Sermo in NYC

Sermo recently hosted a NYC dinner to meet some of its members. Joshua Schwimmer previously blogged about it. Nick Genes with his thoughts, and they're pretty positive.

Think physicians are the only ones pushing medical procedures overtreating? It's nothing compared to veterinarians:

In Sicko, Michael Moore indicts America's human health care, painting a portrait of a system so callous that the loss of life and limb is a matter of simple economic calculation. But in my experience, it's almost impossible to find a callous vet when you need one.
(via a reader tip)

Meet Dr(s). October

Addicted to Medblogs with the most recent cover docs.

More stories from a flawed payment system:

. . . the insurance carrier pays off like a slot machine if a resident in a teaching hospital does a procedure in a demented, terminally ill patient with virtually no hope for reasonable quality of life. Imagine the costs to the carrier.

Yes, you are naïve if you think that it is possible to practice high-quality care without thinking about your ...

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This is what the profession has come down to today:

In the current milieu, volume and procedures are rewarded. My game plan, short of early retirement, will be to refer patients to specialists as often as possible without using valuable time to do the evaluations myself. They can evaluate, precertify tests, authorize appropriate medications, and treat accordingly. Then, I will be able to increase my patient volume and decrease the ...

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They're laying off employees pretty soon after starting up. Much ado about nothing? Not according to these insiders.

Delivering a baby

Sometimes we forget it's messy business:

I don't care what health video you saw in high school, but it clearly digitally-removed most of the blood, fluid, and poop that ends up under the woman pushing. It is not a pleasant affair. From a purely physical perspective, you have a woman pushing a bowling pin through a nostril, and in the process, blood is sliming or gushing out; amniotic fluid (clearish ...

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With some recent scrutiny on cruise ship physicians, here's what it's like to really be one. (via Scalpel)

You bet it is, says The Angry Pharmacist in his typically salty manner.

Who said it? None other than the neurologist-father of the CBS News defensive medicine piece, who left a comment on TBTAM.

He gives more information on his daughter's case of RLQ pain presenting in the ER, including:

1. No fever
2. Cursory hx and exam by PA
3. No pelvic exam

Update:
WhiteCoat Rants (welcome back, I thought you were dead) takes exception.

Hospitals are submitting videos for Siemens' Win a Free MRI contest. Some of the entries are pretty funny - but the whole shenanigan is pretty sad.

The Cheerful Oncologist with a "must-list" of essential skills.

One reason is the attitude of the American consumer. Maggie Mahar is right on the money:

Part of the problem may be that American consumers want and expect more health care. We just won't accept our own mortality: we expect medicine to save us. Indeed some, like medical ethicist Daniel Callahan, have suggested that our high-tech, high-profit health care industry is "in the business of selling dreams."
I like ...

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Thoughts from the Happy Hospitalist:

With my training, expertise and education, I should be able to collect at least $250/hour. I'm pretty sure medicare will pay me less than $75. After overhead I make less than a massage therapist for an hour teaching. Family's happy but I can guarantee you that if I sent them a bill for the other $175, they would be furious. My time should be ...

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Malpractice at sea

Efforts to locate cruise ship physicians involved in malpractice often fail:

Most ship doctors, despite typically wearing a crew uniform, are classified as independent contractors. And cruise companies contend they are no more liable for the doctors' competence than a landlord who rents office space to a physician on land.

One of my favorite authors, and has some nice insights in Blink. Robert Centor writes about his recent address to the Society of Medical Decision Making.

Shared decision making

Great in concept, with this article talking about the PSA in particular:

The prostate-specific antigen, or PSA, test is a simple blood test that can detect prostate tumors on average 11 years before a rectal exam does. To anyone who assumes that catching prostate cancer as early as possible leads to cures, the PSA test looks like a no-brainer.

But the evidence doesn't support that view. If early ...

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Guess the profession: "[we] feel unable to stop it, powerless to resist the stifling market forces that drive their decisions."

Medicine? Goes without saying. But lawyers are also feeling the financial heat. (via a reader tip)

Jay Parkinson on Colbert

He's certainly kicking off his new-style practice with a flurry of media attention. How can it get any bigger than being on The Colbert Report?

Simple solution

Doctors can only adhere to diabetes measures if they have the proper equipment.

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