Limit specialists?

That is Matthew Holt's solution to cutting physician pay:

What's the rational answer? Do what most other countries do and restrict the amount of specialty positions available. Instead insist that most physicians focus on primary care which is both cheaper to the system and more cost-effective. Of course, doing that would be better for the system overall, but it would be worse for individual physicians--or at least for their ...

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Fork in nose

That looks painful. (via GruntDoc)

Cardiac bypass 101



(via Dr. Wes)

The dangers of quality

How P4P can be dangerous if implemented poorly:

The hubris,arrogance and naivete that I believe characterize those who make rules for how to treat individuals based solely on group data ignoring the input of the physicians on the scene is even worse that the folks who simplistically sprout out coarse grain outcome data quality indicators such as percentages of patients with HbA1c less than 7 %. In the later ...

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Sid Schwab talks anal fissures.

Anatomy tattoos

Street Anatomy collects what she can find.

keagirl takes exception to this ridiculous attitude:

The bottom line is that whether we are in clinic, the ward or in the OR, we are a team. We need to work together and do whatever needs to be done for efficiency sake and for the good of the patient. There is not a job in clinic that I consider "beneath me". I'll answer the phones (albeit pretending not to ...

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Guidelines are all the rage these days. For good reason.

The AMA and ACP is supporting the CHAMP bill because it contains a reprieve from the upcoming Medicare cuts.

Don't get your hopes up.

More about the folly of cutting physician Medicare payments.

Bring Vioxx back?

Some patients can't live without the withdrawn drug. (via The WSJ Health Blog)

Who do you believe?

Some residents may not be adhering to the rules. While a study by the group that accredits residency programs found that only 3% of residents worked more hours than the rules allowed, Harvard sleep researchers found that 80% of residents they surveyed worked excess hours.

Roadblocks are being set up as retail clinics spread. Is the AMA winning the fight?

Instead of a waiting room, MinuteClinics provide chairs for customers outside the exam rooms. They also don't have their own bathrooms, so patients who need to provide urine samples must use the regular CVS bathroom. Older MinuteClinics didn't include a hand-washing station for nurse practitioners -- they used a hand sanitizer instead -- ...

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J&J sues the Red Cross

And they're taking it to the blogs.

A link between labor and belly dancing?

Some belly-dance movements mirror those of labor. The idea is that the pelvic gyrations help disperse the pain of contractions, orient the fetus and propel the baby into the world. In early labor, when contractions are relatively mild, the expectant mother may find comfort in dancing slowly and hypnotically, using hip circles, crescents and figure eights. As labor gets more intense, the ...

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A well-documented case of a long-time family physician who becomes a woman. The Boston Globe explores the transition:

"I will begin practicing medicine as a woman," his letter said.

Instead of taking the usual route of moving to a distant city and starting a new life, Berkowitz-Shelton was staying put for his life-changing journey, asking his family, his staff and his nearly 4,000 patients to make a ...

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Anti-smoking shock ads

Do they work?

"Monster Mac"

How much is too much? Check out this 8-patty monstrosity:



(via Dr. Wes)

Vasectomy for iPhone

Dr. A reports on this husband desperate for Apple's latest gadget.

A port-a-cath for who?

A port-a-cath in a patient with a history of drug abuse is generally not a good idea.

There are some pretty important ones on the list.

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