Guess the procedure



(via Unbounded Medicine)

Benefit of DTC ads?

A study shows some unexpected side effects from DTC ads:

In a recent study, Alan Mathios found that people who read more magazine ads for nicotine gums and patches (sold to help smokers quit) were more likely to actually quit than people who read fewer of the ads. The finding, to be published in a forthcoming issue of the Journal of Political Economy, held true whether or not the ...

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Emergency C-section

A family physician who does C-sections? The WSJ's Benjamin Brewer describes a close-call. (via The WSJ Health Blog)

Is it malpractice?

Discussion on France's health system:

. . . the average American physician earns more than five times the average US wage while the average French physician makes only about two times ... average earnings of ... compatriots. But the lower income of French physicians is allayed by two factors. Practice liability is greatly diminished by a tort-averse legal system, and medical schools, although extremely competitive to enter, are tuition-free. ...

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Could the segregation of internal medicine be leading to lower pass rates on recertification exams?

10 truisms of the ER

"Really sick people usually don't have many complaints." Read the other nine.

Maurice Bernstein explores these difficult situations.

The "officist"

With hospitalists all the rage, why bother studying critical care? retired doc explains:

If a residency trained internist becomes a "officist" you have to wonder what was the point of the ICU, CCU sick-patient training in the hospital that he endured and that in fact took up the bulk of his training. I suppose you could say he will be more able to recognize who needs to go ...

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I wonder why this is:

Doctors were more likely to think "Mr. Thompson" was having a heart attack when he was black than when he was white. But they did not prescribe treatment to reflect this -- physicians who thought a black Mr. Thompson was having a heart attack prescribed thrombolysis less often than when they thought a white Mr. Thompson was having one.

Dr. Do-it-all

Meet the only surgeon on the island of Nantucket:

As Nantucket's surgeon, medical examiner, school physician, football team doctor, Lyme disease expert, identifier of excavated Indian bones and occasional Dr. Doolittle, Dr. Lepore has pretty much seen it all.

Being on call

The joys of weekend call:

One of my biggest challenges is understanding why patients consider an emergency as anything that they don't want to wait until Monday, or even daylight. They want lab reports. They want advice on whether to get a flu shot. They want to know what that green cough medicine was their doctor recommended 3 years ago. They want their medicines"” that they only seem to know ...

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It seems that way, when compared to other professions:

William Weeks, a Dartmouth professor, has done a number of studies on the work life of physicians. He found that, if you view the expense of going to college and professional school as an investment, the payoff is somewhat poorer in medicine than in other professions. Tracking the fortunes of graduates of medical schools, law schools, and business schools with comparable ...

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More cases are settled than you can imagine. All the statistics that say physicians often win in malpractice trials fail to take this into account. A settlement almost counts as a loss.

A reader highlights the disconnect between the ivory tower academics and real-world physician when it comes to board exams:

. . . the boards are costly and time consuming. They have spawned a whole industry of CME that feeds on doctors' fears of not being up-to-date. I get a constant stream of advertisements for board reviews and courses throughout the year which makes me believe that the boards have become ...

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A lawsuit from advice dispensed over e-mail:

In one case, an interventional radiologist gave advice to a 65-year-old woman who had selected the "contact us" option on the practice's website. The woman had written that her doctor recommended a vertebroplasty because radiographs of the lumbar spine showed diffuse osteoporosis and a collapsed third lumbar vertebra. The radiologist responded that he, too, recommended the procedure. An orthopedic surgeon performed the vertebroplasty, ...

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Medical blogs 101

A nice starting point for those about to jump into the medical blosophere.

Comparing what we have here versus a NHS-style system:

Is a socialist system that fails 100% of its members when it comes to the supply of advanced medical technology not worse than or better than a system that fails to fund the needs of 15% of the population? Is providing universal health care much more important than providing efficient and quality health care to the vast majority of the population?

#1 Dinosaur looks at the implications of this request:

What if the roles were reversed? Certainly I've written myself orders for routine screening tests. I even have a "chart" for myself in my office to keep track of labs and immunizations and other things. I occasionally go see a doctor -- usually a specialist -- for specific acute problems, but I must confess that I do not have a ...

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Physician salaries

Richard Reece summarizes the ridiculous comparison between physicians salaries here and abroad:

Sermo readers, some of whom had practiced in Europe, commented,

"¢Americans must pay off educational debts of up to $200,000 while European college and medical training is subsidized.

"¢Europeans may work half the hours of Americans.

"¢Europeans enjoy miniscule malpractice costs.

"¢American practice costs are higher.

To sum up, comparative incomes of ...

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