He denied having the disease.

A tragic miscommunication:

Kozel, a pediatrician at St. Louis Children's Hospital, apparently had thought her husband knew to take the baby to the on-site day care; the father didn't see the baby in the back seat and thought he was simply parking an empty car.

A patient with drug-resistant bacteriuria. How to treat properly versus satisfying P4P demands becomes an issue.

As patients become more empowered, they are finding themselves in some awkward situations:

"More times than once, I had to say to the person coming into the room,'Did you wash your hands?' " said a woman who is the president of one hospital, and whose father was recently a patient at a different, well-known (but unnamed) Boston hospital. "When you're going to the mecca, I felt like I shouldn't ...

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A physician builds a hospital empire in California, and gives the finger to insurance companies. A business model of the future?

What is more extraordinary is how Reddy is building his empire. Modern healthcare is largely based on the model in which insurers seek to control costs by paying fixed amounts to doctors and hospitals. Reddy is tearing that down.

When Reddy's company, Prime Healthcare Services Inc., takes ...

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A view from the inside:

It has been more than 20 years since I came from a communist country (Cuba) where I was employed as a physician for over 10 years.

During this time I observed firsthand how socialized medicine really works. The basic failure to provide minimal quality of care, compounded by the scarcity of vital medications and supplies, made every day a battlefield. The waiting list to ...

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Editorial from rural Vermont, where hospitals are having a hard time attracting doctors:

Reimburse doctors for some or all of their education expenses as soon as they become doctors, and pay a hefty percentage of their malpractice insurance, based on their income. Simple, effective, immediate. The benefits would be enormous throughout the system.

And the amount it would cost the government, compared to the billions and billions we ...

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Does the small difference in life expectancy statistics warrant overhauling the health care system?

The truth is that Americans live, on average, longer than people in many countries with socialized care but not as long as people in some countries. If one were to compare the EU average life expectancy to that of the average American the difference is really a matter of weeks.

But that small difference ...

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Medicare and health IT

Their recently announced Medicare/P4P rules presents a huge opportunity for health IT to capitalize.

Several readers here suggest refusing to take insurance if physicians are unhappy with reimbursement.

You can see how unrealistic that is, as this OB/GYN learns a difficult lesson when he plays hardball with the insurance companies:

While O'Flynn didn't work for Premier-owned Miami Valley Hospital, his offices were located there. When Premier couldn't strike a deal with the insurance company early this year, many of his patients ...

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Edwin Leap on the night shift. Well said:

It's time for night-workers to be treated, not as second-class citizens, but as the first class professionals they are, taking one for the team night after night so that everyone else can rest. It's time for night shift, already perilous enough, to stop being the entry level job for he inexperienced until they earn'something better.' It's time for us to ...

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Opera singers also overuse and abuse medications to cope and recover from performances:

Singers often overuse steroids in the form of cortisone to control inflamed vocal cords "” sometimes in amounts that can permanently impair their abilities, say performers and their doctors. Others drink too much. Still others snort cocaine, according to insiders.

Inability to cope sometimes turns into tragedy "” as in the case of American tenor Jerry ...

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More fire for Jacob Hacker's "Medicare-for-all" propaganda piece in last week's NEJM:

Dr. Hacker's only criticism of Sicko, it seems, is that it doesn't offer the solution he prefers, "Medicare for all". While praising Medicare Hacker has this to say about private insurance: "Insurers erect obstacles to care, hassle patients and doctors"¦." It's safe to say Dr. Hacker doesn't take care of Medicare patients. If he did he'd be ...

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More problems with Medicare's medical error P4P policy:

I am now more convinced than ever that policy is driven by money, politics and power, but I would have hoped someone would at least pay lip service to the science.
And in the NY Times, a letter with some real-world implications of the policy:
So, I admit Mrs. Jones, an elderly patient of mine, to the hospital because she ...

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A rare cause of nipple pain.

Some are saying that the inappropriately-high C-section rate is one reason:

Some researchers point to the rising C-section rate, now 29 percent of all births - far higher than what public health experts say is appropriate. Like other surgeries, Caesareans come with risks related to anesthesia, infections and blood clots.

"There's an inherent risk to C-sections," said Dr. Elliott Main, who co-chairs a panel reviewing obstetrics care in California. ...

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Do they reflect what matters to most Americans?

The WHO rankings have more to do with what liberals value in a health care system (fairness, equality, etc.) than what most Americans value in a health care system (quality, access, efficiency, innovation, convenience). Though this doesn't stop people like Mr. Moore from trying to convince everyone that these apples are really oranges.

It can be a problem when the many of the refill requests are for controlled substances.

"Save Grady"

A film to save the troubled Atlanta hospital. (via The Medical Quack)

Anna Pou speaks

She tells her side of the story to Newsweek:

I actually felt sorry for Mr. Foti. What he did was so unprecedented and is typically not done. I know he had his reasons for doing it, but I just felt sorry that he couldn't accept or respect the grand jury's decision. Most prosecutors, if they don't agree, they accept the grand jury's decision graciously. Basically he didn't show any respect ...

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