How much is it driving overall drug costs?

Almost every statistic you read today slams the US health care system. Not enough press is given to what we do well.

The Lancet ranks the US #1 in cancer survival rates in both men and women.

Time to give some credit when it's due. (via Catron)

Harry Potter and rounds

Robert Centor takes lessons from Harry Potter onto his teaching rounds.

Retaliation to pharmacy-based retail clinics? Having a physician-based pharmacy would improve revenue and patient satisfaction. Makes sense to me:

Three out of four Americans would have their prescription filled in their doctor's office instead of a pharmacy if given the choice, a new study finds, suggesting physicians are missing an opportunity to improve patient satisfaction and enhance revenue by not dispensing medicine in their office.

The trials of the visiting nurse - so crucial as more care tends to be outside of a hospital setting.

Experience counts

Edwin Leap goes back to work after vacation:

Honest doctors must admit that it takes practice to practice well. No matter how much people in the ivory towers want us to believe that articles and tests make us competent, those are only a smidgen of good medicine. The rest is seeing people, recognizing sickness and injury, and knowing what to do.

The focused plastic surgery assessment and plan during ER call.

So says the misinformed NY Times. Trust me, I have had many more than a "few hours" of training in diabetes. It is poorly-researched articles like these that push patients towards unnecessary specialist care.

There should be no reason why most cases of diabetes cannot be treated appropriately in a primary care setting - without a referral to an endocrinologist. (via Medpundit)

One method is to hope that the plaintiffs die:

Wall Street now believes Merck's ultimate Vioxx liability is closer to $5 billion than $25 billion, Lehman Brothers analyst Tony Butler adds. The reasoning - with fewer than 20 lawsuits so far making it to trial, some plaintiffs won't live long enough to see any money.

A fine line when it comes to chronic pain management:

Well, first, we are concerned about patient satisfaction. A few month ago, my CEO marched into my office concerned about a patient complaint. The patient had stated the physician was uncaring, refused a prescription and did not listen. I refused to discipline the physician, since the request was for narcotics. I recently had a conversation with another medical director ...

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Limiting resident work hours may be linked with an increase in surgical complications:

Using data from the trauma center at the Los Angeles County + University of Southern California Medical Center, researchers compared outcomes before and after the limits were introduced. They found that the death rate didn't change significantly. But the rate of "preventable complications" rose after the work limits were introduced. "This increase in complication rate may ...

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Sid Schwab on Medicare's misguided attempts to control medical errors:

As one who's gone on record as supporting single-payer health care, this is the sort of thing that makes the position a little hard to defend. It's not that I entirely disagree with the concept. For one thing, I never (nor do most surgeons, far as I know) charged for a re-operation, even if it wasn't for an obvious ...

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He saw 26 patients one day:

On March 30, Sanchez-Arias saw 26 patients, including one man who had an ear infection, McNulty said.

"He said to the nurse, 'What kind of antibiotics do you give for this?' And she said, 'You're the doctor,'" McNulty said.

Such behavior aroused suspicions among the clinic's staff. It is unclear if Sanchez-Arias treated other patients since March.

Dating a doctor

Blogged at Doctor's Girlfriend:

I swear I just wanted to get laid, not become a doctor's girlfriend. As a female, when you tell others that you are dating a doctor, they kind of give you that smirk. You know, "that smirk" that suggests financial security and a possible lift in the social class ladder. Urgh. It's so far from the truth when your partner is a 2nd year resident.

A patient uses a blog to retaliate against a doctor:

Have you ever googled a doctor before a visit? I do it all the time and guess that many others do, as well, or at least should. Thanks to my rant here on my blog, when you google "[name deleted]" my blog post is now the second result!
More on why your Google reputation is important for ...

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Why doctors are such easy targets:

They are disorganized, individualistic, and political when necessary, and very competitive with each other. In fact, most of the competition has been directed toward and against each other in their local communities. When they perceived that their medical organizations did not represent their interests they walked with their feet and dues, weakening major organizations, that potentially could have aborted the mess our healthcare ...

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Sobering words from a medical student:

This "art of defensive medicine" infiltrates the classroom too. We are taught how to ask questions of our patients and treat them in such a way that minimizes our risk of a lawsuit. We are trained what kind of patients to be wary of. Basically, we are taught that we can't trust our future patients, which is confusing to first-year medical students. How ...

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With malpractice damages capped in Texas, lawyers are turning on themselves for cases:

Now that tort reform has capped certain malpractice damages against doctors, lawyers have become more enticing targets.

A recent case won by Joe Jamail against John O'Quinn "“ two of the heaviest heavyweights in Texas law "“ shows how much times have changed.

The high-powered plaintiff attorneys squared off after a landmark breast implant ...

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A small but growing number are going to Mexico for cheaper nursing home care:

"With the right facilities in place, Mexico could give (American retirees) a better quality of life at a better price than they could find" in the U.S. However, Larry Minnix, president of the American Association of Homes and Services for the Aging, said that the lack of government regulation could place residents of smaller Mexican nursing ...

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File under, zero surprise:

People in the United States are living in a world of pain and they are popping pills more than ever to cope with it.

The amount of five major painkillers sold at retail establishments rose 88% between 1997 and 2005, according to an Associated Press analysis of statistics from the Drug Enforcement Administration.

More than 200,000 pounds of codeine, morphine, oxycodone, hydrocodone and ...

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