Home midwife services

A growing trend? Malpractice is an obvious issue, and they are finding out what physicians already know - malpractice insurance is cutting into the business model:

Building the practice has presented challenges. The biggest, said Bryson, was mastering the billing process and getting insurance companies to reimburse her for her services. She's gotten much more adept at dealing with insurers and now gets much better reimbursement than she ...


Ezra Klein in an LA Times' op-ed, outlining the Republican and Democrat approaches to the health care. Here is the Republican's take on the situation, which makes more sense to me:

The Republicans are taking a very different approach. Their plans all proceed from the assumption that the problem in healthcare is that costs are skyrocketing because Americans overuse their doctors. This theory postulates that because Americans don't feel the ...


A story of a belly stud that was driven into the stomach in a car crash: "Jessica Collins' seatbelt forced the stud through her stomach almost to her spine in the crash in Munich."

An ER doc strikes back.

Who’s the patient?

Getting hooked at WhiteCoat Rants. Worth a chuckle.

Especially if you have Parkinson's.

Medgadget vs Sermo

Turning up the heat?

More on critical physician shortages due in part to rising malpractice rates.

Pelvic exams in the ER

How useful are they really?

For such a useless procedure, there is an unreasonable amount of emphasis placed on its performance by our consultants, probably a vestigial remnant from the olden days when CT scans, ultrasounds, and antibiotics were not as powerful or widely available.

A typical ER shift

You'd be surprised at how little time is spent on actual medical emergencies.

The 5-hour CT scan

A woman was forgotten in a CT scanner. Scary thing is, this wasn't the first time this happened:

A physician who works at the practice and knew of the incident said it's not the first time such a thing has happened. "People have been left in the office after hours, when something like that happens "” it's the same sort of thing," said Dr. Steven Ketchel. "My guess ...


Leaving your mark

Sid Schwab on naming anatomy:

When it takes some effort -- maybe a microscope or some really careful dissection -- to discover something, it seems reasonable that your name gets attached. Islets of Langerhans. Ampulla of Vater. Sphincter of Oddi. Valves of Heister. Crypts of Morgani (he got "columns," too.) But where's the cutoff? I don't get why Gabriele Falloppio got to name something as obvious and macroscopic as ...


Chris Rangel on how defensive medicine has changed the practice of medicine:

The practice of emergency medicine (among other high risk specialties) has become so regimented and infused with defensive medicine tactics that many ER docs are not even aware of how this has changed the way they think. It seemed as if this ER physician could not fathom the concept that we would send home a patient who could ...


With the miserable failures of Exubera and torcetrapib, Pfizer is throwing some marketing muscle behind Chantix - an anti-smoking medication that actually works and is quite useful. A look at the recent DTC ad for the product.

An ER doc confesses:

I shouldn't let this kind of thing bother me. Why should I care what the techs and nurses think? Let them walk a mile in my shoes. They're not held accountable if they miss a head bleed or PE or small bowel obstruction or neck fracture. I am.

Bizarre and could be start of a disturbing trend. What kind of corners will be cut in the name of profit?

Critics say a for-profit school will be beholden to investors and will scrimp on educational mission. Supporters assert that Rocky Vista must meet the same accreditation standards of other osteopathic schools. They also say the school's educational outcomes will be the same as nonprofit schools.

Mmm . . . purple urine

What a fascinating cause of this phenomenon:

Purple discoloration can occur in alkaline urine as a result of the degradation of indoxyl sulfate (indican), a metabolite of dietary tryptophan, into indigo (which is blue) and indirubin (which is red) by bacteria such as Providencia stuartii, Klebsiella pneumoniae, P. aeruginosa, Escherichia coli, and enterococcus species.

He has resigned from the hospital, but gives his side of the story:

He said the patient was "a drug addict coming off of opiates, completely in withdrawal (and was) restrained as he should have been by protocol by five technicians. I was only the sixth person, never hitting anybody."

Megan McArdle wonders:

You can't blame it all on lawsuits; my doctor didn't test me for hyperthyroidism because she was afraid of the malpractice suit that would result from my losing too much weight and getting heart palpitations. Nor can you blame it on money; my doctor doesn't profit from giving me blood tests that all come back normal. And I don't think the lack of rational rationing can ...


This physician was pressured to settle, to his regret:

I spoke to some of my senior colleagues and they all advised me to settle. I relented, and what followed was a nightmare of the worst kind.

My insurance carrier increased my premium from $4,000 to $30,000, terminated my liability coverage, and then cornered me to buy a tail for $30,000 or retire. With retirement as no option, I found ...


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