A core tenet of risk management:

That's all the more reason to carefully approach informed consent, that exam room ritual of securing a patient's permission for a test or treatment after discussing its benefits, risks, and alternative measures. If you help a patient form reasonable expectations about a course of action, he's not only in a better position to say Yes or No, but he's also less likely to legally ...

Read more...

Proceduralists

"See one, do one, teach one" doesn't cut it in today's malpractice environment. The (rightly) low tolerance for complications stemming from procedures is creating this new field, which focuses on procedures that everybody used to do:

Awaiting both kidney and liver transplants last year, Larry Pritchard suffered from fluid build-up so severe it sometimes leaked from the skin on his stomach. The condition required a procedure known as ...

Read more...

Shaving in the OR

keagirl talks about her pre-operative handiwork.

Angry Mike says that's the way it should be:

He feels that the ethics committees agree too often with providers. (He states later that ethics committee at Baylor agreed with the clinicians 43 out of 47 times. Gee, I wonder why.)

I will tell you why: Because they know what they are doing . . .

. . . Additionally, I do not understand AT ALL his ...

Read more...

Couz talks about the hospitalist position she took in Canada:

But then the same little hospital that had been courting me to work in emerg presented another option-- they are currently desperate for hospitalist coverage. I can come in for as long as I want, as many days a week as I want and they'll pay me $130/hr to see as many inpatients as I can. They don't seem ...

Read more...

It's only getting worse, and compounded by uneven distribution between specialists and PCP's. Don't say I didn't warn you:

While shortages will create difficulties, an even greater problem will arise from the unequal distributions of physicians by specialty and geography, according to the Pricewaterhouse report.

Only 20 percent of today's internal medicine residents are choosing to go into primary care internal medicine; the rest are going on ...

Read more...

Politics blatantly ignoring the science? It's so wrong, and Sid Schwab has a few choice words:

. . . dammit, there are some areas in which reality -- not to mention the common good -- ought to trump politics, ideology, and theology. People argue, and I don't disagree, that science isn't the same as policy; that scientists aren't the ones setting political agenda. Fair enough. But when science ...

Read more...

Less is more

Yes, stopping medications can sometimes do the trick.

Ezra Klein says if the state-level reforms fail, it will set back the universal care movement. David Catron comments.

If the FDA had approved the claim, pizzerias would have touted that their pizzas could prevent cancer.

Do you think he won the case? Find the outcome here:

. . . a patient presented to an Emergency Department having cut off two fingers with a table saw. The injury occurred at 6:30 p.m. The patient was triaged at 7:19 p.m. The emergency medicine physician saw the patient at 7:42 p.m. X-rays were performed at 11:33 p.m. Orthopedics was finally consulted at 1:00 a.m., more ...

Read more...

The fighter against frivolous lawsuits takes on another cause:

I developed Medical Justice, based on a proactive approach, to tackle the problem of frivolous malpractice lawsuits. Since then we've developed a contract-based solution addressing this new threat and are already seeing results. While it is difficult to file suit against the website itself, you can put safeguards into place to prevent defamation on the internet. In other words, there ...

Read more...

The tragic cases of neonatal euthanasia in the UK.

What links the two? Hate:

So what would drive these men to such hideous acts of murder?

I believe that it is hate. Hate that is taught to them at a very young age. Hatred of the West. Hatred for Jews. Hatred of infidels or anyone, even Muslims, who do not conform to their view of religion as they imagine it.

Being too careful can also be dangerous.

Thus far, their toned-down, non single-payer proposals are politically smart. Michael Tanner disagrees.

"Prostatempathy"

Despite the evidence, physicians still order screening PSA's to populations that may not need the test. Who tends to be the culprits?

Practitioners who were urology specialists, male, infrequent PSA test orderers, and affiliated with specific hospitals had significantly higher levels of inappropriate PSA screening. Compared with attending physicians, nurses and physician assistants had significantly lower levels of inappropriate screening. Under multivariate modeling, infrequent PSA test ordering and ...

Read more...

The specialists that I work with are normally very thorough in their notes and assessment. But apparently that's not happening everywhere.

But the lottery is ok:

The average American spent $177 playing the lottery, more than the average spent on reading materials. Massachusetts is fifth in the nation in per-capital lottery spending at $700.

I had seen this number in previous years, but each time I do, I am blown away. That is $700 for every man, woman, and child in the Commonwealth of Massachusetts. According to the US ...

Read more...

The public perception is that more screening is better. It doesn't help that doctors are not consistent in their screening practices:

The problem with this is that there is a bit of a PR problem trying to explain to parents who think I am not doing what I should by testing their children. Many of my straight-pediatric colleagues still routinely test children's cholesterol, so parents are surprised when I ...

Read more...

Most Popular