Medlogs 2.0

The granddaddy of the medical blog aggregators is getting a much needed update.

This blog has consistently sounded the death throes of primary care - and the ivory tower academics don't seem to get it. John Black sounds of on the many issues leading to the death of the profession:

Primary care is dying, and those in the ivory towers need to start beating the drum. One cannot tell the true vitality of internal medicine by what one saw and heard in ...


A man has a heart attack in a hardware store. Luckily a salesperson was demonstrating a defibrillator to store staff at the same time.

Robert Centor comments on the UK's P4P experience:

I maintain that for any generalist, our jobs remain so complex that report cards must emphasize only a small part of our job. As the Scottish physician so aptly puts, focusing on 15% of our patients probably detracts from the diagnostic energy and quality addressed for the other 85% of our patients.

A powerless feeling?

A UK-based EMT observes C-spine immobilization routinely being done during his visit Stateside. He is angry about it:

There were some interesting responses to my last post about the treatment of a minor collision victim by firefighters. The general thought was that they immobilised the patient to prevent being sued by overzealous lawyers. In addition I was told that only doctors were able to remove the immobilisation collars, that ...


Psychiatric settings are often used simply to advance to plot:

The psychiatric setting is used in media for 1) the entertainment value complete with distortions and 2) in terms of story development, the setting can often provide insights/information into a character that couldn't be gleaned in other ways--though this is more true in terms of written/literary plots where point of view limits access to information.

Code blue

Sid Schwab on what it's like responding to a code:

"Code Blue, room 326; Code Blue room 326; Code Blue room 326...." My first response is to run the room number through my mind to figure if it could be my patient. And whether it could be, or clearly isn't, it's always a sense of dread and doom at what I'll find.

EMRs: What to look for

A good list to start with for those looking for an EMR.

CME to be scrutinized

Your next CME lecture could be audited:

In a recent conversation with the Health Blog, Kopelow said ACCME will likely start sending auditors to CME lectures. "We could have trained monitors observing CME presentations and reporting their findings to us," to see whether the presentations are straying from the rules, he said. The group hasn't yet decided whether the monitors would work undercover.

Michael Hebert argues no:

Is it acceptable to allow people to choose to be without health insurance? I say no. There are too many common, potentially devastating medical illnesses lurking out there. If Cindy were to find a lump her breast, for example, she would probably lose her job and her health, go bankrupt, and eventually, after prolonged suffering, end up on Medicaid. She would also, with her pre-existing condition, ...


Let them go forward with their socialized medicine experiment, and see what happens:

That's why America needs "Healthy Wisconsin." The fall of the Soviet Union deprived us of the biggest example of how socialism works. We need laboratories of failure to demonstrate what socialism is like. All we have now is Cuba, Venezuela, North Korea, the U.S. Post Office, and state motor-vehicle departments.

It's not enough. Wisconsin can ...


It almost killed this man.

Health care costs 101

Great op-ed in the WSJ, which spells it out in simple language:

Reducing health-care spending isn't hard: Just give the government control over the national health-care budget and you'll see spending decline. Access to physicians and hospitals, the newest technology, important therapies and the best medications will also decline over time. But that's the trade-off society makes when the government controls health-care spending.

It's remarkable how gullible people ...


California's attempt seems dead, joining Illinois, Wisconsin, Pennsylvania. Seems like the fine print got them. If states can't agree, good luck reforming on a federal level:

If Arnold's plan does fail, it will join "universal" health-care dreams in Illinois, Wisconsin, Pennsylvania and other states that were also unveiled to hosannas but flopped once the fine print and costs were exposed. Alas, the failure of these state reforms ...


Maggots to treat wounds

You've all heard about it, now see it in action:

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(via Graham)

Graham has serious concerns about giving patients too much control over their medical record:

This is supposed to be a medical record, right? For use by physicians, right? Because from the looks of it, you want patients to use medical terminology (which most don't know, use, or understand) to create their medical record. You want people to know terms like "AV Nodal Re-Entrant Tachycardia" or "Partial Complex Seizure secondary to ...


Drug approvals are way down.

A "success story" of a physician who was victimized by the government, and still loses almost a million dollars defending himself.

Can there be a connection? Researchers in Germany find out.

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