If this is how the government treats a safety-net hospital, I'd hate to think what would happen if they were responsible for all our health care.

EMRs are causing physicians to code appropriately, and resulting in higher payments. So why are doctors being penalized?

Who's comfortable writing something like this? According to The Angry Pharmacist, some physicians are.

Thought Process

A Sid Schwab short story.

Virtual hip replacement

Now's your chance to be a surgeon.

(via ScienceRoll)

Real pathology in a patient that a nurse wanted to "kick [her] out of here."

With physicians facing a 10% cut in Medicare reimbursement, I would like to reprint my op-ed published on August 2007 in the New Hampshire Union Leader.

Monday, Aug. 6, 2007

MEDICARE is planning to cut physician payment rates by 10 percent in 2008. These reductions will continue annually, and it is predicted that the total cuts will be about 40 percent by 2016.

The ...


"I don’t do any medmal"

A qualifying statement by a lawyer receiving treatment in the ER.

Disappointed in normal

Angry ER patients after being told that nothing is wrong.

The RUC conspiracy

The proceduralists dominate the RUC committee, and have formed an alliance, thus is slowly killing off primary care:

In a self-serving game of "you scratch my back," the proceduralists support the inflated work values of one another's new procedures, and as the values float higher and higher over time, and as the number of procedures grows, the value of office-based or cognitive services diminishes in relation. And as ...


Wrong-side neurosurgery

I'm sure that Rhode Island Hospital is not liking this national publicity.

CT scans and cancer

A NEJM study estimates that 2 percent of all cancers in the next 20 to 30 years may be attributable to CT scans.

The price of overtesting and defensive medicine has just gone up.

More testing does not always equate to better medicine.

The TB-lawyer Andrew Speaker?

. . . he represents more than just media-fed paranoia: Just like that kid a few towns away who supposedly came down with a staph infection, Speaker embodies the Great Contagion that always lurks a few coughs away, threatening a country's increasingly fragile sense of security.

Dr. Wes wonders whether some of the big shot hospitals are in bed with the US News and World Report:

But what's funny is that the Big Boy winners are now in bed with US News and World Report - providing content for their issue about all kinds of diseases that they (alone, I'm sure) have mastered.

Notice how mainstream media discounts studies that say there is no survival benefit? Bravo to Merrill Goozner who sees the folly of ordering CT scans to screen for lung cancer before the proper evidence is available.

Taking apart the recent NYT editorial on rising health care costs. The public is starting to realize that this means saying "no" to patients - something that has been rejected venomously during the managed care era:

. . . one suspects that the editors who put their thumbprints on this piece may have been divided on whether we really want to rein in health care spending. On the one ...


The shadowy RUC

Responsible for corrupting the physician reimbursement system?

Dr. Drug Rep flak

Daniel Carlat is taking heat for his controversial expose being a drug company speaker. (via Health Care Renewal)

Patient transfers

Inefficiency leads to headache and frustration for this ER physician.


How the patient is excluded from the reasons why we document:

We doctors, in order to make our living, have been turned into Medicare lemmings and I believe it brings incredible loss of productivity by deferring time, money and resources from patient care to patient documentation:

To appease the lawyers. It didn't happen. You're at fault
To appease the insurance companies. It didn't happen. ...


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