Opting out

More doctors are shunning insurance:

The proportion of physicians who don't participate in managed care plans is rising in a development that may signal a trend toward higher patient costs and less access to doctors, a study to be released on Thursday said.

Kaiser decided to keep organ transplants in-house. They couldn't handle it:

Kaiser's fledging transplant program was unable to handle its caseload, which caused prolonged waiting times and required patients to continue on dialysis, according to the Times.

In contrast with Kaiser's program, in which more patients died than received new kidneys, more than two patients received kidneys for every one that died at transplant centers statewide, the Times ...

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UnitedHealth's CEO failed miserably.

Nick writes about this feeling we've all had as residents:

You've just spent pretty much every day of the month with a resident, maybe a co-intern and student as well -- and every third or fourth night you'd serve together in an exhilarating, giddy, sleepless haze of admissions and cross-coverage. You share a lot of laughs, maybe shed some tears, learn a lot, and certainly freak out about the ...

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Some doctors want their prescribing information confidential. My home state is sponsoring a bill to that effect:

"It's the most powerful tool a drug rep has, for sure," said Jamie Reidy, a former drug salesman who was fired last year by Eli Lilly & Company after writing "Hard Sell," a humorous expose of the pharmaceutical industry. Mr. Reidy said the pharmaceutical representatives received updated prescription data every two ...

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This lawmaker is taking a stand against home ultrasounds:

Democratic Assemblyman Ted Lieu said he feared copycat fans might buy the machine for home use, which doctors say could harm a fetus.

"If someone sees Tom Cruise buy one, they think this is the thing to do," said Lieu. His bill, scheduled for debate Thursday in the California Assembly, would ban manufacturers in the state from selling, leasing ...

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Seen in the WSJ:

In its efforts to reform its health care system, China must avoid listening to "health policy 'experts' from the West" who say it is important to "prevent health care from being exposed to the free market," Atlas, a senior fellow at the Hoover Institution, writes in a Journal opinion piece. He says that western health care systems' mistakes "include sheltering patients from direct payment of health ...

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Medblog press

I have added a few other recent mainstream press articles on medical blogging (found on the right-hand column under "Medblog Press"). These are all the articles that I am aware of publicizing medblogging. If there are others, please let me know and I'll post it.

Two years young



Today, Kevin, M.D. celebrates its 2nd year. I want to thank everyone who reads and supports this blog, and takes the time to passionately discuss the important, controversial issues in medicine.

Here's to many more years of "telling it like it is".

Pathetic is right:

Dr. Peter Viccellio, the head of the emergency department at Stony Brook University Hospital on New York's Long Island, said many doctors refuse to perform surgery on the uninsured or those covered by Medicaid because they are so poorly reimbursed.

"A lot of people show up because they have conditions that are treatable, but in many cases no one will treat them beyond giving them ...

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A 17-year old shows how easy it is to get narcotics in Illinois:

Though you need to show a photo ID to buy cold medicine in Illinois, addictive medications can be obtained with nothing more than an easily faked prescription slip. Pharmacists aren't legally obligated to verify an order is genuine, and tamper-proof prescription pads, a security measure used in other states, are not required here.

There is a "Let's Talk About Fees" campaign in Australia that encourages patients to talk to their doctors about the costs of procedures.

Single-payer woes

Finding a PCP really shouldn't be that hard:

Terry Daley thought her year-long search for a family doctor was over when she heard London physicians last month were appealing for more patients.

But Daley and others who filled out applications say they have been discriminated against by doctors who are cherry-picking healthy patients and rejecting people with medical problems.
Update:
To clear up any confusion - this is from ...

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retired doc points to an article from the Annals:

Academic medicine is the carpenter that fashioned the coffin of internal medicine. Instead of reengineering internal medicine to accommodate changes, it cannibalized the discipline by reducing its worth, creating the hospitalist and ambulatory care internist. These were both nails that helped seal the coffin; the former reduced the influence of the internist in the acute care environment and the latter ...

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Apparently patients thought friendly doctors with great bedside-manner were acceptable, even if they missed almost half of the recommended quality measures:

The patients, all of whom were enrolled in Medicare managed-care plans, received about 55% of the recommended care for protocols such as prompt medication after heart failure and appropriate evaluation after a fall, the study said. But most patients rated all the health care they received in ...

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Hot flashes

A meta-analysis examines non-hormonal options for hot flashes - which is important since many women are reluctant to go on estrogen:

The researchers found that on average, antidepressants and the blood pressure drug Catapres each appeared to reduce hot flashes by about one per day, and the seizure drug Neurontin by about two per day. Estrogen, by comparison, gets rid of two to three flashes a day.

Among ...

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Experts suggested prolonging CPR to keep blood flowing to organs so that they may be better candidates for donation.

Funny stuff.

To no one's surprise, Medicare will go broke 2 years earlier than expected.

David Blaine

The "magician" is going to try to hold his breath for nine minutes. Some interesting physiology goes into this:

Blaine has been working on maneuvers to increase his body's ability to withstand carbon dioxide while also doing yoga-style moves to expand his rib cage and the connecting muscles to get more oxygen into his lungs during his final breath.

"We want him to be able to tolerate ...

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