. . . and is Glaxo trying to take Actos with it?

Health insurance premiums are starting to be linked to lifestyle habits:

Government workers in Benton County, Ark., can now sign up for a plan with premiums that fall from to $500 a year from $2,500 a year if they maintain a healthy weight. Clarian Health Partners, a hospital chain based in Indiana, said last month that it'll start charging workers as much as $30 every two weeks if they ...

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The Well-Timed Period critiques this DTC effort:

I realize that a TV ad is expensive, the time is limited, and the ad's function is to convey a marketing message not to educate. But that's no excuse to misinform.

It's like there's this implicit assumption out there that we mustn't trouble potential Pill users with too much information. And that really annoys me. Explain the difference between a period ...

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A microcosm of the procedure-driven nature of American medicine.

Patients as young as six-months old are showing up.

Louisiana physician-blogger Michael Hebert with his thoughts on the Anna Pou story:

One final question the reader may ask: Do I think Dr. Pou did it?

I don't know Dr. Pou personally, but I do find it difficult to believe that a doctor educated in the United States, knowing the law as all doctors do, would have tried to do something like this. It would have been much easier ...

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Physician websites

A doctor who doesn't have a strong web presence will be at a huge disadvantage as patients rely more on the web for their health.

As medicine continues to evolve to a business, physician "branding" becomes more important:

"The secret is being bigger than your medical practice," says Howard Bragman, founder of the media and public relations agency Fifteen Minutes (whose clients include Robert Rey, a.k.a. Dr. 90210). "If the only money you ever make is doing your medical practice, you're limiting your income. If you can make money selling products or with books, then ...

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Anyone who reads this blog knows what I think about defensive medicine, and how I feel it is one of the leading factors in rising health care costs today.

Two articles in the news highlight this. The first one suggests that defensive medicine practices are spreading to paramedics:

"I think that for most physicians now, it's the fear of being sued for missing a diagnosis," said Scott Maizel, ...

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More Sicko rebuttal:

Why then, is national health insurance in other countries as popular as Moore says it is? One reason is that people do not realize how much they pay for it in taxes. Even mediocre care looks good if you think it is free.

A second reason is that doctors in other countries often don't tell their patients their care is being rationed. Instead, they say, "There's ...

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What he writes is true:

At last, you're ushered into an examining room. The change of venue lowers the level of your fuming. The nurse orders you to strip and don a hospital gown so that the doctor can give you his immediate attention. All this indicates that his arrival is imminent. In fact, as the nurse leaves, she says, "The doctor will be right in." And he is - ...

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An editorial by the numbers - and this is supposed to entice medical students to choose primary care?

If there's no incentive for productivity, many physicians will go to banker's hours to the detriment of patients:

The problem with a flat salary is that there's no incentive to maximize work. Show me a salaried doctor (without a productivity bonus) and I'll show you one who believes strongly in his right to get home by 5PM, regardless of medical problems coming through the door, or over the phones, ...

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Something to consider for those who advocate government-run health care, it will be more of the same:

Three quarters of GPs who referred patients to hospital have had their decisions blocked, a poll for The Sunday Telegraph reveals.

Family doctors say that new "referral management" systems, set up to allow primary care trusts (PCTs) to overrule decisions taken in the surgery, are being used to delay and cancel hospital ...

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Manipulating P4P

Stanley Feld writes about P4P and how insurance companies are going to destroy the physician work force:

Just imagine the worst physician in a community figuring out what tests would give him a high rating and increase his income. He does the required tests routinely whether the patient needs them or not. He misinterprets those tests to the detriment of the patient. Yet he is rated the best doctor ...

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Chest pain from cocaine, clouded by real heart disease. Nurse K on this regular visitor to her ER.

What Sicko conveniently left out:

In Canada, McCreith's story reflects a debate, intensified by the long waiting times, between those who want more for-profit, private care and those who fear the rise of two-tier medicine that undermines the public system.

McCreith offers little doubt about where he stands. "We have universal health coverage," he said. "But it failed me when I needed it the most."

A woman's peripheral IV infiltrated while giving birth:

Memorial Hospital of Belleville and a nurse are named in a medical malpractice lawsuit filed by a woman who claims she sustained IV infiltration while delivering a full term infant.

Trecia Lash alleges that on July 29, 2005, the hospital and nurse Debra Sakho failed to recognize her distress after she complained of severe pain at the intravenous infusion site in ...

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Fires in the OR

Guidelines are being proposed to address this:

The proposed guidelines include lowering the concentration of oxygen given to patients during surgery by diluting it with room air when surgical tools that could ignite a fire are in use. Other suggestions are to reconfigure drapes to minimize oxygen buildup and use suction devices to remove excess oxygen from surgery sites.

Well deserved. See you back in the fall.

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