If you live in the northern territories of Canada, the average distance to see an obstetrician is 900 kilometers.

More for less. It shows how difficult it is to bring new drugs to the market:

The decline in drug development came as scientists in and outside the companies were making great strides in genomics and other sorts of basic research into the way diseases develop, opening many potential new targets for treatment. Yet such progress in the laboratory has not translated so far into many new drugs on ...

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Disciplined for treating pain. Another physician is sanctioned for prescribing chronic narcotics:

"Part of the way we treat pain is to balance the medications that we give to patients with the control of their pain but also with how well they are able to function," Oujiri said. "We realize in many cases we can't completely eliminate the pain, so we treat it to the level where the patient is able ...

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Striking a nerve. Apparently, Orac takes exception to I said a few days ago:

Dr. Kevin's comment revealed a common misconception of what it is really like to work in academic medical centers that is common among physicians in private practice . . . If you're in academia for any length of time, you become aware that many private practitioners appear to have some sort of stereotypical picture of ...

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Medpundit on the PSA: "It's one of those tests that gets ordered more for legal reasons than for medical reasons."

I completely agree. And yes, I'm going to bring up the Merenstein lawsuit again.

A vagal stimulation device for hiccups. Maybe it can help this guy.

Probably not a good idea. Girl gets bird flu from kissing chickens.

A meritless lawsuit in action. This story illustrates why caring for nursing home residents is risky:

I was shocked. After working 12-hour days, through weekends and holidays, always trying to do my best for my patients, I'd been accused of negligence without any basis"”and yet I might be found culpable! I still felt bad for John, but thinking about his father filled me with bitterness. What kind of parent ...

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Taking a deeper look at frivolous lawsuits. "At the same time, Smarr says, unsubstantiated malpractice suits take a heavy emotional toll on physicians, because the doctor's reputation and professional capabilities have been called into question. The resulting distraction adversely affects the delivery of healthcare, says Smarr, who believes that overzealous lawyers play a major role in exacerbating the malpractice crisis. 'All you need to do is read the highway ...

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News flash: ERs are overcrowded. "Emergency patients tend to be sicker and more unstable than others, causing some specialists to be reluctant to see them because of the higher liability and higher malpractice insurance rates, Epstein said.

The result is that some specialists, like neurosurgeons, leave certain states or refuse to provide emergency care."

Illinois has three times the amount of malpractice claims than Canada. "There are approximately 14,000 physicians in Illinois physicians versus 68,000 in Canada. And the lawsuits quoted in Illinois are only for docs with liability insurance from ISMIE Mutual. And of all the legal actions commenced against physicians in Canada, only 125 legal claims went to trial."

Some are saying that Sharon's stroke was caused by ill-advised coumadin use. "A doctor close to the situation told the Israeli newspaper Haaretz that the disease was diagnosed by doctors treating Mr Sharon at Hadassah University Hospital during his current hospital treatment.

The disease, cerebral amyloid angiopathy, could have greatly increased the risk of a brain haemorrhage, following the administration of the medication that he received after his first ...

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Health care costs continue to spiral out of control. "Americans rejected the tougher restrictions of managed care in the late 1990s, and yet they want all the latest advances in medical technology."

And that is precisely the problem. You can't have it both ways.

Softening up the tone of ED ads. "A campaign for Cialis that begins Wednesday includes changes such as having an actual doctor appear on screen during the television commercials to recite the disclaimer warning about side effects. Cialis is sold by a partnership of Eli Lilly & Co. and Bothell-based the Icos Corp.

In altering its advertising approach, Lilly Icos joins Pfizer, the maker of Viagra, the leading brand ...

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Are OTC cough medications useless? Apparently so, says the American College of Chest Physicians. The dose of dextromethorphan (a morphine derivative) in these medications are too low to suppress cough. Of course, because of the potential for abuse, they cannot make these any stronger.

The press and HIPAA. Just how much information can be revealed to the public? (via KidneyNotes)

More questions surrounding prostate cancer screening. I have always maintained that screening for prostate cancer does not save lives. The USPSTF supports this. However, these are case-control studies - randomized trials are needed for a more definitive stance.

Orac analyzes Airborne, the cold-fighting supplement.

The woes of an academic physician. "A growing number of academic physicians are stressed out and depressed because they are being pressured to treat more patients and generate more money, and they have less time for teaching and research, a report published this month concludes."

All I can say is - welcome to the real world. (via Health Care Renewal)

How are doctors combating declining Medicare rates? By doing more procedures:

Ginsburg also said stagnant reimbursement rates for Medicare patients does not mean Medicare patients are less lucrative than they were four years ago. Doctors are billing Medicare for more services per patients, such as lab tests, cardiovascular stress tests and echocardiograms.
Expect this to continue as reimbursement declines.

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