"Sometimes you have to invest money to make money," says Robert Centor. Can generalist care be saved?

A case where atypical depression was missed - due to the celebrity or VIP bias:

Dr. Groopman observes that V.I.P. or celebrity patients sometimes short-circuit the physician's normal diagnostic thinking. For example, these patients may be spared the doctor's usual tests and procedures. As our "top gun," Mike was just such a patient to me. Even as I entertained grandiose fantasies about curing him, my unconscious may have steered me ...

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What does that mean to you? More patients than you think are confused by drug labels:

Did that mean a total of two, or a total of four? A third of patients who were deemed literate got confused. A more clear instruction would be: "Take two tablets in the morning and two tablets at night."

Sick. A doctor is charged with facilitating the death of a man to harvest his organs:

A San Francisco transplant surgeon was charged Monday with prescribing overdoses of medication to speed up the death of a man at a San Luis Obispo hospital and harvest his organs.

Dr. Hootan Roozrokh, 33, prescribed excessive amounts of morphine and Ativan and injected the topical antiseptic Betadine into Ruben Navarro's ...

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A panel stops short of pulling Avandia from the market.

The answer is irrelevant unless costs are contained:

The problem is that nobody is going after the root causes of the spiraling cost of care. To simply call for "more free market" or a "single-payer system" without addressing the incredible waste, lack of accountability, and profiteering by third-parties is simply re-arranging chairs on the Titanic. It is the unfortunate nature of politicians to take a politically-motivated veneer and ...

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Mastectomy

Immediate reconstruction or not? Sid Schwab weighs in:

But having treated many hundreds of women with breast cancer (I lost count a long time ago) and having been (so I was told) more sensitive to the horror and fear than the "typical" surgeon, I feel qualified to express myself. My thoughts are based in the reality I saw in my practice. So here it is: though not opposed, ...

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. . . and is Glaxo trying to take Actos with it?

Health insurance premiums are starting to be linked to lifestyle habits:

Government workers in Benton County, Ark., can now sign up for a plan with premiums that fall from to $500 a year from $2,500 a year if they maintain a healthy weight. Clarian Health Partners, a hospital chain based in Indiana, said last month that it'll start charging workers as much as $30 every two weeks if they ...

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The Well-Timed Period critiques this DTC effort:

I realize that a TV ad is expensive, the time is limited, and the ad's function is to convey a marketing message not to educate. But that's no excuse to misinform.

It's like there's this implicit assumption out there that we mustn't trouble potential Pill users with too much information. And that really annoys me. Explain the difference between a period ...

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A microcosm of the procedure-driven nature of American medicine.

Patients as young as six-months old are showing up.

Louisiana physician-blogger Michael Hebert with his thoughts on the Anna Pou story:

One final question the reader may ask: Do I think Dr. Pou did it?

I don't know Dr. Pou personally, but I do find it difficult to believe that a doctor educated in the United States, knowing the law as all doctors do, would have tried to do something like this. It would have been much easier ...

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Physician websites

A doctor who doesn't have a strong web presence will be at a huge disadvantage as patients rely more on the web for their health.

As medicine continues to evolve to a business, physician "branding" becomes more important:

"The secret is being bigger than your medical practice," says Howard Bragman, founder of the media and public relations agency Fifteen Minutes (whose clients include Robert Rey, a.k.a. Dr. 90210). "If the only money you ever make is doing your medical practice, you're limiting your income. If you can make money selling products or with books, then ...

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Anyone who reads this blog knows what I think about defensive medicine, and how I feel it is one of the leading factors in rising health care costs today.

Two articles in the news highlight this. The first one suggests that defensive medicine practices are spreading to paramedics:

"I think that for most physicians now, it's the fear of being sued for missing a diagnosis," said Scott Maizel, ...

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More Sicko rebuttal:

Why then, is national health insurance in other countries as popular as Moore says it is? One reason is that people do not realize how much they pay for it in taxes. Even mediocre care looks good if you think it is free.

A second reason is that doctors in other countries often don't tell their patients their care is being rationed. Instead, they say, "There's ...

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What he writes is true:

At last, you're ushered into an examining room. The change of venue lowers the level of your fuming. The nurse orders you to strip and don a hospital gown so that the doctor can give you his immediate attention. All this indicates that his arrival is imminent. In fact, as the nurse leaves, she says, "The doctor will be right in." And he is - ...

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An editorial by the numbers - and this is supposed to entice medical students to choose primary care?

If there's no incentive for productivity, many physicians will go to banker's hours to the detriment of patients:

The problem with a flat salary is that there's no incentive to maximize work. Show me a salaried doctor (without a productivity bonus) and I'll show you one who believes strongly in his right to get home by 5PM, regardless of medical problems coming through the door, or over the phones, ...

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