Thoughts from the Happy Hospitalist:

With my training, expertise and education, I should be able to collect at least $250/hour. I'm pretty sure medicare will pay me less than $75. After overhead I make less than a massage therapist for an hour teaching. Family's happy but I can guarantee you that if I sent them a bill for the other $175, they would be furious. My time should be ...


Malpractice at sea

Efforts to locate cruise ship physicians involved in malpractice often fail:

Most ship doctors, despite typically wearing a crew uniform, are classified as independent contractors. And cruise companies contend they are no more liable for the doctors' competence than a landlord who rents office space to a physician on land.

One of my favorite authors, and has some nice insights in Blink. Robert Centor writes about his recent address to the Society of Medical Decision Making.

Shared decision making

Great in concept, with this article talking about the PSA in particular:

The prostate-specific antigen, or PSA, test is a simple blood test that can detect prostate tumors on average 11 years before a rectal exam does. To anyone who assumes that catching prostate cancer as early as possible leads to cures, the PSA test looks like a no-brainer.

But the evidence doesn't support that view. If early ...


Guess the profession: "[we] feel unable to stop it, powerless to resist the stifling market forces that drive their decisions."

Medicine? Goes without saying. But lawyers are also feeling the financial heat. (via a reader tip)

Jay Parkinson on Colbert

He's certainly kicking off his new-style practice with a flurry of media attention. How can it get any bigger than being on The Colbert Report?

Simple solution

Doctors can only adhere to diabetes measures if they have the proper equipment.

The WSJ Health Blog looks at the winner.

A trip to Lourdes

On the tab of a health insurer. Only in the Netherlands of course:

In an unusual scheme, the Dutch company spends about $280,000 a year to fly 600 of its sickest and most disabled clients to Lourdes. The company doesn't expect the Virgin Mary to intercede. It hopes for a different sort of miracle.

"Lourdes leads people to compassion and friendship," says Johan Rozendaal, a VGZ board ...


. . . THAT is an ovarian cyst:

(via a reader tip)

More bureaucratic idiocy invading the emergency room:

* We are required to write down precisely what the patient tells us, even if we know it is the wrong dosage! If the patient says they take 25 mg of Ativan every four hours, we have to write "Ativan, 25 mg" on the reconciliation form.

* If the patient hands us a list ...


"Don't you think you are wasting your time in the Emergency Department?"

The 5-dollar facelift

Aka, a roll of tape.

Here's a simulator for open-heart surgery. What makes it so realistic? Well, after an unsuccessful surgery, you get this message:

(thanks again to Street Anatomy)

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Street Anatomy analyzes its popularity.

"Running the bowel"

So, what exactly does this mean to a surgeon?

Zagats is teaming up with a health insurer for their venture, leading to some questions:

. . . why should anyone use a health plan site to rate doctors rather than an independent one, and for that matter is Wellpoint going to let its customers rate it? I can think of a few who won't rate it so highly!

Chest pain, r/o MI

An efficient assembly-line of profit for a hospital?

Loser pays

A simple reform to help the malpractice crisis:

Some argue that a "loser pays" system would keep poor people from suing. I say it should keep poor people from suing - if they have a frivolous claim. Those with legitimate claims shouldn't have too much of a problem with their suits. And if the "loser pays" system is so bad, why do most other countries keep it around instead ...


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