YouTube and anorexia

More than 8,000 videos on YouTube promoting anorexia. Dangerous.

Numerous articles suggest that depression is under-diagnosed in primary care.

This psychiatrist says otherwise:

Professor Gordon Parker claims the threshold for clinical depression is too low and risks treating normal emotional states as illness.

Writing in the British Medical Journal, he calls depression a "catch-all" diagnosis driven by clever marketing.

The "medical home"

Medpundit on the latest foray by our leaders to give primary care the respect it deserves:

In short, "medical home" is the newest craze in medical euphemisms. It's what used to be called a "primary care provider" in the heyday of HMO's. But the phrase "primary care provider" has gotten a little ambiguous what with retail clinics staffed by nurses claiming to be primary care providers and what not. ...

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"The Tiger can do it"

Referring to a slickly-marketed antibiotic. Damn those sneaky drug rep pens.

Growth in DTC drug ads

For worse, it has entered "exponential mode". (via PharmaGossip)

Drug-eluting stents

The cash cow is dead:

. . . safety questions about the stents have triggered steep sales declines and job cuts for the makers, and are expected to shrink the U.S. market by one-third this year -- a $1 billion drop just four years after the tiny gizmos were introduced.

J&J is cutting nearly 5,000 jobs due in part to a stent decline after studies questioned the devices' safety ...

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Chris Rangel thinks so, and thinks they are starting to act like for-profit hospitals:

After being "rejected" by the charity hospital and still being sick they come to my ER. We admit and treat them and then the hospital sends them a big fat bill (due to CMS requirements private hospitals cannot offer to treat uninsured patients for less than they bill Medicare/Medicaid). Even when the patient requests to be ...

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Legally, there's not. Orac explores further.

Can evil be cured?

Shrink Rap on Tony Soprano and Dr. Melfi:

The next question is whether or not 'evil' can be cured. If not, why attempt treatment? As Anonymous Commenter correctly pointed out, 'evil' is a tricky term. It falls outside the realm of medicine and carries quite a boatload of value-laden judgement. There are behaviors that all would agree are so far outside the realm of compassion that most people would ...

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Email inspector

A hot commodity at Merck.

The first step in personalized medicine?

Warfarin, sold under the brand name Coumadin and in generic forms, yesterday became the first widely used drug to include genetic testing information on its label. The information can help doctors determine how best to prescribe the drug.

"This means personalized medicine is no longer an abstract concept but has moved into the mainstream," the Food and Drug Administration's clinical pharmacology chief, ...

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The reimbursement game says that procedures pay more than cognitive services. Guess what primary care physicians are gravitating to?

Patients will pay large fees out of pocket for cosmetic procedures or anti-aging vitamins. In our capitalistic society, it is clear what is valued.

As long as primary care and "cognitive" specialists are reimbursed so poorly, these ads will have great appeal to many physicians. With the decline ...

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Jerome Groopman fired his. Know how and when to say it's over.

Sad and sick:

A man threw his seriously ill wife four stories to her death because he could no longer afford to pay for her medical care, prosecutors said in charging him with second-degree murder.

According to court documents filed Wednesday in Jackson County Circuit Court, Stanley Reimer walked his wife to the balcony of their apartment and kissed her before throwing her over.

Is the PDA dying?

I recently ditched my Dell Axim after it died. Surprisingly, I don't miss it. I mainly used it for ePocrates, but the transition back to the Tarascon Pharmacopoeia was smooth and painless.

MDNG explores whether PDAs are dying, or if physicians are just shifting to Smartphones.

Medlogs 2.0

The granddaddy of the medical blog aggregators is getting a much needed update.

This blog has consistently sounded the death throes of primary care - and the ivory tower academics don't seem to get it. John Black sounds of on the many issues leading to the death of the profession:

Primary care is dying, and those in the ivory towers need to start beating the drum. One cannot tell the true vitality of internal medicine by what one saw and heard in ...

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A man has a heart attack in a hardware store. Luckily a salesperson was demonstrating a defibrillator to store staff at the same time.

Robert Centor comments on the UK's P4P experience:

I maintain that for any generalist, our jobs remain so complex that report cards must emphasize only a small part of our job. As the Scottish physician so aptly puts, focusing on 15% of our patients probably detracts from the diagnostic energy and quality addressed for the other 85% of our patients.

A powerless feeling?

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