Check out the anger on the NY Times blog. Is it defensive medicine or money? The answer is yes. (via The Health Care Blog)

The war may be over

And the drug companies have won. A piece well worth reading by Medpundit:

I've grown used to patients requesting drugs their friends have recommended. I've grown used to patients insisting that certain drugs are the best in their class, based on nothing more than television commercials. I've grown used to the cozy relationship between drug companies and medical celebrities. But, when my favorite cardiologist, a man I've known ...

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Seems like the doctor did everything within standard of care:

The Blair County civil court jury found Dr. Debra S. Pike of Roaring Spring negligent in treating 39-year-old Cynthia Storm of Hollidaysburg, who went to Pike in January 2002 after discovering a lump in her breast.

The doctor conducted mammogram and ultrasound tests, which did not detect a tumor. Storm continued to say she felt the lump during doctor ...

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A third of married individuals said they would choose someone other than their spouse as their proxy.

Apparently, he was reciting his evening prayers.

Hey, it's working for the drug companies:

In one sense, the ads have been successful. The Kaiser Family Foundation found that every dollar drug companies spend on ads brings more than four dollars in additional sales. But for most others, the result has been soaring medical insurance costs, toxic side effects, and new tensions between doctors and patients, who increasingly badger doctors for the drugs they've seen on TV.

I would tend to agree with his assessment:

At one end, there's the growing field of concierge care. People pay from $1,000 to $10,000 a year just for access to a doctor. The doctor has a lesser workload, and the patient in theory gets more personal attention.

At the other end is emergency rooms, public health clinics and practices that handle high volumes of people with little personal attention.

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Beware the "car curse"

A physician commits suicide after being involved in three car accidents in two days. He believed he was cursed.

Physicians are becoming alarmed:

Dr. Frank Madda of the DuPage County Medical Society said chain clinics "will certainly drive many family-practice physicians, pediatricians and internists out of business. This will result in a decrease in the availability of physicians for all patients."
I don't think that physicians will go out of business because of this, but it does highlight an important consumer priority. Simply stated, patients want access ...

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This is what you get when you reimburse for quantity. Remember, more healthcare isn't always better.

An uncommon case of jimson weed poisoning.

This patient was in the ICU for pneumonia. It took about a year to fully recover.

There is concern about unnecessary exposure to radiation. As stated previously, these tests are useless.

Typically only 10 units is given, along with glucose. Predictably, this did not end well for the patient.

Dr. Hebert takes exception:

Ms. Freeman's death was a very famous event. You know her, even if you do not think you know her. Pictures of her body, slumped in a wheelchair and draped with a blanket, made the lead news story on every continent a year ago. She will remain one of the enduring images of Hurricane Katrina in the minds of everyone in the city, and for ...

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Chris Rangel wonders why he's ordering a CT scan on this 95-year old:

Physicians are trained to do react to symptoms with tests and treatments and to proceed in this direction until a cure is achieved, the problem resolves, comfort is attained, or a terminal/incurable condition is found. But this 95 year old had dementia, diabetes, hypertension, and unexplained anemia. I was in a gray zone here. Was being 95 ...

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May 2005 - One of many posts lamenting what the death of primary care means:

No one wants to wait two weeks to see a doctor. In fact, no one wants to wait an hour in my waiting room. People are much more concerned about getting things done on demand, and they have difficulty finding a primary care doctor who will see them promptly.

May 2005 - A frivolous lawsuit is filed against a physician:

A frivolous lawsuit is filed after a physician suggested hospice care, but the patient lived. Although the majority of lawsuits that do go to trial are won by the physician, the mere act of being involved in a frivolous lawsuit is quite disruptive. Lawyers are paid to be in the courtroom - physicians are not. Every minute spent ...

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May 2005 - The AMA starts charging for access to American Medical News. The medical blogosphere takes exception to this short-sighted act.

March 2005 - A case where a little defensive medicine would have saved this physician:

The physician tried to rely his clinical acumen to make the diagnosis: "Doctors are not magicians or wizards. They can only base their result on what they hear."

This got him into trouble by missing the gallbladder disease. It would have possibly saved the patient, and kept the physician out of the courtroom, ...

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