The threat of lawsuits is one reason, and doing C-section can be equated to a form of defensive medicine:

"They're never faulted for doing a c-section," said Faith Frieden, chief of obstetrics and gynecology at Englewood Hospital and Medical Center in New Jersey. "It's never the wrong decision to do a c-section. No one's ever going to say to them, 'why were you so quick to do the cesarean ...

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tPA for frostbite?

It has potential:

Only 10% of patients with frostbitten fingers or toes who received tissue plasminogen activator (tPA) required amputation of necrotic digits, compared with 41% of patients who didn't get thrombolytic therapy.

One of the most important people on the inpatient hospital team.

Patient demand and defensive medicine has led to an explosion of CT scans and other radiology studies.

A responsible article from the NY Times, highlighting the potential radiation exposure of too many x-rays. Patients take note - more tests does not equate to better medicine:

Advances in radiology have radically transformed medical practice, with CT scans and nuclear medicine exams providing physicians with the ability ...

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No ER waits

Some emergency rooms promise no waiting in the ER. I wonder if this would lead to further unnecessary ER use.

Diabulimia

The practice of stopping insulin to lose weight:

Like many teenage girls, Lee Ann Thill was obsessed with her appearance. A diabetic, she was already suffering from bulimia -- forcing herself to throw up to lose weight. But it wasn't enough, and she'd recently put on 20 pounds.

Then one day at a camp for diabetic teens, she heard counselors chew out two girls for practicing "diabulimia" -- not ...

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A professor with mild autism explains:

Temple Grandin is an assistant professor of animal science at Colorado State University. She wrote Thinking in Pictures and has made numerous TV appearances. She is mildly autistic, which has given her a unique insight into the way autistics think. She contends it is very similar to the way that prey animals, such as horses and cattle, think.

The battle in the NHS continues:

Please feel free to criticise me in any way you like. I have but one request. Your spelling, your use of commas and apostrophes and your general grammar are embarrassing. All doctors have passed "O" level or GCSE English. Could I suggest you get one of them to glance at your copy before you publish?

How the hell do you expect doctors to ...

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That's the word coming out of Glaxo.

Zealot Dan Carlot starts a blog on the topic. (via Pharmalot)

Taking a page from Florida physicians, some lawyers are going without malpractice insurance.

An OB waxes negative on the experience:

I now believe that most contingency recruiters just do not care. They sell, sell, sell and sell some more. They go for volume, they go for the numbers. The more emails they send out, the more people they contact, the more chances they may have to get an answer and sell one of their jobs. That is why they remind me of ...

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On op-ed on the state of medicine today:

The public has been promised perfection in medical care. The wonders of medical science are hailed and the pitfalls that exist in clinical practice are ignored. Illness and hospitalizations that result in poor outcomes are often exploited by malpractice attorneys who stand ready and eager to sue.

PCP time in the US

US patients spend substantially less time in primary care compared to other countries:

The substantially shorter time per capita in the US was the biggest difference we saw in our study. Such a severe shortfall impacts preventive care and management of chronic conditions in the US and could explain why the US does not achieve health outcomes that correspond to its higher level of investment in health care," said ...

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More insight from Richard Reece:

The question reminds one of Clemenceau's famous statement, "War is too important to be left to generals." I, for one, don't equate foreign wars with health care. Nevertheless, the reasoning goes like this. The issues of ware and disease are too big for generals or doctors to grasp or control. Health care may be even more important. It takes 16% of the GNP versus ...

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Richard Reece interviews . . . himself, and talks about health care reform:

Q: Any other myths?

A: Yes. That somehow federally-run top-down care will be more even-handed, equitable, and fair to all. As a matter of act, centralized government is a lousy way to distribute resources. Take Medicare. Its payment schedules are so low and convoluted in paying primary care doctors, that primary care is on the ...

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Scott Gottlieb explains the folly of this:

When it comes to trying to manage drug risks and encourage safe prescribing, the FDA has plenty of reason to worry about how drugs get used. Many practitioners have a hard time explaining remote risks to their patients, and many patients a harder time understanding them. But the FDA can't rationalize the diversity of peoples' medical decision-making or the fact that some ...

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Ah, the wonderful smells of the emergency room.

Autism rift

There is dissension in Autism Speaks, a major charity and voice for the disease.

I'm surprised it's still there.

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