This is not an accident:

By simply being asked "Is this an emergency?", many contacts with the physician are eliminated. Patients often call their doctor because they do not know if the issue is serious enough to be considered an emergency or not. This "filtering" technique does not serve the interests of the patient. Procedural barriers limiting contact with doctors cannot be in the physicians' best interests either.
Phone ...

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Follow-up on the case where the 5-year old died from anesthesia-related complications:

A state report alleged that Riba failed to properly monitor the girl's pulse, breathing and blood pressure after she received a sedative mix of Valium, nitrous oxide and several other drugs.

State officials alleged that in order to protect the public, they needed to suspend Riba's dental, controlled substances and other licenses while the case is ...

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A Canadian physician can't help himself from giving breast exams from behind:

In his defence on the latest charges by the college, Li told the disciplinary committee it had been his practice to examine breasts from behind for more than 20 years. A medical expert told the panel he "never either heard or read of performing such an examination from behind."

"Although this was not, in the panel's view, ...

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A physician is charged with sexual misconduct after a vaginal speculum exam. Just get a chaperone in the room and save yourself the trouble:

After investigation and weeks of anxiety, I've now been exonerated of this charge. So why not forget about it? But I believe this case shows how dangerous it is to practice medicine these days. Some doctors tell me they no longer examine women's breasts for ...

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Group visits

If they can get around HIPAA, it may be worth trying. Being able to bill 18 visits in 90 minutes is worth the expense. Typically only 6 patients are scheduled individually during that time.

This reader wants to go back to the "old way":

I'm sorry, but when I chose my primary care doctor that is who I want on my team looking out for me, not someone I don't know. As the hospitalists will be talking to the surgeon, my primary care doctor should be involved in my care. When they give the medications, maybe your primary care doctor would have done it ...

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During a sports event. This again suggests that many ER visits aren't truly emergencies.

Again, vaccines are mandatory and not giving them is akin to child abuse:

Compared with stricter states, those with easy exemption policies had about 50 percent more whooping cough cases, according to the study. Also, about 50 percent more people got whooping cough in states that allowed personal-belief exemptions, compared with those allowing only religious exemptions, the study found.

Industrial child birth

The New Yorker on C-sections:

And yet there'Â’s something disquieting about the fact that childbirth is becoming so readily surgical. Some hospitals are already doing Cesarean sections in more than half of child deliveries. It is not mere nostalgia to find this disturbing. We are losing our connection to yet another natural process of life. And we are seeing the waning of the art of childbirth. The skill required to ...

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DNR and CPR

The NY Times with an article on who should get the final say on DNR orders. The public sometimes may be misinformed about the effective of CPR from TV:

Some studies show that the long-term survival for hospitalized patients given CPR is about 15 percent; some find even smaller percentages. But according to a 1996 article in The New England Journal of Medicine, the long-term survival rate on ...

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Apparently he was ratted out by a colleague:

Dr. Bruce Lowman's lawsuit claims that as many as two-thirds of the therapeutic cardiac catheterizations performed by Dr. James D. Johnston were medically unnecessary and done in violation of the law. The suit also claims the hospital and Johnson routinely billed Medicare for the unnecessary tests.

That led to the hospital raking in millions in improper billings and in turn rewarding ...

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As this newspaper columnist finds out.

Pretty scary stuff:

The Health Ministry report found that doctors violated the law by experimenting on patients who either did not provide consent or were not mentally capable of providing consent. Some of the experiments did not have any medical or scientific benefit, and some were conducted even though senior doctors warned that they were illegal and unethical.

"Think before you pink"

How much actually goes to breast cancer research? It varies, and it's not always easy to find out.

I'm a believer in the white coat. Apparently NYC docs are too stylish to care:

Wearing a pricey Italian suit, Paul Lorenc, a Park Avenue plastic surgeon, wields a purple pen, marking up faces, thighs, stomachs, and breasts to show patients where he'll be cutting and what he'll be removing; he injects wrinkle-smoothers like Botox and Restylane, and he removes post-operative stitches.

Dr. Lorenc's uniform generally ...

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Physician-patient e-mail gets the shaft here often. Maybe insurers are listening:

Under the plan, patients pay the same co-pay as they would for an office visit, and doctors get reimbursed about $35 for each patient e-mail they respond to.

Two percent.

Apology

Follow-up on a recent entry last month. The complaint was a false accusation:

Willis Knighton hospital officials have completed an investigation into allegations of misconduct by one of its doctors. Their investigation found the claim to be false. Anita Sherman logged a complaint with the Medicaid office about Dr. Manohar Manchandia"¦ the hospital investigated Sherman's claim and found it to be false.
I apologize to Dr. Manchandia ...

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Dinosaur talks about an uneasy feeling he gets about P4P.

Who's to blame for this is debated during a tumor board meeting.

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