Dr. Welby is dead

This is what you get when incentive is based on volume, not quality:

Dr. Bea Karing has had her own practice for about 18 years. Her practice has grown and she is generally known and respected by patients and colleagues as a caring dedicated internist. Her patients range from a new college student who is generally healthy but has had a hard time adjusting to school, to a ...

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Dr. Flea laments at how physicians don't talk to one another:

I know that somewhere in the world there is a community of physicians that actually call one another on the phone and chat about patients. I suspect there are even emergency department physicians who call fleas when their patients show up unexpectedly!

Sadly, I don't live in that world.
(via the Health business blog)

Tough malpractice reforms are putting plaintiff lawyers under pressure, and reducing malpractice rates. In other words, it's working:

Sensabaugh said the caps have allowed cases to be settled quickly and reasonably, and have provided stability for medical insurance carriers.

That stability, said David Rader, president and chief executive of West Virginia Physicians’ Mutual Insurance Co., enabled the company to cut its premiums by 5 percent on Jan. ...

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This year, Bitter Pill Awards were presented in four categories to drug companies engaging in over-zealous and questionable marketing practices. The drug industry's national lobbying group, PhRMA, received two awards, and the remaining three awards were shared among makers of five of the nation's most well-known drugs: Lunesta, Ambien/AmbienCR, Lipitor, Crestor and Strattera.
(via PharmaGossip)

A radiation oncologist is giving this tidbit of advice to patients exposed to polluted water in Massachusetts:

Sacher urged people exposed to Nyanza to get regular checkups and seek medical care whenever they have symptoms that seem unusual or last longer than expected, like a cold or respiratory problem lasting more than a week. They should also demand tests if they are worried, even if a doctor doesn't think it ...

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"Too posh to push"

C-sections are up in the UK as well:

Last year the government introduced a new coding system that classifies caesareans as either elective or emergency. Preliminary figures show that, last year, 45% were elective, compared with 55% classified as emergency procedures. This compares with an estimated 7.5% elective sections in 1998.

64-slice CT scanners. Expect most who enter the ER with chest pain to receive these scans soon:

At this point, most doctors agree that the new scanners should not be used to look for problems in healthy people. In addition to the radiation risk, CT scans may pick up tiny spots of plaque on artery walls that, in the absence of symptoms, are hard for doctors to interpret. ...

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Graham’s next

In Dean's continuing medblogger interviews.

DEA and pain

The DEA investigates a pain specialist and suspends his prescription writing privileges. It's been over a year and the physician still hasn't been charged with anything. In the meantime, the physician is forced to practice alternative pain treatments.

Reducing the jackpot

These physicians should have settled, using the retrospectoscope:

Lawyers for the gynecologist hit with that $28 million medical malpractice award two weeks ago have asked a Sanford judge to reduce it to less than $300,000. Attorneys for Dr. Robert Bowles say that's what the victim asked for in pre-trial settlement talks.

May 1-7th brings attention to this health crisis:

The Problem
Nearly 46 million Americans, including more than 8 million children, are living without health insurance - forced to gamble every day that they won't get sick or injured. That's a risk no one should have to take. Uninsured Americans live sicker and die younger than those with health insurance. Just one serious illness or injury can wipe out an uninsured ...

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Welcome to Canada

Where private health-care is a growing reality.

Fed up

More are becoming fed up with rushed, harried doctors, and turning to holistic care:

Walking around Victoria, I saw signs of this new two-tier health care everywhere I went: yoga studios on every corner, organic cafes, Ayurvedic health centres where people are encouraged to try healing the herbal, holistic way. Maybe it sounds flaky, but you can't argue with results.

And Rush Limbaugh got caught.

There's a good discussion going on at DB's discussing how lawyers and physicians define what acceptable evidence is:

We who favor special health courts believe that this story provides a classic example of poor definitions of evidence. We expect the same definition of evidence for our medical practice and any judgment of malpractice. Having a son in law school, I understand (because he has explained this clearly) that the ...

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Medblogger interview

Clinical Cases and Images is interviewed by a medical librarian.

MRSA

A women is infected with MRSA after getting her eyebrows waxed.

Orlistat

GSK is hoping OTC Xenical (Orlistat) will be a blockbuster. Don't expect miracles however. From UptoDate, here is the results of a meta-analysis of the prescription version:

Almost two-thirds of the subjects completed the first year of treatment. Weight loss at one year varied from 5.5 to 6.6 percent of initial body weight in the placebo groups and 8.5 to 10.2 percent in the orlistat groups.

Mumps

The recent epidemic has left the efficacy of the vaccine in question:

Even among those given both shots, 10 percent are left unprotected against mumps. The failure rate for measles and rubella is only 1 percent. For those who skip the second shot, 20 percent have no mumps protection, with 6 percent to 8 percent remaining vulnerable to measles and rubella.

Celebrex ads

With patents for Lipitor and Norvasc expiring soon, Pfizer is revving up the Celebrex ad machine:

The ads for the Pfizer painkiller Celebrex feature a man holding a boy's hand as they walk up a stadium staircase. "52 steps won't keep you from taking him out to the ballgame," they say.

But a heart attack would.

Each ad includes a boldface warning that begins, "Important Information: Celebrex ...

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