Behind the scenes explaining why ERs are so overcrowded. (via GruntDoc)

News that is being covered by the medical blogosphere. Dr. Charles and #1 Dinosaur with more.

A patient writes about how difficult it is to obtain pain medications in the ER.

The 34-minute execution

All because they can't get a simple IV done right? Sad.

Some say physician assistants will eventually replace primary care physicians, as they are cheaper and almost act as autonomous providers. However, be aware that their training is 1/3 shorter. It is the minority of patients that present "outside the cookbook" that MDs are paid and trained to treat:

But as a physician, you're going to be paid for your ability to handle the ten percent of cases ...

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It could, and likely will, happen. Good for job security I guess:

Florida has the greatest need for primary-care doctors after California, according to the study.

The shortage not only affects uninsured and undersinured patients, but also those with private insurance because many doctors run out of space and time to see patients.

From Slate: "First, get sick." That's a start.

Defensive medicine, lack of primary care access, and a fee-for-service payment model are to blame.

Smokers are suing to find out:

A group of heavy Marlboro smokers have filed a lawsuit in federal court in Boston, asking Philip Morris USA to pay for screenings that may detect the early stages of lung cancer, court documents showed on Friday.

The class-action lawsuit, which was filed on behalf of current and former Marlboro smokers over 50 years old who smoked a pack or more a day ...

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Sickening report that sheds light on an emerging threat to legitimate stem cell research:

"The problem is, I am not sure how the cells are prepared," he says. "A six-week-old embryo can be just 1cm from head to foot, so it's difficult to dissect tissue from it. They may just homogenise the whole embryo." That's a polite way of saying that the aborted babies could have been liquidised.


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Build more cities:

. . . the mass migration of folks from rural to urban areas has done more to slash the birthrate than any old birth control or abstinence education program

What a dog of a drug. An advisory panel said it should not be used for bronchitis or sinusitis.

A surplus is better than a shortage - but not always:

While experts say an excess is better than a shortage, too large a surplus could hamper the government's goal of steadily increasing the production and use of flu vaccines. Because makers, distributors, doctors and health departments lose money from vaccine they cannot sell to patients, they may be discouraged from making or ordering as much in coming years ...

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The policy wonks are on the case: Matthew Holt, Joe Paduda and Ezra Klein.

EHRs in the real world

A doctor gives us the (lack of) incentives to convert:

Start with the cost of more than $37,000, plus some $14,000 per year on maintenance. Then there are the weeks out of practice to learn the new system and the slowdown while everyone becomes familiar with using it. Then add, as Technology Editor Ken Terry mentions, that the payers will simply lower their rates to counteract the improved documentation and ...

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Pre-paid primary care

Concierge care for the masses. A look at an emerging primary care model:

These days, the soft-spoken, but formidable family physician is mixing it up in the role of healthcare reformer. Three years ago, Wood began advertising that his clinic would provide unlimited primary and urgent care for a monthly fee of $83 for an individual, $125 for a family. Wood immediately ran afoul of the state insurance commissioner, ...

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The kidneys of a longtime friend, scheduled to be given to a patient, instead is given to a stranger. The patient sues the donor network.

Serial healthcare killers

Since 1970, over 2,000 patients died at the hands of suspected serial killers in healthcare settings.

A study published at the BMJ:

Higher IQ at the age of 10 years was associated with an increased likelihood of being vegetarian at the age of 30. This relation was partly accounted for by better education and higher occupational social class, but it remained statistically significant after adjusting for these factors.

More quotes from the ER at Trench Doc.

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