This is life in the pseudo single-payer VA. Imagine a whole country subjected to this standard of care.

SWAT docs

Meet a physician on the SWAT team:

There is a growing trend among the country's SWAT teams -- not just in Dallas -- to add doctors to provide immediate lifesaving treatment on the scene. Far from the controlled environment of hospitals, these doctors learn to work on trauma victims even as they take fire.

The insight of mortality

Walking out after a shift in the ER causes this physician to reflect:

Leaving my shift yesterday, I walked past a family grieving the unexpected death of an elderly loved one. There they were, gathered in the conference room, making phone calls, comforting one another. I was in my jacket, a drink in my hand (tea, mind you), my backpack over my shoulder. I was headed ...

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Ridiculous, says Dr. Wes:

As though our patients can go down to the corner store and pick one of these up for their heart. I guess J&J feels patients can discern when a drug-eluting stent is preferred over a bare metal stent, or better yet: when a stent is appropriate and when it is not.

ER nurses and childbirth

An "Oh Sh**!" moment:

I may have mentioned before, ER nurses DO NOT like childbirth. There is blood from places you can't put direct pressure on and wet, slippery infants involved.

One of many tips from a new hospitalist. This one is especially poignant in this litigious day and age:

Call in consultants. It bothers me to call in the GI folks for every case of diverticulitis and the endocrinologists for all uncontrolled diabetics, but that's what I do now. As one of my partners told me, "Just because you can take care of a patient's problem doesn't ...

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The GI cocktail

With a Scalpel twist.

Losing a guide wire

One of the worst sinking feelings a physician can have is losing a guide wire while placing a central line.

Candy heart

Literally.

Dosing amoxicillin

Some insight from The Angry Pharmacist:

You think that when we reconstitute the Amoxicillin I count the number of drops in the graduated cylinder? Hell no, I just eyeball it, dump it in, shake, and send it to the mother who's child is either screaming his/her head off . . .

A day in the life of a Happy Hospitalist.

Detailing physicians

Simply a bribe?

Myocarditis in children

The incidence is increasing in Boston, and no one knows why.

Patients are watching

Before launching into a comedy act, don't forget that patients are also part of the audience.

Most trial lawyers point to the statistic that malpractice comprises of less that 1 percent of health care costs.

However, they are missing the fact that the threat of malpractice litigation raises costs by encouraging defensive medicine, as well discounting the significant amount of cases that are settled prior to trial.

CT scans and radiation

CT scans are becoming routine, partly due to patient expectations and defensive medicine. The exposure to radiation is something that has been underpublicized, so getting the word out is helpful:

A chest CT, for example, exposes a patient to about 8 millisieverts of radiation - 80 to 400 times the radiation exposure from a chest X-ray and, recent studies show, close to the lowest doses received by Japanese ...

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Texas tort reform

It's economics 101 people:

Basic economics teaches that imposing higher costs and burdensome regulations on businesses leads to fewer businesses and higher costs for consumers.

The opposite is also true: Lower costs and fewer restrictions in a marketplace will lead to more market participants, greater supply, and lower prices for consumers. Texas' medical malpractice insurance industry provides a clear example of this principle.

Not sure how this mix-up could have happened:

The Tanzanian man who had a knee operation when he had a tumour in his brain, has died after finally having the operation he required.

Emmanuel Mgaya, 19, died hours after the surgery, performed two weeks late.

Meanwhile, Emmanuel Didas, 20, who had brain surgery although his complaint was in the knee, is slowly recovering but he remains partially ...

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Finding a case of metastatic seminoma.

Would giving hospitals the same amount for every residency help?

"The distribution of resident training funds also should be reworked," Dr. Weiner told amednews. "The government spends more to produce a surgeon than it does to train a family physician, because surgeons take longer to train and the government subsidizes each year of their salaries." Weiner suggests that the government give programs a certain amount for each resident regardless of ...

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