Lawyers in the ER

Are they reluctant to tell physicians their profession? GruntDoc thinks so:

The most reticent to tell me what they do are lawyers (and I'm just guessing here, but if I was a lawyer in an ED I'd worry a little that I'd get over-tested and overdiagnosed due to medmal paranoia . . .

It's causing all sorts of confusion and dilemmas:

New York City appears to be on the forefront when it comes to transgender rights. Last month, the agency that runs the subway system agreed to allow transgender people to use the restrooms of their choice. Now comes news that the city will probably allow people born there to switch the gender on their birth certificates.

According to a proposal that's ...

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Medicine has too much variability, says Aggravated DocSurg, and can't be compared to flying a plane:

Now let's compare the pilot to, oh, I don't know, a general surgeon (what I lack in imagination is made up by a complete deficiency of imagination), and that surgeon will do four operations today. The first is a laparoscopic cholecystectomy on a healthy 50 year old; the second is an incisional hernia ...

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He takes exception with the AAP's reasons for opposing these clinics. I think this physician commenter truthfully explains the cause of the fear:

The big threat to us is that they cut into our biggest financial gain - the 2-minute visit. I make way more in 10 2-minute visits than I do 2 diabetic checks. I don't want to give our "bread and butter" (when it comes to revenue) ...

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Observes someone who works at a pharmacy. It's either ampicillin or ibuprofen. The more interesting observation is that these same patients often later return with prescriptions for broader-spectrum antibiotics, prescribed by the ER.

Bloodbath at Pfizer

PharmaGossip with more on the sales force cutdowns.

TBTAM reports on the HPV test and how to convince your doctor to order tests you may not need. However, with ancillary tests bringing in revenue, doctors may not need much convincing.

A urologist reports a bizarre case, which is reason enough to read. However, when patients threaten to leave AMA, they act as if this is some kind of threat against us. Trust me, it makes no difference to the doctors if they chose the path against medical advice.

Let the conspiracy theories begin. This anti-Kaiser website suggests Kaiser is paying off Holt to be a token "blogging presence" during this PR event in the midst of their EHR debacle.

Mom microwaves baby

This news comes out the same week that a man puts a baby in the freezer. Sick.

From the WHO: AIDS, heart disease and depression.

You have to quit completely.

Rude doctors

Dr. Malpani offers some insight:

For one thing, doctors in hospitals are very busy and they often just don't have time for the common pleasantries which we take for granted in our daily life. Many of them are brusque and down-to-earth because they need to get on with their serious job of taking care of their patients, and they simply cannot afford to chit-chat with patients or their relatives. ...

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Which is why PSAs continue to be ordered in 85 year-old men.

Another nice NY Times essay. The benefits of an impersonal hospital environment, and why doctors don't cry:

Monitoring the potassium, adjusting the antibiotics, getting the latest scan result "” this is a full-time job, enough to keep a patient and family completely distracted from the awful truth. The welter of information, so much of it useless, is the accidental genius of our current health care system.

And ...

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NY Times' Abigail Zuger on giving money to patients:

I still indulge in fantasies of saving my needy patient with a solid hunk of cash, an anonymous check "” enough to buy her food and transportation; expert, consistent medical care; a few treats; and a little something in the bank.

It is an idiotic fantasy. But perhaps no more idiotic than for me to write out checks this ...

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Cover-up at the BBC

Dr. Crippen exposes some shoddy reporting, and subsequent covering of tracks, over at the BBC.

Why do you use as a placebo versus homeopathic treatment? Orac discusses the excuse of why homeopathic treatments are not conducive to double-blind, placebo-controlled studies.

A town loses it's orthopedic surgeons to retirement. They could not recruit others, which causes this OB to lament:

I arrived at the office from the hospital at noon on a January day and began to look at the mail on my desk. On the top was the bill for my liability insurance coverage for the coming year, necessary for defense against lawsuits. The amount was a startling increase, ...

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Behind Bush's anti-science family planning office appointee:

As medical director of A Woman's Concern, a small chain of nonprofit pregnancy counseling clinics that offer no information on birth control, Keroack has agitated against abortion and even contraception "” including for married women. The organization continues to push the discredited nonsense that abortion increases a woman's chances of breast cancer and is more dangerous during the first eight weeks of pregnancy ...

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