What's your best chest pain story?

#1 Dinosaur looks at potential implications for Medicare's recent P4P decisions:

How long before Medicare refuses to pay for an appendectomy if the pathology is negative? If the appendix was normal, then it didn't need to come out, right? What about a negative breast biopsy, or any kind of exploratory surgery that doesn't yield positive pathological findings? Couldn't a cardiac catheterization that showed clean coronaries be considered "unnecessary"?


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With their reliance on ads and marketing, will they be credible?

Google will have to do a huge amount of work to establish credibility with the medical profession. If they are to put themselves forward as a legitimate website for healthcare related needs, they will either have to exercise a large amount of editorial control, or they will have to come up with a totally new financial model for ...

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America's single-payer health system, The Indian Health Service, is in dire need of reform:

Inadequacies in coverage, care and facilities are so great that the Census Bureau's current population survey does not consider American Indian and Alaska Natives "covered" under IHS - more than a third of American Indian and Alaska Natives went without suitable coverage in 2004.

retired doc on how critical thinking has evaporated as more suits run hospitals and clinics:

. . . medicine has become more and more corporate and the business school belief that one does not need know a business to run it is increasingly applied to medical practice . The business-speak jargon now echoes through the hospitals and clinics and we talk about vision statements and leveraging this and that ...

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A rare complication of a dental procedure seen in the ER.

Laurence J. Kotlikoff with a voucher-based system designed to satisfy the left and right:

Nothing would be nationalized. Virtually all of the cost would be covered by redirecting existing government healthcare expenditures as well as tax breaks. Doctors, hospitals, and insurers would continue to market their services on a competitive basis.

This is not a French, British, or Canadian solution. It's an American, market-based solution that Republicans should ...

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Sid Schwab on his DVT. Do physicians follow their own advice?

A closer look at the S-CHIP bill which includes a "quality" benchmark to raise hemoglobin levels in ESRD patients, despite little evidence supporting the practice. GoozNews with more.

Drug-coated stents

Beginning of the end for this troubled technology?

This week's installment in drug-coated stents' never-ending tale of woe comes from Britain, where the National Health Service could soon stop paying for the devices altogether.

A recent report commissioned by the government found that drug-coated stents, which cost about $2,300, aren't worth the extra money compared to older bare metal stents, which cost about $700.

He denied having the disease.

A tragic miscommunication:

Kozel, a pediatrician at St. Louis Children's Hospital, apparently had thought her husband knew to take the baby to the on-site day care; the father didn't see the baby in the back seat and thought he was simply parking an empty car.

A patient with drug-resistant bacteriuria. How to treat properly versus satisfying P4P demands becomes an issue.

As patients become more empowered, they are finding themselves in some awkward situations:

"More times than once, I had to say to the person coming into the room,'Did you wash your hands?' " said a woman who is the president of one hospital, and whose father was recently a patient at a different, well-known (but unnamed) Boston hospital. "When you're going to the mecca, I felt like I shouldn't ...

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A physician builds a hospital empire in California, and gives the finger to insurance companies. A business model of the future?

What is more extraordinary is how Reddy is building his empire. Modern healthcare is largely based on the model in which insurers seek to control costs by paying fixed amounts to doctors and hospitals. Reddy is tearing that down.

When Reddy's company, Prime Healthcare Services Inc., takes ...

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A view from the inside:

It has been more than 20 years since I came from a communist country (Cuba) where I was employed as a physician for over 10 years.

During this time I observed firsthand how socialized medicine really works. The basic failure to provide minimal quality of care, compounded by the scarcity of vital medications and supplies, made every day a battlefield. The waiting list to ...

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Editorial from rural Vermont, where hospitals are having a hard time attracting doctors:

Reimburse doctors for some or all of their education expenses as soon as they become doctors, and pay a hefty percentage of their malpractice insurance, based on their income. Simple, effective, immediate. The benefits would be enormous throughout the system.

And the amount it would cost the government, compared to the billions and billions we ...

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Does the small difference in life expectancy statistics warrant overhauling the health care system?

The truth is that Americans live, on average, longer than people in many countries with socialized care but not as long as people in some countries. If one were to compare the EU average life expectancy to that of the average American the difference is really a matter of weeks.

But that small difference ...

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Medicare and health IT

Their recently announced Medicare/P4P rules presents a huge opportunity for health IT to capitalize.

Several readers here suggest refusing to take insurance if physicians are unhappy with reimbursement.

You can see how unrealistic that is, as this OB/GYN learns a difficult lesson when he plays hardball with the insurance companies:

While O'Flynn didn't work for Premier-owned Miami Valley Hospital, his offices were located there. When Premier couldn't strike a deal with the insurance company early this year, many of his patients ...

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