasingly savvy patients who can check out "hospital ...


Honoraria for doctors

An internist defends the practice:

"Drug companies are like lions," Grimm says in the story. "For lions, it's their nature to kill zebras and eat them. For drug companies, it's their nature to make money. They're not really trying to improve anybody's health except if it makes them money "¦ On your side, you're making a bit of money, but you're also trying to educate the doctors. And in ...


A law firm is unable to blog because of their malpractice carrier. Will the same thing happen to medical blogs?

A physician group in Boston calls itself Atrius Health. Here's the thought process that went into this decision:

"'A' is first in the dictionary and easy to recall. The 'T' sound is very strong, solid, abrupt, but balanced by the beautiful i-u-s," Smith said. "Atrius sounds nice. It is a pleasant word to say."

Duct tape for warts

A new study has come out, conflicting with previous research. Dr. Charles with a summary.

A survey suggests that the public thinks so:

About 52% of respondents said physicians overtreat patients because of concerns about medical malpractice lawsuits, 45% said "to make more money" and 44% said "to meet patient demands," the survey found.
My quick estimates of the reasons why physicians overorder tests would be 70-80% due to defensive medicine, 20-30% due to patient demand - although there is overlap here with defensive medicine ...


Couz discusses adult circumcision with a patient:

Due to my anti-circumcision bias, I admit to often emphasizing the risks and the complications associated with this elective, cosmetic procedure. I also explained that as this is no medical indication for circumcision, he would be required to pay for the procedure out-of-pocket.

Two different headlines shows how the media can interpret the same financial report.

retired doc with more insight, as always:

Dr. Brett does not elaborate on what the process would be to decide which interventions are or are not effective but one can assume that would not be done by the individual physician in consultation with the individual patient.Those decisions would be made by committees appointed by the one party payer (which Dr. Brett favors) either directly or indirectly. Ironically, the egalitarian ...



An orbital blowout fracture that is. (via Radiology Picture of the Day)

Two Women

A single-payer cautionary tale.

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Statin box office

WSJ on the statin wars. Lipitor is in the lead, but losing ground. I normally prescribe simvastatin (for a potent statin), or pravastatin (if there is a history of muscle toxicity) first. Lipitor comes a distant third.

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