I harped on this before, now another physician feels the same way:

As a practicing general internist, I feel like an endangered species.

I am in my mid-50s, and planning my retirement. I have watched many of my colleagues leave the practice of general internal medicine, and I have seen few younger colleagues replace them.

There are many factors that cause general internists to leave the practice, ...

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Great story from the WSJ.

It's part of Google Co-op. MedGadget with more details.

A view from the other side (NEJM - subscription required). This time it's George Annas, the medical ethicist and JD from Boston, with a dissenting view on the malpractice problem:

Like most defendants in tort litigation, physicians have always despised malpractice suits. Even those who consider litigation appropriate in cases of serious injury to a patient still think of the system as fundamentally flawed and corrupt. But modifying ...

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This doctor wants the funds diverted to more common problems, like cancer:

A senior medical health officer from B.C. has issued a warning that too much money and resources are being poured into pandemic planning, when the real threat is low.

Speaking at a disaster forum in Banff, Dr. John Blatherwick said the $400 million set aside in last week's federal budget for pandemic planning would be better spent ...

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He laments:

People, malpractice is one percent of the dollars, and it's about 17th on the list of major health care problems and issues we face in this country! It's the abortion issue of health care - polarizing way way beyond it's importance.
Deal with it. With 40 percent of malpractice cases being baseless, there is certainly reason for the obsession with malpractice. When physicians let ...

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This one has potential, unlike Pfizer's inhaled-insulin dog Exubera:

The U.S. Food and Drug Administration said on Thursday it approved Pfizer's Chantix tablet to help cigarette smokers stop smoking.

The active ingredient in Chantix, varenicline tartrate, acts at sites in the brain affected by nicotine, the FDA said.

The drug may help smokers trying to kick the habit by providing some nicotine effects to ease the withdrawal symptoms, ...

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Just how many do we need?

For a host of reasons, at least half of patients fail to comply with the treatments their doctors prescribe. Dr. Edward C. Rosenow III of the Mayo Clinic College of Medicine calls compliance "the sixth vital sign," as important as respiration, heart rate, temperature, blood pressure and pain in evaluating a patient's medical status.

Some of "coma effects" probably doesn't film well:

Not showing typical coma-related effects such as muscle wasting, bed sores and incontinence may be a conscious decision on the part of filmmakers to "maximize entertainment but is a disservice to the viewer," they write in the journal Neurology.

Both sides of the tort reform debate are using this study as ammunition:

About 40 percent of the medical malpractice cases filed in the United States are groundless, according to a Harvard analysis of the hotly debated issue that pits trial lawyers against doctors, with lawmakers in the middle.

Many of the lawsuits analyzed contained no evidence that a medical error was committed or that the patient ...

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This doc goes overboard while on vacation:

Even when I'm on vacation, I can manage my patient's care thanks to a program called pcAnywhere that gives me remote access to the office network. When I was in Aruba with my family last year, I used pcAnywhere to view lab results in my EHR and prescribe medications.

Microsoft’s EMR

Microsoft Word that is. This physician explains how he does it.

Fascinating story from the New Yorker. (via kottke.org)

Trephination is an ancient surgical procedure where a hole is drilled in the skull. This kit is circa 1750. (via Boing Boing)

That's pretty underhanded:

Five nonprofit Southern California hospitals alleged in a lawsuit Monday that Blue Cross routinely authorized surgery and other expensive treatment for its members and later refused to pay.

The suit is the latest development in an unfolding scandal over charges that the state's largest health plan operates a special department that illegally searches for excuses to dump individual policyholders after they develop costly conditions, such as ...

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Kaiser relents

Regarding the kidney transplant scandal: "Let me put it this way, (Kaiser) will do what the patients want them to do."

To nobody's surprise, some are going overboard with fear after viewing the bird flu movie last night:

After watching the ABC movie '‘Fatal Contact: Bird Flu in America' last night, telephone helplines from all over the USA have been receiving calls from anxious viewers. At Medical News Today we have received 112 emails from people in the USA with questions ranging from '‘How could other countries be so selfish ...

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See if you can tell the difference.



All signs point to Google Health coming tomorrow. Here is what the blogosphere is saying.

blogservice:
"'What constitutes credible health care information on the internet. Is there room for emerging and new discoveries, opinions, views of clinical experts?' These are good questions. Medicine is as much of an art as a science. Allowing people to access information from many sources is ...

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Prescribing in the absence of any evidence occurs about 15 percent of the time. (via a reader tip)