Eye-opening:

When I look back, I think it is part of the reason that they recruit people like me -– political science majors, history majors, business majors -– because I didn'’t have the ability to question anything they told me. I can'’t tell you how quickly I could get in over my head if I was talking with a physician about these things. Although I might have known a specific ...

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A gun in the vaginal vault. It's 24 crossed with ER:

How the hell were we to get the gun out without the damn thing discharging?

In the end, there was no real option. She was sedated and taken to the OR for an exam under anesthesia. They put a bulletproof vest over the patient's body to protect the anesthesiologist in ...

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Maria writes about some of the unsung things that go with being a physician. Although I probably wouldn't be too comfortable with prescribing sleeping pills for my friends.

Health Care Renewal with a nice piece on this. So many EHRs are not geared towards what providers value most: productivity and faster charting. Forget the bells and whistles.

In fact, I read somewhere (sorry, I can't find the link) that most EHRs actually increase the time spent charting. Think that would be an incentive to adopt an EHR?

Once policyholders rack up medical bills that are too high. Matthew Holt comments on this.

Professor Bainbridge takes on the medical blogs on the ER waiting room homicide case:

Reading the comments from doctors on the medical blogs was quite informative. The MD's basic attitude seems to be "shit happens and lawyers suck."
His own commenters seem to disagree with him.

Behold the adolescent medicine specialist.

He had been retired for four years:

"I considered myself retired, but I decided not to be anymore," Dr. Lynn said, a big smile spread across his face, his voice brimming with laughter. "Besides, I could use the money.

"But seriously, I look at it totally different now," he said. "When you're younger, all you think about is taking lots of patients and you think of the money. Now ...

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Cosmetic addiction

It's Botox:

Doctors found 40% of patients using Botox expressed a compulsive desire for further treatments.

People need to keep having jabs otherwise the effects of the treatment - which paralyses the muscles - rapidly wears off.
And in a related article:
Less than 10 percent of adults in the US has ever had some type of cosmetic surgery, yet almost twice as many hope to do so ...

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The psychiatrist slain recently reignites this debate.

Due to psychological issues.

The ER wait as murder case

Apparently a jury opined that this should be in criminal versus civil court:

The jury came back with a finding that the emergency room provided "a gross deviation from the standard of care that a reasonable person would exercise in the situation. We the jury believe the matter of her death to be a homicide."
This is causing some confusion, as there is no such charge as "negligent homicide". ...

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Makes sense, since every ER remodeling/new ER would have significant impact on the nurses.

Medicine and luck

Luck (or being unlucky) sometimes plays a role in medicine, as DB points out. Lawyers usually use this fact to their advantage:

Of course, malpractice lawyers do not believe in luck. As an obstetrician told me yesterday, a bad infant outcome is always blamed on the obstetrician, while most bad outcomes really represent bad fortune.

Medpundit says not so fast:

Those improvements sound impressive, but they are the same improvements and the same rate of improvement that can be had by diet and lifestyle changes, a fact the authors freely admit in their conclusion. Watching the diet and walking a half hour every day is certainly less expensive than the $175 a month it costs to take Avandia at the 8mg dose in the ...

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The "hateful patient"

Not patients who hate physicians, but traits of patients that physicians find difficult.

A nice primer, done Dr. Charles-style.

Congrats to Diabetes Mine

Diabetes Mine is awarded a 2006 LillyforLife(TM) Achievement Award:

Amy Tenderich, San Francisco, is the winner in the Journalism category. Tenderich, who has diabetes, founded the diabetes blog "DiabetesMine.com" in 2005. From product reviews to personal accounts and interviews to the most up-to-date diabetes news, Amy reaches people with diabetes and the general public with her accurate and timely reporting.

Yes, it's because of the money:

As more U.S. doctors opt for better-paying specialties such as cardiology and orthopedics, residency programs for family physicians here are increasingly drawing doctors from abroad.

This year, 28 of the 78 first-year residents in family practice programs in Minnesota came from foreign medical schools. At Hennepin County Medical Center, eight of 10 places were filled by foreign graduates. At the University of Minnesota's ...

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Sometimes, just use some common-sense:

"I've had new patients come in and tell me during the first visit that W, X and Y medications don't work for them, but Z does," said Dr. Charles Cloutier, a Prattville family practitioner. "When patients take that approach, it's a huge tip-off."

Cloutier said he doesn't call in prescriptions for controlled drugs after hours or on weekends, and he is cautious when he ...

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