And learns something about bedside manner, or the lack thereof:

However, Derm's lack of any appreciable bedside manner has me reevaluating one of my longest-held beliefs, that people don't really care if their doctor has a great bedside manner, but only really want a doctor who is very competent and does the job right.

And, painfully, I have to look hard at myself. I am, occasionally, a touch ...

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All thanks to Medicare Part D:

The windfall, which by some estimates could be $2 billion or more this year, is a result of the transfer of millions of low-income people into the new Medicare Part D drug program that went into effect in January. Under that program, as it turns out, the prices paid by insurers, and eventually the taxpayer, for the medications given to those transferred are ...

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That is something the Florida Supreme Court is considering:

Getting U.S.-quality medical care on a cruise ship can be difficult, according to attorneys who file medical claims for seafarers and cruise passengers. Almost all doctors who work on ships are foreign-trained and reside overseas. That limits the jurisdiction of U.S. courts in cases where something goes wrong. Whether ships have vicarious liability for the actions of doctors arose as a ...

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The Lancet writes about what doctors already know (if someone can e-mail me the full-text article, I'd appreciate it):

The pressure on doctors from the malpractice liability system in the United States, Australia and United Kingdom may be limiting the quality of care they provide.

The common law tort system allows patients to collect when a doctor is careless or causes injury. Daniel P. Kessler, Ph.D., Professor of ...

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How an off-label treatment does as well as a new drug at 1/40th of the cost.

A story of a tragic psychiatric case on the wards:

To simply say this woman is depressed, to attempt to medicalise the enormity of what she is experiencing, is not helpful. How can medicine cure this situation? How is anyone ever going to make this better? For some people, life is just too painful and sometimes there's no simple answer.

First Medpundit, now The Blog That Ate Manhattan returns. Happy days are here.

To so-called "cheapest office in New York":

Although he has been mistaken for a drug dealer, voyeur and even porno-watcher on wheels, Sweidan told the newspaper he prefers his rolling office to his conventional digs.

Apparently the American Society of Anesthesiologists has advised doctors not to participate:

Gaitan, who was appointed by President George H.W. Bush, told state officials that, among other things, a board-certified anesthesiologist had to ensure that inmates were sedated enough during execution that they would not feel unnecessary pain . . .

. . . Missouri officials sent letters to 298 board-certified anesthesiologists in Missouri and southern Illinois "inquiring of ...

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The NY Times looks further:

Zidane was tired and frustrated, and Materazzi'’s words -— no one is saying precisely what they were, though Zidane said his mother and sister were mentioned -— proved too much.

"You're talking about a situation of absolute intense pressure,"” Mr. Sagal said. “And you are talking about a player in particular who is unparalleled in his ability to stay narrowly focused. What ...

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Procedure-based medicine has been disproportionately reimbursed for years. If the cuts are redistributed to primary care and E&M visits, I don't have a problem with it:

The Bush administration says it plans sweeping changes in Medicare payments to hospitals that could cut payments by 20 percent to 30 percent for many complex treatments and new technologies.

The changes, the biggest since the current payment system was adopted ...

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Apparently they weren't too forthcoming with information:

"What do you need this information for?" he said. "Let me tell you where I'm coming from. When I take my car to the mechanic, and he says this and this and this is wrong with the carburetor, I don't even listen. I'm not a mechanic. So what good will this information do you? You're not a doctor."

WashPost talks about how religious beliefs affects treatment decisions:

Patients around the country describe similar experiences -- being shocked, judged, humiliated, frightened and angered when they have encountered health-care workers who are overt in some religious beliefs.

Sometimes providers proselytize gay or unmarried patients but do provide care. Sometimes they refuse to fill prescriptions for birth control or morning-after pills but refer patients elsewhere. Other times they refuse ...

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The demise of the brachial plexus clinic can have serious implications for Baylor.

One problem - if this went through, no one would take on difficult patients or hard-to-control diseases:

The way physicians are paid is how stockbrokers used to be paid about a decade ago, Udall said.

"“They were paid on transactions, they were paid for selling or buying the shares,"” he said. "“They weren't paid based on whether the stocks did well. A few years ago, they changed that."”

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Another sign of an overmedicated society:

The breakfast buffet at Camp Echo starts at a picnic table covered in gingham-patterned oil cloth. Here, children jostle for their morning medications: Zoloft for depression, Abilify for bipolar disorder, Guanfacine for twitchy eyes and a host of medications for attention deficit disorder.

A quick gulp of water, a greeting from the nurse, and the youngsters move on to the next table ...

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Some are advising against malaria prophylaxis:

Some homeopathic practices tell people they need not take conventional anti-malaria drugs in high-risk parts of the world, an investigation by BBC2's Newsnight has revealed.

Instead, the clinics say that their remedies are sufficient to protect against malaria.

Here are results from a recent survey:

. . . only 37.6 percent said they would choose to enter primary care again if they could start their careers over. Over one-third said they would go into a surgical or diagnostic specialty instead. Meanwhile, 28.6 percent said they would not choose to go into medicine.
(via a reader tip)

Medpundit’s back

Welcome back! The medical blogosphere has been somewhat empty in your absence.

December 2004 - Analysis of Reggie White's death, and the connection between sleep apnea and heart disease:

There has been some connection between coronary artery disease and sleep apnea, although the data is far from robust. A study done in the 1980's suggested an odds ratio of 2.0 for angina in those with sleep apnea.

Another found a significantly increased risk of myocardial infarction for those in the ...

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