Translated into dollars: $2.4 billion in the first year.

Another example of how YouTube can be used to teach medicine. Here's one of an aortic dissection:

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(via Clinical Cases)

It had a street value of $1,000. (appropriately via KidneyNotes)

Joe Paduda explains why.

PPIs and hip fractures

Media hysteria from an observational study. retired doc says not to get so worried.

Spot on with this one:

More sectarian strife among providers. The latest staving off of the Medicare Part B cuts papered over the cracks for a little while, but the difference between profitability among different specialties and different hospitals is becoming really politically visible. There's no essential reason why diagnostic radiologists should earn four times the amount of primary care doctors, for example. At some point this discussion ...


An ultrasound you don't see everyday.

Pressure is on to ban cheese advertisements during kid's shows.

Medical librarian Dean Giustini with a BMJ editorial. (via Clinical Cases)

This is a predictable, and worsening, result. The problem is that many do not have a "bill-paying" mindset:

People who have agreed to pay several hundred dollars a month for a high-deductible policy are probably responsible enough to also fund an HSA, he said, especially as insurance companies encourage them to do so.

The underlying problem is "the mind-set of someone who does not pay their bills," ...


Quite a bitter rant.

An incident that occurred in Sweden:

But when the American woman, accompanied by her husband and niece, went to meet the doctor in his treatment room, he declined to examine her.

Rather than introduce himself, the doctor waved the patient's papers and shouted "she doesn't have strep throat, she doesn't have strep throat". He then added that he would not treat her.

"He said he didn't like Americans," ...


A case where a family requested an attending, rather than a resident, to do a procedure at a teaching hospital. When that fails to happen, a malpractice suit follows.

Interesting research on reward-based decision making:

The preference for immediate over delayed rewards of larger value, which researchers term "delay discounting," has already been linked to impulse-control problems, such as substance abuse, addiction and pathological gambling.

Despite appearances, some physicians and hospitals are forced to rely on reps:

. . . the most urgent reason we need our reps is that hospitals are low on trained staff these days. With the myriad parts and pieces it takes to do a spine fusion, knee replacement or robotic prostatectomy, operating room staffs need help keeping the trays and trays of little parts organized and ready for action. In ...


Removal of a benign brain tumor goes wrong. The third neurosurgical opinion gets nailed in a $16M lawsuit:

"I was the third opinion on this and we were all saying the same thing," Morcos said. "This tumor was blocking the fluid spaces of her brain, causing a threat to her life "” not immediately, but eventually. There was some bleeding, but it was properly managed with medication. She ...


Surely, a colonoscopy should have been ordered - but does the patient bear some responsibility?

But, the doctors successfully argued that Boyd bore some responsibility for her treatment and diagnosis because she was a medical professional who could have known her symptoms were cancer indicators. Boyd also had a family history of colon polyps (her father had several removed almost a decade earlier), and she never completed a take-home test ...


A collection of odd medical studies during the past year.

More and more are using YouTube to disseminate medical advice. Some legitimate, most not. This could be a good tool for things like inhaler or glucometer teaching.

Diary of the so-called "Elephant Man", who was involved with the drug trial gone horribly wrong last year.

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