New York City is offering discounts on eClinicalWorks if 30% of their patients are enrolled in state-funded insurance programs, such as Medicaid. That's a pretty big catch.

Major media eagerly lapped up hype for a medical device. Now that Medicare has rejected it, will they be so enthusiastic in reporting it?

A psychiatrist has an epiphany:

A drug salesman chided him one day for showing "less enthusiasm for our product" than usual and "I had a kind of epiphany," said Carlat, also on the faculty of the Tufts University School of Medicine. "I realized the obvious -- that I was being paid to say good things about drugs, regardless of what my actual opinions were."

Artist Koen Hauser comes up with some slightly freaky images of digital manipulation.



(via Unbounded Medicine)

Boy with earache

A most surprising cause:

Dr. David Irvine said it looked like the boy had something in his ear when he examined him.

When he irrigated the ear, the first spider came out, dead. The other spider took a second dousing before it emerged, still alive. Both were about the size of a pencil eraser.

Futile care

How some are abusing EMTALA in futile cases:

Zee Klein wasn't about to just let her mother die, no matter what some hospital committee decided. But instead of waging a high-profile fight against the hospital, she decided to get her mother out on her own.

It wasn't going to be easy. For one, Medicare wouldn't cover Pereira's care if she were transferred to Christus St. Joseph, the downtown hospital ...

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Pretty impressive image from Radiology Picture of the Day.

Panda Bear tells it like it is on complementary medicine:

It wants to be legitimate but manages to avoid the responsibilities and liability of real medical practice. As most CAM treats nebulous symptoms with equally nebulous modalities, there is no measurable standard for efficacy of any of the treatments . . . There are no bad outcomes just as there are no good outcomes. It's all highly subjective. ...

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"Hand in a Box"

Another med student short. The trials of male medical students during an OB/GYN rotation.

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HIV and Eminem

Learn about HIV/AIDS via rap.

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Do not call back is the take-home message:

Of the many reasons a plaintiffs' attorney might call you, none are to your benefit. If the attorney thinks you have some malpractice liability, he may want to pump you for information in the hope that you'll say something that will make his case for him. Or if the primary defendant is a doctor who treated the patient before you did, the ...

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More frustration boils over in this letter:

I can not think of a single colleague who enjoys practicing medicine due to the fear of litigation.

Lawyers are only too aware that they don't need to be correct but to have just enough information to convince a jury of laypeople. Why is there rarely a case brought against a lawyer for a frivolous lawsuit? Why isn't it automatic for the ...

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As pay-for-performance takes hold, get ready for more of this:

Should I start statins on the drooling demented to lower their LDL? Should I preach to paranoid schizophrenics that they must quit smoking? Doing so might help ease my burdens"”will it ease theirs? Without a financial incentive, I treated practice guidelines as guidelines, and I treated patients as patients. With financial incentives, will the guidelines become my goal? Will I ...

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Talk about a career change. (via GruntDoc)

It can get pretty bloody.

The assault continues on his credibility. David Catron, Michael Cannon and David Hogberg take their turns.

I did my residency at Boston University, where I'm proud to say had one of the few house staff physician unions. There is no question in my mind that if we were allowed to, physicians should unionize.

Health Care Renewal has more in response to the layoffs happening at Merck:

The union members (largely clerical, administrative and skilled labor) have ensured job security for themselves, ...

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Their sensational, media-grabbing reports on medical errors are eroding trust in the medical profession, which is not always good:

The now famous IOM report on medical errors - To Err is Human had as a goal to improve medical care. The authors, honorable though they are, contributed to decreasing trust in our medical institutions. Many have debated the validity of this report, but few would debate the negative impact ...

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Complaining

Should it be suppressed? Medpundit on patients who complain:

Constructive criticism isn't a fault, but constant complaining for the sake of complaining is. We see this a lot in medicine- patients who refuse or reject every treatment recommendation for a specific complaint but then continue to return with the same complaint. All treatment options have been exhausted, and still the complaints continue. It's usually at that point that ...

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It's about time our professional societies joined the 21st century - I'm still waiting for the ACP to start one. Here's what they say about the upcoming MinuteClinics set to invade Massachusetts:

They could kill our fragile primary care system. Our primary care network is already in crisis. Allowing mini-clinics to skim the easy, less complex patients might be the death knell of primary care, and our ...

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