Leaving AMA

Physicians have different takes on patients leaving against medical advice. Some would gladly show patients the door. Others would really try to fight to do what's best, like this resident:

"We tried deals and scare tactics, telling him as clearly as we could that he was more likely to die if he left this way," writes Dr. Viviany R. Taqueti. "When he countered with 'that is up ...

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(via Street Anatomy)

Maria calls it extortion. While reading the piece, I was waiting for the punch line: "Practicing medicine while board-certified: priceless."

Chris Rangel has emerged from his blogging sabbatical with some great stuff about physician-employees and incentives:

But as an incentive the company agreed to pay this local internist PER PATIENT (just like what any self-employed doc gets). This internist was only too happy to comply. He got to the hospital at 4 or 5 am, saw patients until 10 or 11 am, then went to see his office patients until ...

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The potential case of the year.

Investor's Business Daily with their take:

"Sicko" is bombing - financially and politically. After three weeks in wide release, it has managed to scrape together just $15.8 million in box office receipts. For most documentaries, that would be a notable take. But given the expectations, this is an enormous failure.

Box Office Mojo, which tracks ticket sales, notes that the movie will struggle to match "Bowling for Columbine," Moore's ...

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The outrage continues as radiologists are excluded from the mix. (via GruntDoc)

Futile care

Another large driver of health care costs comes under scrutiny:

"The biggest problem here is futile treatment," he said. "That's when it's clear after some time that a patient, under normal medical circumstances, is never going to get better.

"People say there could be a million in one chance of recovery, but we can't work that way."

A doctor in Canada suggests offering vaccines in bars to reach young adults.

Gawande on Sicko

In a New Yorker op-ed:

"Sicko" doesn't really offer solutions. Yes, it visits France. But it doesn't discuss the difficulties of reforming a system that encompasses sixteen per cent of the economy. It doesn't investigate the tradeoffs that universal health care will inevitably require. It's an outrage machine.

Sanjay Gupta takes us inside the OR:

Then, the procedure began. You could immediately notice the diseased part of the lung. A healthy lung has a very smooth border. It almost glistens, and it has a reddish look about it.

But Speaker's diseased area had a lot of bumps on it. Other parts of the lung were much darker. It almost looked like some of the cells had ...

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Dr. Rob connects the two.

Harvard Pilgrim CEO Charlie Baker explains the byzantine world of the Explanation of Benefits.

Competition from generics are hurting Zoloft, Norvasc and Lipitor sales. Torcetrapib was supposed to save them - but now the pipeline looks pretty empty.

From India



(via Running a hospital)

Some are wondering about the double standard that exists:

"So how come it's okay for patients to blog about their psychiatrists, without disguise, without permission, without hesitation?"

I just had to address this because this one-sidedness (if that's a word) is something I see in the correctional world. Here's how it happens:

Inmate X gets released and goes to the media. He/she alleges that the correctional facility, ...

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Kudos for the WSJ for publicizing risks of cardiac CT testing. Not enough emphasis is placed on the potential risks of the latest and greatest diagnostic tests:

The authors concluded that the lifetime risk of cancer attributable to 64-slice scans, used to diagnose heart disease, varies widely. It's highest for women, younger patients, and for scans that look at the aorta and coronary arteries. The risk for cancer ...

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One of the risks of a blogging hospital CEO.

NBC's Robert Bazell on Sicko's use of the bone-marrow/kidney cancer case:

Almost any insurance plan would have turned down the request for an experimental treatment, with no proven value, costing tens or hundreds of thousands of dollars. It is critical to note that the national health plans in Canada, Great Britain, France and Cuba that are featured in "Sicko" would also have turned down such treatment. No matter where ...

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Regarding the surplus of Texas physicians:

What happened next is worth remembering the next time you feel cynical about politics. The legislature took steps to make it cheaper, and they worked.

Our state leaders effectively lowered the cost of medical malpractice insurance 20 percent by capping the awards for "non-economic" damages that lawyers could win against doctors. Runaway verdicts became a thing of the past. The medical malpractice ...

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