Whether or not to let residents operate on you. A physician responds:

I was talking to a physician today who needed back surgery a year ago. When he went to the hospital, he demanded that no resident take part in the case because in his words "I didn't want to wind up paralyzed." Probably an extreme statement, but you get the point. So for every physician who writes in ...


Physician's don't care about making the EMR the centerpiece of the patient encounter:

"You have to realize that physicians have been trained four years in med school, then three to seven years in post-graduate training. The funny thing is that they want to take care of patients. They don't want to become specialists in creating medical records. They look at the medical record as an incidental cost of doing business. ...


Some tough talk on DTC ads and Big Pharma propaganda:

I would put journal articles funded by Big Pharma in the same category as news articles written by white supremacist groups.

A long and winding road. For those who don't appreciate what physicians go through.


(via Dr. Wes)

Saying "no" to a patient in the emergency room can provoke a spectrum of responses, including some bizarre ones:

She escalated; I explained my thought process. She yelled, she wept, and she begged. I held firm, and she was discharged. On her way out she stopped by the charting station and said, with a vicious spite in her voice, "I hate you. You are ...


Instant WBC?

They're thinking of having WBC as a point-of-care test. Is this really needed?

Also, more useless WBC's being ordered means a higher percentage of falsely abnormal test results. This inevitably leads to more clinical testing, more diagnostic dead-ends, more needless patient anxiety, and more wasted healthcare dollars.

Amy Tenderich comments on a recent speech by the ADA's Chief Scientific Officer.

Physicians at the AHA conference are firing back at Nissen's controversial Avandia meta-analysis:

The validity of Dr. Nissen's findings was challenged by Silvio E. Inzucchi, M.D., clinical director of the Section of Endocrinology at Yale. "Any minor manipulations to this information can be done to show either how much harm rosiglitazone is doing, or how much good it has done," Dr. Inzucchi claimed.

He said that in the Nissen ...


There is no cure for Type I diabetes, so it seems she was either mistaken or misdiagnosed:

. . . doctors interviewed agreed that if Berry was truly a Type 1 diabetic, it would be suicide to simply stop taking insulin. They surmised that the 41-year-old actress was either mistaken, misinformed or misdiagnosed, and probably always had Type 2, which tends to affect people later in life and can ...


More Blogger problems

Apologies for the disappearing and reappearing posts over the last few days. Blogger has been having problems publishing to an FTP site. Hopefully they are now fixed.

There are some posts were the comments don't show up. I fixed most of them, but if there are any I missed, please let me know.

"Suicide tourism"

NYC is a good place to die for many people.

Good, fast, or cheap

When it comes to health care, you can only have two.

Exploring the case of Julie Thao.

DrRich explains why:

. . . they are also a particularly compelling example of how covert rationing inherently fosters waste, profligacy, inefficiency, and tangled and counterproductive incentives, throughout the healthcare system - even in the private sector, whose proponents invariably extol its natural efficiency.

A plastic surgeon talks about this condition that affects 2-10% of women.

How you get treated depends on who the physician is:

When you go to your doctor or to the ER its a crapshoot what care will be given and what tests will be done. It depends on the doctor. It depends on the doctors experience. It depends on the doctors fear of liability. It depends on whether you have insurance.

An ER physician suggesting that not everyone needs to be admitted? That's going against the grain.

Free health care is like "buying your friend a prostitute." (via Catron)

How the government is holding medicine back from the electronic age:

If any of you are wondering why your own doctor doesn't communicate with you using email, IM, and other ways that simply make sense in today's world, wonder no further. They break federal law with every email and IM since the vast majority of physicians have contracts with insurance companies or Medicare.
Also interesting how Jay Parkinson flaunts breaking ...


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