Scalpel discusses his second lawsuit. Many would have done the same thing - discharge an ER chest pain home after a negative cardiac cath 6 months prior.

Her blood alcohol level was four times the legal limit for adults who drive.

A hoax, or a hidden psychiatric disorder?

The image is an imperfect reproduction of a particular postcard dated 1972. A blogger (in Russian) claims his psychiatry professor found one aspect of this eerie painting that reveals the patient's disorder. Allegedly, only one of his students in the past 15 years has figured it out. The psychoanalytic mystery has piqued the interest (in Russian) of the online community. A number ...

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With poor primary care reimbursement from Medicare, this scenario was predictable. Vermont is now reaching out to high-schoolers to drum up primary care support:

Harrington said the only way to attract more doctors to primary care is to lighten the administrative load, increase Medicaid reimbursement rates and expand programs that help new doctors pay off medical school loans of up to $150,000.

Reardon says the Area Health Education ...

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And there was a $500 bid on it.

35 percent of patients don't, and this number is likely to grow.

Medical school in Cuba

Some US citizens are going to medical school there. For free.

For instance, here's an example of a bleeding finger injury from the controller:

His take on House, M.D.:

Will someone please enlighten me: what the hell sort of doctors are House and his groupies? I'm not talking about assholery: that part is clear enough. I mean specialty. In no big hospital that I know of would the same people sitting around thinking off over a patient be the ones to do all those procedures. Biopsies. Radiologic interventions. Of late they've tapered off ...

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An ugly dispute involving a brain-dead patient's religious beliefs and Boston's BI-Deaconness leads to court:

Last week, doctors declared Cheng, a grandfather of seven who suffered cardiac arrest the day after Thanksgiving, brain-dead and said it was time to remove him from the ventilators and intravenous medicines keeping his organs functioning.

But the family refused to let doctors take Cheng off the life-support system because his heart was ...

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Not sure what kind of prenatal care was done, but gestational diabetes was missed, leading to the birth complication:

Birmingham's High Court heard Daniel's family GP and community midwives had failed to spot his mother, Ingrid, had developed gestational diabetes during pregnancy.

She was encouraged to have a home birth, but because of her condition, Daniel was born weighing 11lb 8oz and his shoulders became stuck during labour.

RIP Torcetrapib

Devastating news for Pfizer. This was the HDL-raising drug that was anointed the star of Pfizer's pipeline:

According to Pfizer spokesman Paul Fitzhenry, 82 patients taking the combination of torcetrapib died, compared to 51 deaths in the arm of the study where patients were taking Lipitor alone. Each arm of the study had 7,500 patients. Pfizer said that the study didn't raise any questions about Lipitor's safety.


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A jury sometimes doesn't realize the ripple effects of large malpractice awards. These letters aim to educate them after they awarded $5.7 million:

. . . mammography is one of the lowest reimbursed tests in radiology, and it carries the highest litigation risk.

No one wants to read mammograms. Many radiologists would rather do invasive procedures than read a mammogram.

So to the jury in this ...

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Another success story:

Reforms that West Virginia legislators enacted in a medical malpractice crisis have worked like a charm.

Doctors who could not keep up with malpractice premiums five years ago now see their rates dropping.

Where five years ago insurers slashed their West Virginia business or cleared out, today dozens of insurers compete for premiums of doctors and hospitals.

Probably, said the on-duty ER physician:

The Saint John hospital emergency room was crowded and over capacity the day Lillian Mullin, 78, was sent home with the bowel problems that killed her 24 hours later, a doctor told a coroner's inquest on Thursday.

Dr. Tushar Pishe was on duty at the ER when Mullin arrived with abdominal pain and severe diarrhea in February 2005. He told the jury that ...

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Another example of the unregulated "hired gun" business in medical malpractice cases:

A Florida surgeon lied about regularly performing coronary bypass surgery while presenting himself as an expert witness in medical malpractice cases, a federal prosecutor said Friday. The doctor denied the accusation.

A federal grand jury indicted Dr. Alex Zakharia on perjury, mail fraud and wire fraud charges, Detroit U.S. Attorney Stephen J. Murphy said in a news ...

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One of three tips to protect against medical malpractice.

Solving the ER crisis?

Some are charging fees for non-emergent ER care. I expect, and encourage, this to be commonplace soon:

Federal and state laws ensure that anyone who comes to an emergency room for care is seen. But Bill Bell, general counsel for the Florida Hospital Association, said that doesn't mean they all have to be treated there.

"If there is no emergency after screening, the law is no longer applicable," ...

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Another example of how profits are influencing medical decision making. However, this is another case of physicians responding to Medicare's ridiculous reimbursement system. Don't hate the player, hate the game.

DB with two posts, and Joe Paduda. I still think this should be universal.

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