They're cracking down on narcotic prescriptions up north as well:

"I can predict the net effect is (doctors) are going to tell even legitimate pain patients who aren't at risk, 'I'Â’m sorry, the college is looking over my shoulder, I can'Â’t prescribe this any more,'" Dr. Jovey said. The last provincial budget committed $300,000 to a review of pain management services across Nova Scotia.
The only pain management clinic in Nova ...

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Meet the physician who is clogging up the court system with frivolous lawsuits:

"In 40 years of practice, she is one of the most litigious and filing non-attorneys I have ever seen," said Tom Keever, chief of the Denton County district attorney's civil division . . .

. . . Rohr, who serves as her own attorney, has filed suit over such things as being forbidden to go to ...

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The bureaucracy of the NHS has pushed this UK physician into retirement:

"I would probably have stuck in for a few more years but the bureaucracy is catching up and I can't keep up with it any more.

"The targets are not all for the benefit of the patient.

I feel strongly that a lot of these changes are for saving money, not for helping the patient ...

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Home-made x-rays

This guy found out how to do x-rays at home using a dental x-ray machine (bought on eBay) on Polaroid 600 color film.



(via kottke.org)

Take a trip down memory lane.

Cadaver skin

Used for burn victims:

Cadaver skin is removed from donors shortly after their deaths, then processed and distributed by skin and tissue banks. It has long been the preferred option for a patient with the most severe burns until a graft of the patient's own skin can be applied. Although some synthetic skin has come on the market in the last 20 years, new products have not appeared as ...

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(via The Huffington Post)

Miffed

A patient wonders what he (or she) paid $25 for:

I went to my doctor'Â’s office just to check my blood pressure. He charged me $25 and I didn't even see him. His nurse took care of me.

Why does my doctor charge that much when I can go to the grocery store and get my blood pressure checked for nothing?

Congratulations to those mentioned in the Oakland Tribune.

Transgenders

The challenges of caring for a transgender patient. They're right when they say there's no formal training in this:

Some medical experts say doctors are unschooled in how to deal with transgender patients and often are confused on everything from hormone therapy to sex reassignment surgery to the proper personal pronouns _ he or she? Some are simply uncomfortable with a transgender patient, advocates say.

A Canadian physician recommends screening for homocysteine. There is no data to support this recommendation:

While screening for hyperhomocysteinemia itself is not difficult, a benefit from lowering the homocysteine concentration on cardiovascular and venous thromboembolic disease remains unproven. Thus, even if we identify patients with an elevated homocysteine concentration it is not clear that acting on this information is of benefit.

Some common sense talk fueling the fire for tort reform:

Open societies flourish because they are driven by intelligence and information; the U.S. tort system creates an enclave of idiotic whimsy in the heart of the most open society in the world. But the Vioxx litigation does not merely celebrate dumb prejudice. It's extraordinarily expensive. For this year alone, Merck has set aside a legal war chest of $685 million. ...

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Apparently, a new profession of the "patient advocate" has sprouted:

Some advocates have minimal medical training; others are nurses and doctors. Some charge nothing; others thousands of dollars. Some advocates might help save your life; others may complicate patient-doctor communication.

It's so early in the life of this new profession that it's not entirely clear what an advocate is or how to judge whether you've found a good ...

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Dr. Welby is dead

This is what you get when incentive is based on volume, not quality:

Dr. Bea Karing has had her own practice for about 18 years. Her practice has grown and she is generally known and respected by patients and colleagues as a caring dedicated internist. Her patients range from a new college student who is generally healthy but has had a hard time adjusting to school, to a ...

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Dr. Flea laments at how physicians don't talk to one another:

I know that somewhere in the world there is a community of physicians that actually call one another on the phone and chat about patients. I suspect there are even emergency department physicians who call fleas when their patients show up unexpectedly!

Sadly, I don't live in that world.
(via the Health business blog)

Tough malpractice reforms are putting plaintiff lawyers under pressure, and reducing malpractice rates. In other words, it's working:

Sensabaugh said the caps have allowed cases to be settled quickly and reasonably, and have provided stability for medical insurance carriers.

That stability, said David Rader, president and chief executive of West Virginia Physicians’ Mutual Insurance Co., enabled the company to cut its premiums by 5 percent on Jan. ...

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This year, Bitter Pill Awards were presented in four categories to drug companies engaging in over-zealous and questionable marketing practices. The drug industry's national lobbying group, PhRMA, received two awards, and the remaining three awards were shared among makers of five of the nation's most well-known drugs: Lunesta, Ambien/AmbienCR, Lipitor, Crestor and Strattera.
(via PharmaGossip)

A radiation oncologist is giving this tidbit of advice to patients exposed to polluted water in Massachusetts:

Sacher urged people exposed to Nyanza to get regular checkups and seek medical care whenever they have symptoms that seem unusual or last longer than expected, like a cold or respiratory problem lasting more than a week. They should also demand tests if they are worried, even if a doctor doesn't think it ...

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"Too posh to push"

C-sections are up in the UK as well:

Last year the government introduced a new coding system that classifies caesareans as either elective or emergency. Preliminary figures show that, last year, 45% were elective, compared with 55% classified as emergency procedures. This compares with an estimated 7.5% elective sections in 1998.

64-slice CT scanners. Expect most who enter the ER with chest pain to receive these scans soon:

At this point, most doctors agree that the new scanners should not be used to look for problems in healthy people. In addition to the radiation risk, CT scans may pick up tiny spots of plaque on artery walls that, in the absence of symptoms, are hard for doctors to interpret. ...

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