Dr. Charles takes on the tough questions.

How employers are cautiously testing the medical tourism waters:

Despite the five-star facades of some hospitals -- fountains, white marble floors, even a Starbucks and McDonald's inside Bumrungrad's lobby -- the comfort of having a major surgery near home with family at the bedside is a far cry from the experience in the developing world, where culture shock alone can be stressful.

Pollution, poverty and insane traffic are all part ...


Extreme germiphobia

From the NY Times, a $60 device that sprays a hospital-grade disinfectant on doorknobs every 15 minutes.

Tough case, unfortunate outcome where zero malpractice was committed. Sending a patient suspicious for coronary artery disease for a stress test is routine. This one had a massive MI post-test, leading to a verdict - will this lead to more patients going straight to a heart cath? (via a reader tip)

An active euthanasia proposal in the UK that is crossing the line:

The college is arguing for "active euthanasia" to be considered for the overall good of parents, sparing them the emotional burden and financial hardship of bringing up the sickest babies.
(via a reader tip)

Want to start a blog?

#1 Dinosaur gives some basic tips. Keeping it regularly updated is key for me.

Scary stuff in Japan:

A total of 11 transplants took place using the kidneys from the sick, unknowing patients, the report alleged. Hospital officials said at a Friday news conference that 11 such transplants allegedly were carried out between 2004 and this September.

Apparently, the process started out innocently enough when one physician asked another if he had any kidneys he was going ...


So, what's being done about it? Seems like a lot of the solution is hiring more staff and disassociating reimbursement from volume.

The Cheerful Oncologist suggests shock tactics, like in Singapore.

The doorway diagnosis

The impact of first impressions during a physician visit:

Whenever I enter a room with a patient in it, I try to stop in the doorway, and before anything else happens, I take in the scene. I want a look before my impression can be biased by information or personality or anything but the overall clinical picture. Most doctors do this, or try to. It's called the doorway survey, ...


They're talking about Actiq, which is being widely used inappropriately - with the drug company turning the other cheek.

This is pretty accurate:

To cover their own butts, doctors sometimes take a needless trip up yours. A nationwide sample of "surveillance" colonoscopies--follow-up procedures done after polyps are removed--found that up to 50 percent of doctors recommended these tests unnecessarily. This better-safe-than-sorry mindset keeps docs safe against lawsuits, and isn't limited to colonoscopies.

Get the truth: Watch out for the most overused procedures: MRIs and CT scans, echocardiograms, and ...


Learn to avoid being dazzled:

"We want to appeal to physicians' natural skepticism," said Dr. Ethan Halm, an associate professor of medicine and health policy at Mount Sinai School of Medicine.

The prestigious Manhattan school is including a new type of training at its Morchand Education Center, famous for its use of actors to play patients.

For these sessions, the actors will play pharmaceutical company sales representatives. The ...


Continuing to see patients after you get "the letter".

And this year will be no different. As long as the formula stays, this will be a yearly exercise.

The physician workweek

Bottom line: More are working longer weeks, while seeing less patients.

No, according to the Arkansas Governor:

AP stalwart reporter Ron Fournier, gives Gov. Mike Huckabee the spotlight to answer the question of whethere we have an "inalienable right" to health care. The governor concludes not. Legally, that's perhaps correct. But should it be the situation in the world's most powerful and prosperous country?

Zero surprise, considering how undervalued it is here:

"Although the U.S. pays more for health care than any other country, we are under-investing in our primary care system," Karen Davis, president of the Commonwealth Fund, the foundation that sponsored the survey, said in a statement. "Other countries have made high-quality primary care a priority by putting into place the financial and technical systems that support access to, and delivery ...


What a ridiculous event. The GOP should be ashamed:

The city has stopped offering free flu shots at early voting sites after Republicans alleged it was a ploy by the mayor to lure more Democrats to the polls.

The vaccinations, for people 50 and older, had been offered at early voting sites in predominantly black and Hispanic neighborhoods. Health officials said they had singled out medically underserved ...


Most do. (via Dr. RW)

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