Two MGH psychiatry residents travel to Ethiopia and find a huge need for mental health help:

Only a handful of overwhelmed doctors staff this 360-bed hospital -- not surprising given that the entire country of 75 million people has just 17 psychiatrists and 190 psychiatric nurses.

Earlier this year, two psychiatric residents from Massachusetts General Hospital traveled to the Addis Ababa hospital as the first participants in a ...

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Editorials blast the recent partial-birth abortion ruling:

"With this decision the Supreme Court has sanctioned the intrusion of legislation into the day-to-day practice of medicine," writes Dr. Jeffrey M. Drazen, the Boston-based journal's editor. Physicians are open to oversight and discussion of delicate matters, he says, but those discussions should occur "among informed and knowledgable people who are acting in the best interests of a specific patient."

The ...

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Transvaginal surgery for GI procedures may be the new minimally invasive standard. It takes some getting used to the idea:

The idea, he says, is to offer patients operations with less pain and fewer visible scars.

And the notion makes sense. Such procedures would allow surgeons to avoid cutting through a patient's abdominal wall, which contains a bounty of nerves and takes time to heal.

"The ...

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Prostate enlargement and bradycardia: the latest case from the NY Times.

Caffeinated soap

Too lazy to brew coffee?

Inventors have created a soap infused with caffeine which helps users wake up in the morning.

The soap, called Shower Shock, supplies the caffeine equivalent of two cups of coffee per wash, with the stimulant absorbed naturally through the skin, manufacturers say.

As the Cochrane Researchers have found out, it's more difficult than it seems to study improvements in hand washing.

The controversy surrounding forced psychiatric treatment rises in the wake of last week's massacre:

For Gambs, last week's shootings at Virginia Tech highlight major failings in our nation's mental health laws: Long-standing laws protecting patients' rights make it difficult for authorities and family members to intervene and order a loved one to receive treatment.

"It absolutely breaks my heart and makes me so sad that so many people died ...

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Scalpel with another real-world example:

She claimed that she discussed her symptoms with a relative in Guatemala who is a physician, and he told her to take some ibuprofen, and of course she got better. Why didn't I think of that? Time for me to start looking for some CME, I suppose.

If I was a physician in Guatemala, I wouldn't have ordered any tests either, and I ...

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CT for a UTI

Charity Doc with the last sad lawsuit, where he is accused of not obtaining a urology consult for a textbook UTI.

A choice that physicians face multiple times daily. And people still say that defensive medicine doesn't amount to much:

Having been involved in two malpractice cases"”one that resulted in a judgment against me and a second that was dismissed"”I've learned something about efforts to assign blame. Despite the ruling of negligence against me, the hospital peer review (excluded from evidence at trial) found "excellent care, well-documented." The jury ...

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Medicare fee cuts

It backs PCPs into a corner:

When costs go up, Medicare cuts fees across-the-board. Specialists respond by performing more procedures, but PCPs can't do anything but see more patients in less time.

The divergence between primary care and specialists' income is increasing, and it's troubling to see some physicians react by doing things beyond their scope of training.

EHR overcoding

Audits are increasing as EHR overdocumentation becomes more prevalent.

A cautious approach is stressed by Trisha Torrey, as she comments on the upcoming launch of Revolution Health:

Case's program, and the commentor's program, involve patients keeping their own records online. These are the systems that make me more nervous, because there are no standards, and because too many people are not savvy enough to be cautious enough about what they store online. They are fertile ground ...

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Plastic clogs: Banned



Due to static electricity that interfered with medical equipment in Swedish hospitals.

A Russian boy travels to Oklahoma for a risky surgery that unfortunately left him brain dead. The father lashes out at the hospital:

Kurbanov, speaking through a translator, said the doctor and hospital were more interested in promoting themselves than properly caring for his son.

The news story amounted to a "TV commercial" that "talked about the hospital and the doctor and that even people from Russia came ...

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Google listens. Congratulations. (via Clinical Cases)

A three-step primer. (via Pharmalot)

The P4P guideline states that antibiotics for pneumonia should be administered within 4 hours of presentation in the ER. A study suggests that 90% compliance may not be possible, and wonders how much unnecessary antibiotics will be given to try and meet this metric. (via retired doc)

See if you can spot it.

According to his grandparents:

Yang-Sun revealed the eight-year-old was diagnosed as autistic soon after his family emigrated to the US.

She said: "He was very quiet and only followed his mother and father around and when others called his name he just answered yes or no but never showed any feelings or motions.

"We started to worry that he was autistic - that was the big concern of ...

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