A useful cancer drug, where cost is prohibitive:

Doctors are excited about the prospect of Avastin, a drug already widely used for colon cancer, as a crucial new treatment for breast and lung cancer, too. But doctors are cringing at the price the maker, Genentech, plans to charge for it: about $100,000 a year.

This plaintiff's hired gun blew up in their faces:

Testifying for the plaintiff was Dr. Chadwick Smith, professor of arthritic surgery at the University of Southern California and a world-renowned practitioner and expert in orthopedic surgery.

"The standard of care was not met," Dr. Smith had said under oath "This patient is much worse after the operation."

Dr. Smith testified in court under questioning from Fitzgibbons that ...

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A doctor and a lawyer debate malpractice. Surprise, they disagree:

Medical malpractice costs less than 2 percent of overall health care spending in the United States, according to the Congressional Budget Office's 2004 report "Limiting Tort Liability for Medical Malpractice."

"Anything you do in the legal system you can't make much of a difference as for the cost of medicine," Corson said.

When politicians think they know more about medicine than doctors:

Last week, Colleges and Universities Minister Chris Bentley announced plans to train an extra 104 doctors at several universities, including the University of Ottawa, over the next few years at a cost of $20.8 million.

Ironically, the government is now trying to address a doctor shortage that was deliberately created by governments in Ontario and across Canada just over ...

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Following up on the story that kimchi helps halt bird flu, comes the kimchi air conditioner:

The new air conditioner filters the air through a chemical mix that includes an enzyme extracted from kimchi, which is reportedly capable of eliminating the H5N1 virus.

Doctors respond to Mitch Albom's long wait for a lab test:

Forty-five minutes for a blood test! Outrageous, disrespectful, unfair and a waste of time. Mitch Albom should shift his medical care elsewhere -- unless, of course, he has no choice, like the 1.5 million Michiganders who are either underinsured or uninsured. Or maybe he has Medicaid, which reimburses only 39 cents on the dollar charged, or Medicare, which ...

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20 percent of people with chronic pain do not seek help.

Behold the official New York City condom:

The city's Department of Health and Mental Hygiene announced plans on Monday to release an official city condom "with unique packaging" in the coming months, the idea being both to promote safe sex and to allow the department to track more easily who uses the million condoms it gives away each month.

The recently publicized mortality-predictor questionnaire: "Do not try this at home."

Another possible use for it is in future pay-for-performance initiatives:

The researchers think their mortality predictor might be a useful tool in the "pay for performance" trend that is part of the nation's health care system. Medicare and other insurers are increasingly basing reimbursement rates on how patients fare, said Covinsky.

"One health plan can look ...

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Did the AMA bow to Congressional pressure on pay-for-performance? Yes, according to these two memos:

By the end of 2007, physician groups will have developed performance measures to cover a majority of Medicare spending for physician services.
Here is a link to their previous stance.

An ER physician talks defensive medicine.

So it makes me a little crazy when it's claimed that doctors aren't motivated by fear of lawsuits -- we are. Now if you want to claim that the overall fraction of healthcare dollars spent on defensive practice is low -- 1-2% of all spending -- I might agree with that. But bear in mind that the healthcare expenses in the US are ...

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Drug reps in the UK took physicians out to strip clubs.

A doctor was forced to implant a screwdriver shaft during an orthopedic surgery:

"There on the back table was a sterile stainless steel metal shaft of a screwdriver that measured the same diameter as the rods that I intended to use. I then used a bolt cutter and measured the rod just to be sure. I then put bone graft on both side in order to fuse his spine. The ...

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The athlete's physical - echocardiograms for everyone? This doctor is in trouble for missing a heart condition in a 16-year old who died suddenly.

Save auto industry jobs by reforming legal system. Punitive caps, frivolous lawsuits, eliminating "judicial hellholes" . . . sound familiar? (via Overlawyered)

Pfizer is considering marketing torcetrapib on its own. This is the new HDL-raising drug in the pipeline. In a move to protect their profits, it was originally only paired with Lipitor. Has Pfizer come to its senses? We'll see:

"The current trial designs might not optimally meet the scientific needs of prescribers, the clinical needs of patients, the economic needs of payers, or the regulatory needs of policymakers," wrote Professor ...

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Most are unhappy with penis-enlargement surgery. "Experts said spam e-mails and advertising were giving men unrealistic expectations about penis surgery."

Many stroke patients miss out on clot-busting drugs. However, consider what is going through the minds of ER docs when deciding the use the drug:

I abhor TPA. I too am a Board Certified ER Doc. Now if a patient comes in having an acute stroke, I can be sued for giving TPA ("He didn't explain the risks well enough") I can be sued for delayed treatment with TPA ...

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intueri brings us the Valentine's Day edition of Grand Rounds. Come get the best of the medical blogosphere, personal-ad style.

In doctor's office, it's hurry up and wait. Mitch Albom waits 47 minutes for a blood draw:

Forty-seven minutes. I am led inside. They stick the needle. I press the cotton. I put on my coat. I exit the office. The faces don't look up, but I know what they are thinking. They are thinking, "How long?" They are hating every minute of it.