Ambien for depression?

Are you kidding me?

They recently announced they will not appropriately reimburse some cancer drugs. The Cheerful Oncologist is baffled at this decision:

What on earth is going on here? Why would our government reimburse cancer care providers for less than the actual cost of a new lymphoma treatment, not to mention the cost of the physicians, nurses, equipment and space needed in order to give the treatment at the correct dose, in ...


Medicare Part D

Despite what you hear, seniors are pretty happy with the plan:

This year, 87% of those enrolled in a plan said they were very satisfied or somewhat satisfied, up from 75% last year. And 71% said they're not likely to switch plans next year (private companies offer different flavors of coverage).

The FDA suggests genetically testing Asians before giving the anti-seizure drug carbamazepine.

Croc backlash

Let the assault on Crocs begin. Some pictures of a mangled Croc and foot courtesy of an escalator.

(via Well)

Boxer’s Fracture

Don't try to fool Dr. WhiteCoat.

Doing something right?

Or as the Boston Globe says, "Americans may be too fat, but at least their cholesterol is low."

Nuclear scans around the world are being put on hold. A look at the Canadian politics behind the situation.

A small sample of what will happen once we hand over the healthcare reins to the government:

Perhaps we could give the government a trial run as a healthcare insurer by letting it handle a smaller prototype to see how it would do. Oh, wait. Medicare reimbursement is going to decline 10 percent (did any of my expenses decline 10 percent last year?); our local government-run city hospital ...


Mammogram accuracy

Apparently, it varies by radiologist:

They found that sensitivity -- the ability to accurately detect cancer -- ranged from 27 percent to 100 percent. False positives ranged from 0 to 16 percent.
Those are some pretty big ranges.

Conveniently forget how we got to this mess in the first place.

Nursing home care

In some cases, it's a disgrace:

The staff in nursing homes are very poorly paid, therefore you can't attract and retain high quality people - for example: a nurse my hospital fired for falsifying documentation and coming to work with alcohol on her breath now works at the local SNF. Those corporations are going to hire the minimum amount of staff they can get away with.

Anyone who takes on Paul Krugman gets high marks in this corner. Obama did, and now is facing the wrath of the progressive bloggers. See how this is a good thing:

Obama's greatest strength may be in understanding the views of other political groups far better than those who attack him. Seeing Obama pursue a liberal agenda while still managing to differ from the orthodoxy of the Democratic ...


Daniel Carlat uncovered a potential scandal. Roy Poses with further analysis:

It seems that many trusted medical or health care institutions are now connected to some favored health care corporation(s), and many physicians, academicians, and academic, government, and not-for-profit health care leaders have part time gigs for such companies. The complexity of such relationships sometimes defies understanding. Who can you trust? Who really is for patient care, education, ...


With a disproportionate composition of sub-specialists, this shadowy group is skewing the reimbursement pot against primary care:

The story of the RUC often reminds me of conspiracy theories. They (we never really know who they are) determine the fate of the world (or at least the economy). The RUC has disproportionate power and has apparently taken a reasonable idea (RBRVS) and may have corrupted it.

Licensing drug reps

Washington DC is thinking about this. A good step if it goes through.

Dead en route to the ER

The decision whether to bill for the encounter or not.

Striking a nerve

Scalpel, as always, does a good job of that.

Too many doctors?

Dartmouth has long advocated that there are too many physicians. Perhaps some clarification is in order. There are too many proceduralists, not enough generalists. If primary care is appropriately incentivised and its numbers increased, the cost problem will be solved right there.

All for one patient in one year. No wonder the system is going bankrupt.

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