HIV misdiagnosis

A positive is normally confirmed with a Western Blot, making false positives exceedingly rare. However, that usual step wasn't done for some reason:

Serrano's ordeal began in 1994 after an anonymous test at a clinic in Fitchburg showed that she was HIV positive. Serrano and her attorney, David Angueira, say they are unsure whether the initial test was a false positive, or if it was a record mix-up.

A ...

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Online vaccine videos

Don't believe what you see on YouTube.

"Deplorable." (via Dr. Wes)

The SGR

Shadowfax about the fatally-flawed Medicare formula responsible for decreasing physician reimbursement. Does Medicare get it? Well, you can read Secretary of Health and Human Services Mike Leavitt's blog to find out.

Richard Reece and Roy Poses with their thoughts on the matter.

He's suing the makers of heparin for the medical mishap. The hospital has already apologized. Will it be enough?

Suicide by hanging

A CT of hypoxic brain injury.

Worry

There's so much on the plate now, it's easy to lose sight of the patient:

I feel sure - or at least hope - that the good doctor still worries about their patients but it seems all the other worries - like how to keep the practice viable and not be audited by CMS and somehow be stewards of the limited medical resources, or if you prescribed the "wrong" ...

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Chronic pain in the ER

A chronic pain sufferer asks Scalpel for some honest advice:

The bottom line is that we are under no obligation to give anyone narcotics ever, so once an emergency medical condition has been ruled out, then all we really have to give anyone is our advice. Anything more than that is personal preference and medical judgment, which is quite variable (as you have undoubtedly discovered).

How physicians are trapped by the coding system: "You can't win; you can't break even; you can't even get out of the game.

Unless, that is, you really get out."

Dominic Carone talks about how much of your medical record is actually true.

They actually came out in support of single-payer. Ugh - I feel sick.

The traditional "cost containment" approach is a poor idea:

A bad idea for dealing with cost is "cost containment." What that means is cracking down on the prices and incomes of doctors, hospitals, and drug companies. Government attempts to do this run afoul of organized political opposition. Moreover, it is very difficult to implement heavy-handed negotiations on price without at some point stifling innovation and hurting quality. When it is ...

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Patients who can tell who's working in the ED by looking at their cars:

It seems that some "frequent flyers" in our emergency department actually know what cars the different ED physicians drive. When they see Dr. Feelgood's car in the lot, they register for pain complaints. When they see Dr. NSAID's car in the lot, they go somewhere else.

Gorking Grandma

Almost a third of nursing home residents are on antipsychotics:

And patients can be given the medicines, whether they are psychotic or not. The drugs are often used to calm demented patients, some with Alzheimer's disease, and to help maintain order in nursing homes, which are often understaffed and reluctant to use physical restraints. But the FDA hasn't approved the drugs for these uses, compounding the ethical questions.

The blogging hospitalist talks about a somewhat surreal appearance in 2004.

To no one's surprise, the internet and medical studies have helped lawyers find potential plaintiffs:

Using an advanced Google search strategy, we determined the number of Internet "hits" for websites soliciting plaintiffs for medicolegal action before and after publication of a study that highlighted the risk of dysglycemia among patients taking the antibiotic gatifloxacin. We found that early online release and print publication were associated with an immediate and ...

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I am consistently baffled at why single-payer pundits want to put our health care in the hands of the government. People like Ezra Klein and Paul Krugman simply don't know what they are asking for, and have zero insight into how restrictive Medicare really is for a practicing physician.

Their ridiculous reimbursement decisions, rules and restrictions are far, far worse than any private insurer. Roy Poses ...

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CT scans will go on

Despite the recent media attention on the association between CT scans and cancer, they will continue to be ordered unabated. With the current litigious climate, physicians are caught between a rock and a hard place:

"In addition, the fear of lawsuits is another reason CT scans are conducted by many physicians. Multiple successful lawsuits have been won against physicians for not performing CT scans, and the nation needs ...

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Pressure to order tests

Almost a third of physicians surveyed will bow to patients' wishes if an MRI is demanded. With patient satisfaction and physician ratings becoming more important, expect this number to rise:

"There's a lot of pressure on physicians to keep their patients happy," Blumenthal says. "Part of the problem with the American health care system has been that there is no throttle on test-ordering."

Pay physicians peanuts, they will stop accepting insurance. Watch what's happening in California.

Stand up and applaud these physicians who have taken a stand and dropped insurance plans. Doctors are tired of being extorted by third-party payers and won't take it anymore:

It's hard to say exactly how many local doctors have stopped accepting insurance because it's a private business transaction that isn't tracked by government agencies. About ...

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