Luckily there was an OB on board.

Bribes for referrals

A psychiatric center is accused of bribing local doctors to bring in referrals.

They have a category for best medical/health blog this year. Congratulations to all.

PharmaGossip with thorough coverage.

Analysis from nature.com:

But it is also possible that the whole idea of blocking CETP is flawed, says Moti Kashyap, who directs atherosclerosis research at the VA Medical Center in Long Beach, California.

When HDLs excrete cholesterol in the liver, they actually rely on LDLs for part of this process. So inhibiting CETP, which prevents the transfer of cholesterol from HDL to LDL, might actually cause an abnormal ...

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. . . due to a town's healthy eating habits.

A patient expresses frustration and how her doctor reports lab results. His "no news is good news" philosophy is terrible advice. Physicians review several hundred lab, radiology and consultants' notes per day. There will be times where abnormal values slip through the cracks.

Who really pays for jackpot verdicts and multi-million dollar settlements? Not the doctor nor hospital, but society as a whole:

Medical malpractice insurance is even more problematic. Every doctor with the same type of practice pays the same as every other doctor in that same type of practice. The world's best surgeon pays the same price as a night-school butcher surgeon. What this means is that good doctors pay ...

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Too busy training to, you know, treat patients:

The medical profession is not noted for effective lobbying on its own behalf. This probably principally derives from the fact that most men and women who pursue the grueling and academically challenging route of four years of college majoring in a science (not "public policy" or any other type of "basket-weaving" major), then four years of medical school, then years of ...

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Behind one of the largest malpractice awards in Canadian history. At issue is how the patient understood the discussion of the risks of Clomid:

According to Ms. Bovington, now 44, Dr. Hergott warned her that having twins was "out of the question" given her history of premature births, but that he could safely prescribe her a low dose of Clomid without running any risk of twinning.

Ms. Bovington ...

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This is a system that some here want to emulate?

Most depressing of all is that our work is dictated by irrelevant and conflicting targets that render us impotent to deliver the care our patients need. This week, managers decided that 26 surgical beds must be closed to save money for the trust. This was implemented overnight and the beds physically removed from the ward.

These same people oversee ...

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More crazy x-rays. This time a CT of a man after a car accident. The tooth of his son was embedded in the frontal sinus.


Some impressive-looking x-rays:

When 12-year-old Chris Stewart crashed his racing car, the force of the smash was so great that his head was wrenched from the top of his neck.

With the ligaments which attach the skull to the spine torn, and his head held in place by just skin and muscle, he was more likely to die than live.

A new study looking at marathon runners, suggesting their hearts may be "stunned" while running the 26.2 miles:

The runners (41 men, 19 women) had normal cardiac function before the marathon, with no signs of troponin in their blood. Twenty minutes after finishing, 60 percent of the group had elevated troponin levels, and 40 percent had levels high enough to indicate the destruction of heart muscle cells. Most also ...

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Shoddy telephone advice such as this leads to a lawsuit for Scalpel.

Not exactly the flatulence, but the subsequent match that was lit to dispel the odor. What is the differential for this? I would say various types of malabsorption syndromes, lactose intolerance, celiac disease, bacterial overgrowth or irritable bowel syndrome to name a few.

Nice WSJ article. The p value that the deaths were caused by torcetrapib was 0.007 - which is very statistically significant.

However, if there were only two fewer deaths, 80 instead of 82, the p value would have rose to 0.011. That would still be statistically significant under normal circumstances (signified by a p value < 0.05), but above Pfizer's target threshold of 0.01 for ...

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Great writing all around. Congrats to all who were involved.

And removes two of the most offending negative MD comments:

"Clearly we do see some comments that are overly aggressive like the ones we did delete," he said, referring to two comments one which said a doctor was "the worst of the worst. He butchered me" and another which said, "Are you planning to commit suicide? Go to this doctor and he will kill you."

A disturbing and growing trend. Telephone medicine like this is just asking for trouble:

Already, though, says Dartmouth pediatrics professor James Sargent, there are many situations where doctors call in antibiotic prescriptions and refills "without cause for alarm."

For example, Sargent said via e-mail, his practice often calls in prescriptions for antibiotic drops for pinkeye and pills for sore throats in people who have a family member ...

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