Joe Paduda writes:

It appears the answer lies in declining reimbursement rates. These hard-working docs are spending plenty of time (over 45 hours a week) with patients, but their reimbursement rates have not kept pace with inflation. For example, Medicare has increased fees by 13% during the study period, while the underlying inflation was 21%. And, private payers' reimbursement declined from 143% of Medicare's rate in 1997 to 123% in ...

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The BMJ has this unfortunate case:

According to the BBC, the British Medical Journal cites the case of a 15-year-old girl who was struck by lightning in a London park while talking on her phone. She suffered a burst eardrum and cardiac arrest and, a year later, "has severe physical difficulties as well as brain damage which has led to emotional and cognitive problems".

This is one plausible solution to malpractice reform that I've always supported. Dr. Charles writes more on a bill introducing health courts:

Our lawsuit culture is disgusting. Anyone who stands up to do anything of consequence in our society is at risk of being sued for it. Teachers, policemen, doctors, coaches, ministers - we're generally trying to make the world a better place, but we're all living in fear, ...

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A small, unscientific survey to be sure - but I'm not surprised by the results.

It makes it harder for hospitals to fire physicians, since this doctor is making the hospital beg for mercy:

Randall Andrada, who represented Fremont-Rideout Medical Group, declined to comment following the Wednesday's verdict. During the closing statements, he said the hospital leadership "got the message" the jury sent with Friday's award and pleaded with the jury not to award additional monetary damages.

Primary care is facing the same challenges and deterrents in Canada as well:

Dr. Brian Berger, who has a family practice in Richmond Hill, says many young doctors stay out of family medicine because it's too time-consuming. He says young doctors have other priorities, like spending time with their families or pursuing other interests.

"More doctors want to do sort of part-time family practice. A lot of people may ...

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They are trying to drive generic drug makers out of business:

It's a novel approach in the long battle between brand name drugs and their generic rivals: Merck & Co. is slashing the price of its cholesterol drug Zocor so low for one insurance plan that members will actually pay less for the original pills than for the generic.

That tactic has some consumer advocates fearing the practice will ...

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Dr. Centor outlines a fundamental reason why medical students are avoiding primary care:

Some would argue that this is really a lifestyle issue. I would argue that money drives lifestyle. Family physicians and general internists have responded to lowered reimbursement by increasing the number of patients they see each day. These increases must decrease quality of care and decrease physician satisfaction.

Shawdowfax speculates:

The most common proposal I have heard for government-funded single payor health care is something along the lines of "Medicare for all." The clear implication from this, for physicians, is that all patients would be reimbursed at the same rate. While you would think this is a good thing, I expect that many doctors would fight it tooth and nail. For a ED group that is well-managed ...

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Disturbing news coming out of China:

WHO was surprised by the report, which came not from the Chinese government but from eight scientists in a research letter in the New England Journal of Medicine.

"We will formally request the Ministry of Health to clarify this," and why it has taken more than two years to come to light, said Roy Wadia, a WHO spokesman in China.

The expert witness was shown to demonstrate "a lack of adequate subject matter knowledge", but is protected when his professional society tries to sanction him:

A Baton Rouge federal judge has issued a temporary restraining order against a national medical association, protecting a prominent local neurosurgeon who claims he is the victim of a professional smear campaign.
(via This Makes Me Sick)

Another pro-reform citation of the Studdert study:

Dr. Bret DeLone, a Harrisburg-area surgeon, disputes the association's conclusion that the system is working well. He pointed to another study, published last month in the New England Journal of Medicine, that said more than half of the money awarded in medical malpractice lawsuits went to attorneys' fees and administrative costs.

"That's where the money ends up. ... Of course ...

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This is probably done to combat the increasing use of elective colonoscopies, which is costing insurers money:

The American Gastroenterological Association issued a statement Monday charging the insurer's pending new policy on performing outpatient endoscopies "will hinder the medical judgment of physicians as to the proper setting for endoscopic procedures, based on the specific needs of individual patients." According to the medical group, Blue Cross of California, ...

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Some say they are putting lives at risk:

The member, who did not wish to be named, works at a Southampton hospital. She said mistakes over the term 'hypo" and "hyper" had already been made by overseas staff who were nowhere near the doctor concerned to clarify his dictation . . .

. . . Other blunders included writing "known malignant" instead of "non-malignant", "urological" instead of "neurological" ...

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It's based on employer mandates:

San Francisco, eager to put its own stamp on the health care debate, unveiled an ambitious plan Tuesday that would make it the first city in the nation to provide every uninsured resident with access to medical services.

When rolled out next year, the city's 82,000 uninsured residents would become eligible for a wide array of benefits, regardless of employment or immigration status. ...

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This supposed controversy should never have gotten this far:

"It saddened him to see that knowledge was twisted in such a way to play in the hands of the anti-vaccine movement and not really appreciate what vaccines are all about.

"They are about protection of individual, but also protection of the society so you achieve 'herd immunity'.

"Maurice believed in that and it really pained him a ...

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I often have patients who stop taking their statins or refuse to take them because of "side effects". This can range from muscle aches to memory loss (the latter side effect of which there is conflicting data for).

One option would be to switch to a more hydrophilic statin - like pravastatin (now generic) - which have been shown in studies to decrease the incidence of muscle aches ...

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Studies show that home games increase testosterone levels:

Two new studies also show how the hormone may especially peak before home games, and that female athletes likely experience the same hormone flux.

The first study, of male ice hockey players, found higher testosterone levels in athletes competing at their home rink, compared to playing an away game. The other, a Portuguese study of female soccer players, found that ...

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Dr. Hebert writes about his frustration.

PointofLaw.com wonders why more lawyers don't get sued after losing a case:

The fascinating thing is that lawyers are never subject to that level of second-guessing. In any given litigation, one or both sides to the dispute ends up with less than an optimal result. In any given litigation, both sides' litigation decisions can be second-guessed. Yet, even with hundreds of millions of dollars at stake, one almost never sees ...

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