E-mail and medicine

"The revolution will be e-mailed," says a gleeful op-ed in the NEJM. Medicine is about 10 years late to the party. That's nothing to celebrate.

Midwives are facing rising malpractice costs which birth centers are finding harder to cope with:

Another reason that we are losing birth centers is because they, and CNMs more generally, face rising malpractice insurance costs that make continued operation financially infeasible. Midwifery care costs insurance companies less that hospital births, but this makes it harder for birth centers to offset the rising costs of their insurance. Also, obstetricians are increasingly ...


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(via Health Care BS)

The dilemma facing private practice cardiologists today:

As such, he refuses to perform what Happyman calls the "trifecta" of ECHO, stress test and holter on every person that walks through the door. This left him the option of seeing, as he puts it "100 patients a day". He is now joining a practice at a hospital across town.

So the message appears to be that if you are ...


A recent study confirms what has been suggested here and elsewhere - there is a pro-screening bias in the media, which often comes from the journal articles themselves:

We identified 854 articles, and 143 were eligible for the study. Most were original research. Benefits were mentioned more often than harms (96% vs. 62%, P<0.001). p="0.03).
(via Schwitzer)

Must read op-ed on the effects of the Lucia case in Florida:

Dr. Haedicke was on call for Memorial Hospital and came in to see her. He evaluated her, drained her abdomen, ordered antibiotics and consulted four other physicians (who were also sued) to evaluate her condition. Her own surgeon returned to Tampa later that afternoon to assume care. Dr. Haedicke had seen her for a total of five hours.


I have written previously about the importance of your Google reputation. Now, there are some firms to specialized in clearing up negative or misinformation. The WSJ with more:

Ms. Parascandola set out to minimize the bad publicity. She hired a company called ReputationDefender Inc. that promises to help individuals "search and destroy" negative information about them on the Internet. Businesses and others have long employed so-called ...


VA "facts"

Single-payer cheerleaders often point to the VA's pseudo single-payer system to support their cause. However, can their statistics even be trusted?

Some have suggested this to be a mechanism to control health care costs. I actually think this is a good idea, and would provide global standards to reduce practice variation.

As I stated in my defensive medicine piece, the presence of evidence-based global standards of care would also help in reducing defensive medicine:

A simpler way would be to have clinical, evidence-based, guidelines globally applied to malpractice ...


Doctors who continue to do this are akin to gamblers.

It worked. 15 physicians responded to the recruiting ballad.

So-called "mystery shoppers" are secretly taking notes about waiting room service:

The note-taker is a mystery shopper, one of a new breed of hospital employees in Boston and nationwide who secretly watch fellow workers to see whether patients are treated courteously and helpfully.

ER boarding

Overecrowding has led to an increase in boarding (the practice of treating patients in the ER hallways):

The group sent a 10-question survey about boarding to its 2,821 members in New York State, New Jersey and Connecticut. In New York, 28.2 percent of those responding said they "personally had experience of a patient dying as a result of boarding."

In Connecticut, 16.2 percent of the doctors responding said ...


More from the case at Martin Luther King Jr.-Harbor Hospital last month:

In the 40 minutes before a woman's death last month at Martin Luther King Jr.-Harbor Hospital, two separate callers pleaded with 911 dispatchers to send help because the hospital staff was ignoring her as she writhed on the floor, according to audio recordings of the calls.

"My wife is dying and the nurses don't want to help ...


Lawyer drug ads

DTC ads are ok, but Big Pharma is taking exception to lawyers' ambulance chasing ads:

But there's more than a little irony here. For years, drugmakers have been criticized for ads that minimize risks, and push consumers to ask docs for scrips. The issue is so contentious that Congress is weighing limits on DTC advertising. But when lawyers run ads - well, that's a problem.

For those wanting "free" health care - you get what you pay for:

Providing the high level of medical care that is expected by the American public is not cheap. Attempts to nationalize, socialize, quasi-socialize, or we-swear-we're-not-going-to-socialize will do nothing to lower costs unless medical care is strictly and severely rationed.

Physicians are encouraged to tell it like it is when dealing with child obesity:

The recommended terms cut to the chase, at least medically, but don't mean that doctors should be insensitive or use the label in front of every patient, he said

"We need to describe this in medical terms, which is'obesity.' When we talk to an individual family, we can be a little more cognizant of ...


A JAMA study suggests that race matters:

What Popescu found was that that black patients were less likely to receive invasive, aggressive treatments following a heart attack -- procedures like bypass surgery or receiving an artery-opening stent.

Rising Cesarean section rates and how lawyers like John Edwards are the root cause.


The NY Times with a profile. Unsurprisingly, they lack corporate support:

Not surprisingly, Cafepharma lacks corporate fans.

Pfizer, the subject of the site's most popular bulletin board, declined repeated requests to discuss Cafepharma. Shreya Prudlo, a spokeswoman, said that Pfizer monitored every "communication channel" that reached its constituency, and that each needed to be "viewed based on their accuracy and integrity."

Medtronic, which has the busiest ...


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