Daniel Carlat speculates on how much Big Pharma pays Medscape for their industry-sponsored CME programs:

How much do companies pay in order to take control of what doctors learn? Good luck extracting this information from Medscape, but rumor has it that about $500,000 gets you a sort of "base package" which includes four articles. The sponsoring company gets to specify the topics and the authors, of course. There is ...

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Balance billing

Something that can help solve the primary care crisis. (via The Happy Hospitalist)

And don't really care about security concerns.

A significant proportion of medicines are prescribed "off-label". Targeting these cases will have detrimental treatment effects - medicine isn't black and white. Scott Gottlieb writes:

It is true that some off-label drug use is based on very unsettled science and has more risks. But medicine "” and not just cancer care "” involves lots of hard choices.

If you can't beat 'em, buy 'em.

Here's what you need to know.

Here's a surefire way.

Don’t just go to any ER

If you want optimal patient care, go to the hospital where you normally get your care.

Eating flour

Scalpel encounters this during an ED visit. An example of pica, of which one cause is iron deficiency anemia. Eating ice is another example.

Ask for a hospitalist

You'll be thankful if, God forbid, there's ever a Code Blue situation.

The Medicare donut hole

Some are calling it brilliant.

The 10% Medicare cuts are going to hurt most physicians. Some are passing on the cuts to patients. Great idea, but is that legal?

Christofides said that if the cut takes effect, she will charge all her patients a fee to recoup her costs, which have risen while Medicare payments have remained flat since 2002.
(via The Medical Quack)

Midwives and primary care

More women are using midwives for their primary care:

The trend, according to doctors, midwives, and public health specialists, is connected to the rising popularity of midwifery, as well as a shortage of primary care physicians and obstetricians/gynecologists.

According to the American College of Nurse Midwives, 90 percent of visits to midwives are now for primary, preventive care, including gynecology.

And should medical schools require work experience prior to entrance?

I've come to the realization that medical schools should require several years of postbaccalaureate experience before even considering applicants. My take on it is that the whole dynamic of the medical profession would change simply by requiring work experience as an entry to the field.

Internet vs physician

More than 1/5 of of patients in this survey used information gathered from the internet to challenge their personal physicians.

Try tackling some of these USMLE questions.

What better way is there to show your love?

ThatÂ’s the latest pitch in the growing field of VIP medicine for the masses. An Atlanta-area firm called Team Doctors Preferred Access is offering a $199 TravelWise gift card that promises your favorite road warrior an express lane to primary care doctors and hard-to-reach specialists for a year. Many of the docs are current or former physicians for professional sports teams.
...

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TV shows like House and Grey's Anatomy glamorize American medicine. It's also luring physicians to the US:

"They really teach me a lot," he says, about how hard American doctors work, how dramatic their lives are, and about America's technological edge. "I was amazed America has diagnostic departments like [the ones featured] in House," he says.

The big difference between American and Filipino healthcare styles, he says, is ...

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So, what do women really do - and do health professionals care? (via Women's Health News)

The future of primary care:

Fortunately, I know plenty of doctors who listen to and speak with their patients. They've stopped seeing people in 7 minutes. They see them in 15-, or 30-, or 60-minute appointments. They don't miss things because they take their time, are thorough and follow-up with the referring physician or family. They work patiently, yet efficiently and never say no to a consult. Even on ...

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