An ad-free, evidence-based medical information site by the BMJ. Looks good, wish I can try it.

Numb to lawsuits

Orac observes that insurance plans are getting less restrictive asking about malpractice lawsuits:

This insurance company, at least, only seems to care whether the physician applicant has lost or settled more than one big malpractice case in the last five years. It doesn't even ask if you've settled for smaller cases. You can conclude one of two things here. Either the insurance company in question is lowering its standards (unlikely, ...


David Williams on the travesty of code blending:

Anthem seems to be acting shortsighted. Assuming that Anthem and other payers gain from EHR adoption, they should allow physicians to generate higher revenues through improved documentation. That will encourage adoption. Indeed, studies of the benefits of EHR adoption typically include "increased reimbursement from more accurate evaluation and management coding" among the benefits to physicians.

Once EHR adoption has increased ...


An independent panel has concluded that an elective C-section is the patient's choice and her decision should be honored:

Any decision between cesarean delivery by maternal request or trial of labor ultimately lies with the woman, once the potential risks and benefits associated with C-section have been discussed, concluded an independent panel of experts on cesarean section.

"Her decision should be honored," said Dr. Mary E. D'Alton, panel chairperson, ...


One unlikely survivor from the TGN1412 drug trial may lose body parts:

Wilson had slipped into a coma for three weeks after taking the drug, and after awakening, discovered that he may lose parts of his fingers and toes, which had turned black because of his reaction to the drug.

My favorite - "When you question his credentials he flashes a photo of himself with President George Bush saying: 'You're doing a heck of a job, Doc.'"

Congratulations to GruntDoc, who is featured prominently.

Due to poor dental coverage in the UK:

Every time he has tried to sign up, lining up with hundreds of others from the ranks of the desperate and the hurting "” "I've seen people with bleeding gums where they've ripped their teeth out," he said grimly "” he has arrived too late and missed the cutoff.

I applaud price transparency, but it's not that easy:

Still, it's harder to price hospital care than other items people purchase.

Here's why: hospitals establish basic charges for procedures, but those amounts are discounted through negotiations with health plans. In addition, patients have varying co-payments and out-of-pocket expenses as well. Procedures can also cost more if patients have chronic illnesses, allergies or other complications.

He was allegedly told he was not a registered patient at the clinic.

No shows cost

The UK government spent over 6 billion on a new computer system, that doesn't do patient reminders.

Dear doctor

What patients would like doctors to know.

He writes:

The training programs of physician's assistants (PAs) and nurse practitioners (NPs) dispense with much of the medical school minutia filled intense basic science courses and provide more direct practical clinical training in less than half the time it takes to train most MDs.
Although there is something disturbing about doctors who do not know where the prostate gland is.

It's supposed to be announced next week. Screenshots here. (via Google Blogoscoped)

Also, Google Health vs Kosmix vs WebMD.

As you may know, Anthem Blue Cross and Blue Shield in Ohio is blending 99213 and 99214 codes into a single rate. This is a chilling trend that must be stopped.

As physicians adopt EHRs, documentation and patient care is going to improve - necessitating a proper reimbursement rate. Use of EHRs should be rewarded, not penalized:

"Before my EHR, I wrote on a piece of paper," ...


"Plaintiffs' lawyers love it when physicians point fingers at each other. They can just sit back and watch the doctors destroy each other."

Another benefit of a "laborist":

Besides improving patient care, a laborist can lower a hospital's malpractice liability and insurance premiums, says Louis Weinstein, ob/gyn department chair at Thomas Jefferson University Hospital in Philadelphia.

"If a laborist prevents one lawsuit every five years, he's paid for himself," says Weinstein, who's promoted the use of these specialists.

That's one way to get the point across. (via Orac)

According to this new study (sponsored by mid-wives). Of course, many men will be ok with this.

Which is precisely what happened to Kaiser in the kidney transplant scandal:

Kaiser Permanente's speedy rollout of a vast new kidney transplant program in 2004 overwhelmed regulators with paperwork, putting organs out of reach for hundreds of patients, a newspaper reported yesterday.