This is obviously causing controversy:

But the plan, which pharmacists have talked about for a decade, has some physicians worried about patient safety. Other doctors have suggested it will create a conflict of interest because pharmacists could benefit commercially from the medications they prescribe.

Nice idea, especially since many decisions in medicine are based on percentages and probability.

I was quoted today in an AMNews article talking about unnecessary testing (subscription needed). It's quite sad that despite all the evidence that the USPSTF provides, many physicians follow the ones made up by layperson juries during malpractice trials:

The real guidelines physicians follow, often unconsciously, are the ones judged to be the standard of care by jurors in medical liability trials, Dr. Anderson said.

"Medical standards ...

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Using genetic testing, they found that they had a 70 percent chance of developing stomach cancer.

It may help in rural areas:

"About 90 percent of psychiatrists and psychologists live in urban areas and about 20 percent of the population of the United States lives outside of an urban area," said Beth Hudnall Stamm, Director of the Institute of Rural Health, Idaho State University.

Dr. Tobin and her colleagues serve patients in ten counties across the state, on average each patient almost 120 miles ...

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The lawyer refers to them as "hired guns":

"These are guys who travel -- some of them travel the country -- and they fill in where hospitals are in need of staffing," he said. "Nurses do it, too.... I like to refer to it as riding the circuit. They're hired guns. They go into an area that's short of a specific specialty or need, and they fill that need."

This will be huge, as many physicians and patients will jump at the chance to use a stronger generic statin (as opposed to lovastatin):

Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital in Boston, said he has no problem prescribing generic Zocor to patients.

"It's fine," Cannon said. "It's become standard in the industry to try to use generics first."

Cannon added that Lipitor's dominance is ...

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Makes sense:

A local attorney recently offered his opinion that health care tort reform is not needed. He appealed to the emotion of the reader with sad stories about alleged victims of medical malpractice.

Too often, it is the telling of a sad story, rather than actual malpractice, that plaintiff's attorneys leverage to the financial gain of their clients and, of course, themselves.

Jurors are poorly equipped to ...

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A recent WSJ article explains why:

Socialized health-care systems fall short in these critical cases because governments strictly ration care in order to reduce the explosive growth of health spending. As a result, patients have less access to specialists, diagnostic equipment and pharmaceuticals. Economist David Henderson, who grew up in Canada, once remarked that it has the best health-care system in the world - if you have only a ...

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How sad is this? (via kottke.org)

Unbelievable.

I wonder what the other guests thought.

How ignorant:

"I'm not a fat cat doctor living in a palatial mansion in Maple Ridge," he said. "That picture of doctors is an American picture that doesn't belong in Canada, quite frankly."
Really. Tell me how many Canadian doctors are in debt after medical school.

From the letter to his patients:

"After almost 18 years of practicing medicine in Davis Square, I am looking forward to many more years as your family physician. There will be only one major change that will occur in July - I will begin practicing medicine as a woman."

That's one tough ophthalmologist:

The Tucson eye surgeon convicted last month of conspiring to kill his former partner broke another inmate's arm in a jail fight, a Pima County sheriff's spokesman said.

Bradley Alan Schwartz was reading in his eight-man cell early Monday when a fellow inmate flipped liquid from a lemonade cup at him, Deputy Dawn Barkman said.

Schwartz walked up to the other man, who threw ...

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It's happening in some parts of the country. However, capitation tends to be more expensive short-term than fee-for-service. Will insurers have the long-term vision to pay more now, for cost-savings later?

It was thought that he was drunk, and this information was relayed down the chain of care.

It's all about the cost, forget the physician relationship:

FP Michael J. Morris of Willmar, MN, thinks the insurer's approach to this issue works against its efforts (and those of other plans) to encourage primary care doctors to manage patients' overall health. A nurse at a walk-in clinic, he says, isn't likely to check patients' cholesterol, make sure they're up on their immunizations, and talk to them about their weight ...

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Flea points out that non-urgent cases pays the bills:

And finally, there is the bottom line. I congratulate the authors for recognizing the financial pressures on ED's to see non-emergently ill patients. I hasten to point out, however, that this is an explanation, not an excuse.

The IOM report confirms what I have long suspected. The ED's themselves are not motivated to fix the fundamental problem of over-use of ...

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And how the VA's EHR can solve it. I've used VisTa and it's good. Too bad the government can't see that the solution for healthcare's IT troubles is right under their nose.

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