Increase co-pays. With many ER visits being non-emergent, a study has shown that this does not harm overall health:

While emergency visit rates decrease substantially as the co-payment increases, the findings show no increase in the rate of unfavorable clinical events (hospitalization, intensive care admission) and no increase in deaths. The study appears in the latest issue of Health Services Research.

The population-based experiment followed over ...

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Interesting case where growth-attenuation therapy is used to permanently halt a 6-year old's growth so parents can continue to care for her at home:

"Achieving permanent growth attenuation while the child is still young and of manageable size would remove one of the major obstacles to family care and might extend the time that parents with the ability, resources, and inclination to care for their child at home might be ...

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Not surprisingly, he lapses into a coma mid-flight.

Why one should never give medical advice outside of the doctor's office:

One medical liability lawyer stated that his company defends many doctors who were consulted in an informal manner, such as, at their child's Little League baseball game.

Many times in these situations, vital information is lacking, therefore, limiting the doctor's ability to give a reasoned answer. Usually, the doctor is unaware of the questioner's medical history. This ...

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Should've done the C-section earlier. Poor outcomes like these are scaring OBs into an all-time high in C-sections.

The baby appears healthy despite receiving no prenatal care and a mother who smoked.

The founders were sent intimidating letters, but aren't backing down:

The Silicon Valley, Calif., operators of RateMDs.com have removed two out of the seven most scathing comments about unnamed doctors cited by the Canadian Medical Protective Association (CMPA). But they ignored all other requests made of them by that organization and the Canadian Medical Association, the latter whose chief executive officer, William Tholl, also sent a recent letter saying ...

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The cause of SIDS?

Possibly because of varying sensitivities of the brainstem to serotonin:

The research team, led by doctors at Children's Hospital Boston, compared brain tissue from 31 infants who died of SIDS from 1997 to 2005 with samples from 10 babies who had died of other causes. They focused on an area of the brainstem called the medulla, which regulates breathing, sleep-and-wake cycles and other vital functions.

They found, among ...

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Dr. Genes:

The way doctors and patients size each other up, try to read each others' hands. Even so, most hands are straightforward -- you know how it'll unfold from the flop. Other times, you have to wait for labs to come back, there are raises and calls. But no matter how benign the situation might start out, you never really know which patient is going to take ...

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Some local pharmacies are giving antibiotics away for free to compete with Wal-Mart's $4 generics. Will this lead to continuing overuse? Very likely:

From a patient care standpoint, I see this as a real problem. Wal-mart had the right idea, kind of, with offering some discounted chronic medicines - like blood pressure medicines and antidepressants. But, offering antibiotics?

Many studies have shown that you don't need ...

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Some good stuff from Dr. Wes today. First, his thoughts on the (soon to be) routine triage test in ERs, the multidetector CT scan. Who pays for this? Well, if you're an ER doc, it really doesn't matter. 100% sensitivity offers pretty good lawsuit protection at any cost:

The (multi-)million dollar question is this: who will pay for this scanning? Sure the patient with ...

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Their anti-physician stance is costing them members. Serves them right.

Always nice to see my alma mater in the medblogs. Dr. RW worries that non-evidence-based teachings like Chinese medicine are going to pervade traditional medical curriculum.

And they're doing everything they can to stop it. (via PharmaGossip).

Pharma Marketing Blog talks about Rozerem's big marketing push, and wonders how such ludicrous displays passes FDA regulation:

BTW, how are little promos like this on medical conference sites sponsored by CME providers like M|C Communications -- host of the Pri-Med Conference -- regulated by the FDA? For example, the benefit statement above is not balanced by risk information, nor is there any link on this page to ...

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And may actually encourage youths to smoke. Devilish reverse psychology from the tobacco industry.

It's starting to look that way. It didn't really stand a chance.

The film was too horrific for some.

Apparently by a family member. Tragic.

50 to 75 percent don't follow their doctor's instructions:

Either they don't fill a prescription, or they don't change a dressing, or they forget to take their pills, or they fail to follow instructions in some other way. Even more surprisingly, the people with the chronic problems, such as high blood pressure, have the highest non-compliance rates. Children, too, are often victims of caregivers who fail to follow a doctor's ...

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