Medicine and luck

Luck (or being unlucky) sometimes plays a role in medicine, as DB points out. Lawyers usually use this fact to their advantage:

Of course, malpractice lawyers do not believe in luck. As an obstetrician told me yesterday, a bad infant outcome is always blamed on the obstetrician, while most bad outcomes really represent bad fortune.

Medpundit says not so fast:

Those improvements sound impressive, but they are the same improvements and the same rate of improvement that can be had by diet and lifestyle changes, a fact the authors freely admit in their conclusion. Watching the diet and walking a half hour every day is certainly less expensive than the $175 a month it costs to take Avandia at the 8mg dose in the ...

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The "hateful patient"

Not patients who hate physicians, but traits of patients that physicians find difficult.

A nice primer, done Dr. Charles-style.

Congrats to Diabetes Mine

Diabetes Mine is awarded a 2006 LillyforLife(TM) Achievement Award:

Amy Tenderich, San Francisco, is the winner in the Journalism category. Tenderich, who has diabetes, founded the diabetes blog "DiabetesMine.com" in 2005. From product reviews to personal accounts and interviews to the most up-to-date diabetes news, Amy reaches people with diabetes and the general public with her accurate and timely reporting.

Yes, it's because of the money:

As more U.S. doctors opt for better-paying specialties such as cardiology and orthopedics, residency programs for family physicians here are increasingly drawing doctors from abroad.

This year, 28 of the 78 first-year residents in family practice programs in Minnesota came from foreign medical schools. At Hennepin County Medical Center, eight of 10 places were filled by foreign graduates. At the University of Minnesota's ...

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Sometimes, just use some common-sense:

"I've had new patients come in and tell me during the first visit that W, X and Y medications don't work for them, but Z does," said Dr. Charles Cloutier, a Prattville family practitioner. "When patients take that approach, it's a huge tip-off."

Cloutier said he doesn't call in prescriptions for controlled drugs after hours or on weekends, and he is cautious when he ...

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So-called prescribed lying.

A new type of boot camp is emerging in China for misbehaving children:

"As only children, their parents give them everything they want and they don't have to do anything for themselves," said Wan, who charges about $300 a month for her program. "The kids still say they are unhappy and misbehave. That's because they don't know what happiness is. Here we provide bitterness, so they have a point ...

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A surgeon retires . . .

. . . a bit too late: "A Belleville doctor who retired last year because of escalating medical malpractice insurance is being sued by a former patient."

Doubtful, since academia has huge money backing them up:

Stanford University Medical Center took a bold step this week, but don't expect to see community physicians jumping on board this anti-industry train. Academic research centers like those at Stanford, Yale and the University of Pennsylvania (the latter two having implemented similar, yet less far-reaching policies than Stanford's) have huge endowments and can afford to turn their backs on pharmaceutical ...

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JAMA thinks so, as parents told to "wait and see" significantly reduced antibiotic use for ear infections. This can satisfy both the patient expectation of an antibiotic during a visit, as well as the provider worried about antibiotic resistance.

Spinich and E. Coli

A pair of ScienceBlogs has this story covered, both in The Loom and Aetiology.

Wise words from Dr. Schwab's blog.

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Code properly

In these times of declining reimbursement.

A patient presented with chest pains and is incorrectly triaged:

Vance had waited almost two hours for a doctor to see her after complaining of classic heart attack symptoms -- nausea, shortness of breath and chest pains, Deputy Coroner Robert Barrett testified.

She was seen by a triage nurse about 15 minutes after she arrived, and the nurse classified her condition as "semi-emergent," Barrett said. He said Vance's daughter ...

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More from the Anna Pou, Lori Budo, and Cheri Landry situation:

Many of us were well aware that our homes and possessions had been swept away in the storm. And too many had the terrible burden of knowing their loved ones were missing, some presumed dead. As professionals, we had to put these thoughts aside and ignore great personal sorrow in order to work as a team to ...

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A man, about to undergo bypass surgery, is binging before the fateful day. A dubious use of medical dollars on someone who's clearly doubtful to stay compliant post-surgery:

"I''m gonna go everywhere I wanna go. I''m gonna eat everything I wanna eat. I''m in full swing now," said Stockbridge, a 325-pound, 5-foot-10-inch city worker who''s halfway through a two-week binge as he hits all his favorite local food ...

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It's starting to get old. But he makes one valid point - reducing physician reimbursement does not necessarily reduce health care costs:

And after about 20 years of seeing the rate of health care costs increase dramatically the government and private payers have looked for ways to slow their health care costs. The government tends to lead the charge on this because the government pays for Medicare which is ...

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