The Medicare secretary won't negotiate, even if he could:

One rather obvious stumbling block: HHS Secretary Mike Leavitt, who oversees Medicare, has said he wouldn't negotiate drug prices even if the law permitted him to do so. For negotiations to work, the head of HHS has to be willing to use whatever cudgel Congress devises. (A House bill would address this by requiring HHS to negotiate, while a Senate ...

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A physician e-mails me his thoughts on drug rep detailing:

I have been thinking about the drug rep thing. I see them. I eat their lunch and I shake them down for enormous quantities of samples. I try to play their arguments off against each other and I treat them decently.

I also send every patient for whom I write a new prescription home with a trial (one to ...

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Some patients may be influenced to (not) sue based on what the physician is wearing:

A patient suing over a post-surgical error said that she knew her surgeon wasn't focused on her because he came to her room in jeans, a T-shirt and athletic shoes. "Every other physician said he probably came and checked her and then went into the locker room and changed into scrubs, but what the ...

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Of course, this radiology ad left out some important caveats such as "the $1,200 fee may not be covered by their insurance, or that incidental findings that require further testing may ultimately found to be benign."

Virtual colonoscopies, and CT screening for lung cancer and heart disease are not ready for routine use yet.

A pro/con debate over the PSA prostate cancer screening test at the ACP Observer:

Will more aggressive screening at an earlier age lead to detecting more tumors at an earlier, more treatable stage? Or would it simply lead to overdiagnosis of tumors that may never become life-threatening?
No surprise, but those in favor of a lower PSA threshold are urologists, while an internist speaks against it.

Of course, urologists ...

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They often don't contain what's on the label. No surprise in this unregulated industry:

"We've known about this problem for a long time," said Dr. Wallace Sampson, editor of The Scientific Review of Alternative Medicine and a clinical professor of medicine at the Stanford University School of Medicine. "Dosing in these products can vary from 0 percent to 300 percent."

Lack of monitoring is the big problem, ...

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What a bizarre photo-op. A famed malpractice trial attorney rubbing moisturizer on a nursing home resident's legs:

Dressed in jeans and a blue work shirt, Edwards, the 2004 vice presidential nominee, helped awaken Irving Zywoto and tried to explain to the 83-year old resident who he was.

"Remember the last presidential election in 2004? Kerry and Edwards? I'm Edwards. I'm running for president this time," he said.

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A kidney transplant surgeon has taking this controversial stance on organ donation:

For the past several years, Matas, a longtime proponent for increased organ donation, has taken a rather controversial stance in the debate over the sale of organs.

"I've struggled with it," Matas said. "There are tons of reasons for why one shouldn't go forward with it."

Why, then, does he believe in creating a regulated system ...

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Overlawyered with what they have in common.

Scalpel writes about how a few drug seekers leads to suspicion to those even with legitimate back pain.

The problem really is that simple:

. . . in health care, we get what we provide incentives for. We currently provide lots of incentives for advanced technologies and high-end treatment, and we get a lot of that. We provide very little incentive for preventive medicine and get very little of that.

A physician in Colorado writes an open letter imploring physicians to think about upcoming health reform:

Although I completely agree that there are genuine problems with the current system, more government interference in medicine can only make things worse, not better. One basic principle we all learned in medical school was, "First, do no harm". This applies as well to politics as it does to clinical practice. Most of ...

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Roy Poses wonders whether pay-for-performance should also apply to hospital CEOs.

John Dickerson in Slate has his doubts. (via Health Care BS)

WebMD with a takeoff from the Fox show. A sample question:

If you eat just one candy bar a day in excess of your calorie needs, in a year you will put on:

1. 15 pounds
2. 26 pounds
3. 52 pounds

An article in JAMA suggests that most back pain is just normal aging, not caused by working. However, despite this finding, some don't expect much to change:

Still, I am skeptical that anything will happen from this exposé, as too many professionals benefit from the system, including doctors, lawyers and chiropractors. Insurance companies also benefit from this dysfunctional system by collecting a percentage of the cost distributions as ...

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Some want a NHS-like system here Stateside. A look at how sciatica is treated in the UK.

It will be more helpful if Robert sees the physiotherapist. The physiotherapist is clever enough to order NHS MRI scans. She will spend about 90 seconds with him, and then order the scan. There is currently a two-month waiting list for MRI scans. Once Robert has had the scan, he will ...

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Why can't medical devices look more like iPods? (via MedGadget)

Do my eyes deceive me? A responsibly-written cancer screening article? From major media? Maybe there is hope after all. Needless to say, this is a must-read (emphasis mine):

. . . if you really want to find as much cancer as possible, we would suggest whole-body CT, MRI and PET scans every month. But that would be absurd. Why? Because the goal is not to find ...

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Many have been promoting ePrescribe as a savior for medication errors. The Angry Pharmacist cuts through the hype. I use ePrescribe occasionally, and his concerns are bang on.

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