The trial showed the benefits of the diabetes drug Byetta. The accompanying editorial is not kind.

Again, major media is dismissing evidence-based medicine with regards to cancer screening. We might as well give up and start practicing medicine based on anecdotes and expert opinion - since no one listens, nor accepts, the evidence. CNN correspondent Sanjay Gupta further damages the evidence-based movement with his bias during his show.

Maurice Bernstein writes about how making diagnoses are rarely black and white:

In fact, I think the art really trumps the science itself in most cases. Why do I say that? It is because no two patients are the same and no two same diseases present exactly the same way nor are their courses exactly the same. It is also because lab tests are rarely or ever 100% ...

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That's what you get when bureaucrats run the show.

Much has been written about the drug seekers. How about patients who refuse to take Oxycontin because of the media exposure? (via White Coat Notes)

He broke the "doctor's offices are buckets of money" story, with repercussions this afternoon within AstraZeneca.

Medical Economics answers the questions surround this issue:

Once medical advice is proffered"”whether in the office, over the phone, or in a friend's dining room, a doctor-patient relationship is established, as is a duty of care. That duty is what makes you a potential defendant . . .

. . . If you think a friend or relative won't sue you, think again. Court records are full of such ...

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Some common sense tips.

It sounds like they're having the same problems up north:

Over the past decade, family doctors have quietly narrowed their practices according to their personal preferences and needs. Most urban doctors have given up obstetrics, hospital care and palliative care. Without these, onerous call schedules disappear. These docs have come to appreciate the freedom of time and with that taste of freedom, few would go back.

Many former traditional ...

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It has been said many times that malpractice cases are emotionally scarring for physicians. Consider this report - and note that these are cases that were either dropped or ruled in favor of the physician:

Dr. Roberts' bleak portrait of the medical profession hits home with those who have dedicated themselves to medicine, only to find their good works forgotten and records blemished after a malpractice suit. Dr. ...

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Some serious problems at that assisted living facility.

Scary claim. The physicians who lost a record malpractice case says their insurance-appointed lawyers coached them to tell lies:

In the doctors' suit against their former malpractice lawyers, they claim that the lawyers who were hired by their malpractice insurance company were protecting the interest of the insurance company and not theirs. One of the doctors said he was pressured by the lawyers to say that he always gave ...

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Transplant tourism

It's a cash cow for hospitals in China, and inviting plenty of controversy:

Doctors and human-rights groups around the world have decried China's practice of harvesting organs from prisoners condemned to death. Concerned that lucrative foreign transplants create an incentive for China to execute more prisoners, critics in Israel are pushing for legislative restrictions. Last week, in part due to what it called the growing problem of transplant tourism, ...

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On the surface, it seems she over-prescribed. However, on looking deeper, physicians are often caught between two unpalatable options:

"On the one hand, if they prescribe too much medication for a patient "¦ they could be in trouble, even [facing] criminal prosecution," Johnson said.

But there has also been a movement in health care to provide more adequate pain management and mental health management for patients.


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One of my favorite bloggers is taking a sabbatical. Sounds like the stress of doctoring circa 2007 has claimed another one. Hope all is well and come back soon. (via GruntDoc)

The focus on universal care only masks the real solutions:

Everyone agrees that far too many Americans lack health insurance. But covering the uninsured comes about as a byproduct of getting other things right. The real danger is that our national obsession with universal coverage will lead us to neglect reforms "” such as enacting a standard health insurance deduction, expanding health savings accounts and deregulating insurance markets "” ...

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Why generalists are dying. (via GruntDoc)

Psychiatrist Maria wonders if hospitalizing patients at low clinical suspicion for suicide is a form of defensive medicine:

Some psychiatrists routinely hospitalize patients (through coercion, either with or without the "help" of friends, family, et al.) who endorse suicidality when "clinical suspicion is low" that the individual will actually commit the act. The belief is that if someone is in the hospital, the risk of suicide drops significantly"”after all, the ...

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Celebrex: The new ad

John Mack does the dissection.

A recent study suggests so, although I thought that routine preventive maintenance were covered in most high-deductible plans.

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