EKGs for everyone?

More on the ER death outrage in LA. The Physician Executive wonders how far should we go to prevent one death:

I suspect that there were resource allocation decisions by both policy-makers and administrators that probably contributed to this death. As tragic as it is, not everyone can be saved, nor should we as a society try to save everyone.

ER Jeopardy

Emergiblog plays along:

The answer: "I want to know if Dr. Generous is working right now."

The question: "Who wants to know the chances of getting a pain shot before coming to the ER?"

And it is precisely why this sense of entitlement to health needs to end:

People with insurance have said to me,'I didn't get that prescription, because I'd have to pay with my own money!' As if I suggested that they sprout wings. (Crazy talk, that! Investing in your own health, when you could buy a new i-pod and download some music!)

I don't blame my ...

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Consider the following widely-quoted assertions:

1) The United States has lower life expectancy and higher infant mortality than Canada, which has national health insurance.

2) Some 47 million Americans do not have health insurance.

3) Health costs are eating up an ever increasing share of American incomes.

John Ford
comments on the analysis of the statistics.

The NY Times profiles John Holcomb and the controversy surrounding his use of Factor VII during trauma surgery.

Blogger problems

Blogger has been having publishing trouble for the last few days. That's why comments have not been publishing consistently, and posts disappear and reappear. I apologize for the inconvenience.

The 64-slice cardiac CT

Turf war ahead. Like virtual colonoscopies, these CT scans has its sights aimed at cardiac catheterization. Questions about radiation dose and mortality benefit remain. Like any new diagnostic study, these uncertainties need to be communicated clearly with the public.



I am honored that Kevin, M.D. has been selected as a finalist for the 2007 Weblog Awards in the Best Medical/Health Issues Blog category.

Voting concludes on November 8th, and you may vote once every 24 hours.

I appreciate your continued readership and support.

What an x-ray.

A miraculous story of how a fetus survives multiple abortion attempts.

Many don't after a missed reading, as they don't have a relationship with the patient:

When the radiologist has performed his or her duties by interpreting the film, to whom is the radiologist professionally related? The patient? Or the physician who ordered the X-ray or other exam? And what if later it is found that the radiologist has made a mistake or missed a critical diagnosis..has, for example, made ...

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47 million uninsured

A critical look at this oft-quoted number:

If 10 million of the disingenuous "47 million uninsured" are in fact illegal immigrants, are we to understand that all of these candidates are actually calling for nationalized health care coverage for illegal immigrants? Perhaps, in our beneficence, we should pay for healthcare for anyone worldwide who comes to our country. If this is what is being suggested in using these numbers, ...

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An EpiPen stuck in the finger. Here's what happened next. (via ERnursey)

DNRs and being sued

Defensive end-of-life care?

I saw doctors overturn patients DNR's when the family asked (when the patient was not able to speak for themselves) because they were afraid to get sued. I've participated in the intubation, insertion of multiple invasive lines and tubes in people with severe heart disease, diabetes, multiple amputations and strokes confined to a nursing home in their 90's for god sakes because the family "wanted everything done."
Sad.

"What's the deal with the ED being used for second opinions?"

Well, patient's don't like waiting. In the ED, you can get a CT scan, MRI and a consultant/ER physician opinion all in one visit.

Problem is, they "have never developed humility in the face of disease":

It is easy, for example, for your acupuncturist to promise a perfect cure because they're not really treating anything, just some nebulous mumbo-jumbo like a dysfunction of your ability to receive pure qi from the heavens. Side effects? None, of course. It's perfect medicine because, despite being based on a completely imaginary idea of physiology ...

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Munchausen by Proxy

A mother fights the stigma of this misdiagnosis.

Which is why medical students are staying away in droves:

Medical students, burdened with $200,000 in debt are voting with their wallets, choosing gastroenterology with it's $200 13.5 minute colonscopies, or cardiology, with it's unlimited access to procedures (echo, ekg, cath, stress test, pacers, ICD's and on and on). Money is currently being made by procedures,not cognition. And there is no relief in site. In fact, Congress is proposing dropping ...

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It's all through documentation, and can be easily manipulated:

You can see how statistics lie. Doc B may be an "inferior" doc, but knows how to play the system. Doc A maybe a doctor's doctor but won't play the documentation game, just practices good solid medicine. His published actual vs expected mortality data will pop up as an outlier for a doctor to avoid, when in fact, he could be ...

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Are they turning this drug-resistant infection into a public joke?

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