Overtreating pain

Aggravated DocSurg explores the downside of the "fifth" vital sign:

Couple that issue with the militant attitude of JACHO [sic] ----there shall be no pain!!--- whose guidelines insisted that anyone with a pain score greater than 5 must be reassessed. In the real world, unless a nurse wants to go through the headache of extra paperwork, reassessment means "remedicate." And, of course, there is the all-too-frequent patient who describes ...

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Trusting Medicare

Some are advocating "Medicare for all", partly because of the low-interference such a system will provide. Can this stay true in the future?

As Medicare expenditures rise, this illusion of non-interference will become much harder to maintain and indeed Medicare itself may become less popular. I am always curious to hear -- from single-payer proponents -- which interest groups they think will have a decisive say over ...

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Dr. Rob with some friendly advice that all patients should read.

Dr. RW turns two

Congratulations! Keep up the great blogging.

Sometimes, it's difficult to tell:

Most medical schools don't spend much, if any, time teaching their students how to cope with low-literacy patients, and most doctors aren't particularly adept at detecting reading problems "” or knowing what to do when they identify someone who can't read. And with the specter of "pay for performance," in which doctors' reimbursement will be tied to meeting certain quality goals, there is concern ...

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More feedback on yesterday's study suggesting that older physicians are bemoaning the resident work-hour restrictions. retired doc comments:

This is not a hard data article but a presentation of the impressions of IM resident training program teachers most of whom trained in a era that was very different. One difference is that many faculty likely grew up medically with their limbic cortices branded with the concept that ...

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Think before jumping to conclusions on this recently released study:

The drinking of diet soda, while unlikely to largely contribute to (cause) the development of metabolic syndrome, is a behavioral trait that is associated with others that are negative. So if you DO exercise and otherwise eat a balanced diet, you shouldn't feel awful about drinking a diet soda every now and then: its the behavioral patterns which are reflected ...

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The WSJ Health Blog writes about a recent survey suggesting that older physicians are work-hour restrictions the thumbs-down:

But the faculty docs had mostly bad things to say about the rules, and those who had been teaching for five years or more were more likely than their less-experienced colleagues to be sour on the work limits. Among the overall findings:

* Eighty-seven percent of the doctors thought continuity ...

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Sid Schwab tells all.

Speaking of painful ways to die . . . (via plasticized.com)

No surprise to regular readers here.

The primary care shortage will only worsen. Are insurers listening?

"The reason there's a real threat of a shortage of primary care physicians is that they are paid much less than other physicians," says Ann S. O'Malley MD, MPH, a senior researcher the Center for Studying Health System Change. "Their incomes are lower than surgeons and other specialists, and a lot of what primary care physicians do ...

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Some ads actually cause more youths to smoke. What sets the effective ones apart?

"Anti-smoking ads have the greatest impact on smoking attitudes and behavior when adolescents think that their peers are listening to those messages," Paek said. "And that makes sense because people are more likely to listen to what their close peers say rather than what the media says."

Reforms from an unlikely source is helping improve its image:

Another change applies to lawyers from outside Madison County who want to file cases there because they have heard about big verdicts. Those lawyers now face a lengthy and cumbersome registration process to justify why suits are filed in Madison County.

Also, every medical malpractice lawsuit filed in Madison County now faces mandatory mediation before lawyers can try filing ...

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The woman's daughter had a hysterectomy due to cervical cancer, so she offered to carry her daughter's twins.

Families coming to the US for medical care may stay here for extended periods of time. Not being allowed to work, their funds may not last the duration of treatment.

It's hitting upstate New York hard:

While newly licensed doctors flock to New York City, Long Island and Westchester County, where there is already a glut, far fewer choose to practice in the vast upstate region. For instance, during the years the study was conducted, Essex County in the Adirondacks lost 22 percent of its doctors, while there was a 19 percent increase in Nassau County, on Long Island.

Animal care

Medical services for pets is poised to become the next big moneymaker:

Think of how many sectors of the healthcare business world will pile on to Rover or Whiskers. Before, Whiskers was the family feline who might get an occasional feline distemper shot. Now Whiskers is a potential gold mine for a whole new multi-faceted revenue stream! And who ever dreamed of this same potential for the family ferret? ...

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A wife is accused of killing her husband with the paralytic rocuronium. GruntDoc comments.

From blog to print

Some bloggers are making into print. Dr. Crippen wonders if they are "sanitizing" their prior blog posts:

What are bloggers up to?

"Tell it all" until the book deal appears and then sanitise it retrospectively? With Tom Reynolds what you see is what you get. He did not "“ to my knowledge "“ retrospectively re-edit Random Acts after his book appeared.

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