Merck/Vioxx update

A "hand-picked" plaintiff drops her case, while Merck readies for the next round of trials - including Merck v Lanier II.



Gross anatomy lab . . . or bakery? Amazing, or sick, depending on your view. (via Grand Rounds)

The right-wing, anti-science crowd dissents viscously:

Rightie reaction? John Amato has an audio of Rush Limbaugh accusing Fox of faking his symptoms. "He is an actor, after all," says Rush. (Rush is from a very wealthy and influential southeast Missouri family.) . . .

. . . While Michael J. Fox (like me) has some skin in the stem cell game that most people don'Â’t, that doesn'Â’t give ...

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The farce of the privacy law and lack of enforcement:

Two years ago, when Bill Clinton had heart surgery performed in New York's Columbia Presbyterian Medical Center, 17 hospital employees -- including a doctor -- peeked at the former president's health care records out of curiosity. Earlier this year, Boston-based Brigham and Women's Hospital repeatedly faxed patient admission sheets to a nearby bank by accident. The faxing continued even after ...

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Apparently, Paris may not be all that it's cracked up to be:

Around a dozen Japanese tourists a year need psychological treatment after visiting Paris as the reality of unfriendly locals and scruffy streets clashes with their expectations, a newspaper reported on Sunday.

"A third of patients get better immediately, a third suffer relapses and the rest have psychoses," Yousef Mahmoudia, a psychologist at the Hotel-Dieu hospital, next ...

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Asking, "Is this an emergency?", may not be the best approach:

Now a new study casts doubt on the widespread practice of screening after-hours calls to physicians. Requiring untrained patients to decide which problems are serious enough to deserve immediate attention and which can wait until morning is unrealistic and potentially dangerous, some experts say. It also may represent a little-recognized source of preventable medical errors, they add. It ...

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Reimbursement, combined with the liability climate that demands objective testing in court, is quickly killing the history and physical:

One of the problems with our medical system is the bias to pay doctors more for performing a test or procedure than for using our heads to make a diagnosis or manage a disease . . .

. . . If I spend 30 minutes in an extended ...

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Don't nag, unless it doesn't work, then nag.

Debate on whether this is real or psychosomatic.

DB is against P4P. A telling comment from the post: "Bribing doctors to do their job can only lead to a generation of doctors who have to be bribed to do their jobs."

The post-CABG bra

Novel idea:



Dr. Kathryn King, a University of Calgary researcher, says her study of 481 women in 10 cities across Canada suggests those who wore the bra had significantly less post-surgical breast pain and discomfort, compared to women in a control group . . .

. . . The new design stops the weight of the breast from putting pressure on the surgical wound. It also ...

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A survey reveals the reasons consumers cite explaining high health care costs. They surely don't blame themselves. (via Managed Care Matters)

Say it ain't so:

We have two sustainable options: A Medicare-for-all system, like that in Canada, or a socialized system, like that in Britain and our own VA and armed services systems. The latter uses salaried physicians while the former still leaves room for fraud and overuse. In the end, health care can be either a social service or a market commodity, but not both.

But make no mistake ...

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retired doc on a recent NEJM perspective regarding Lilly and Xigris. Dr. RW and Health Care Renewal also chime in with their views.

This pundit isn't going on any medical tourism trips anytime soon:

However, Newsweek does not break out statistics on the types of Americans (all 150,000 of them - 0.2%) who go to get treatment in SE Asia. How many of these people are there for plastic surgery or gender reassignment?

They try to say it's the "cost."

That's nice. But if the doctor screws up royally, who are ...

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More stringent CME

A newspaper reader is pissed that a heart murmur was missed in a young athlete's death, and wants more physician CME:

Is it any wonder that the physician who examined young Bruda's heart missed his murmur? This observation dovetails with another brief article describing the restoration of Sen. First's (sic) medical license after his accountant falsified his submission to the Tennessee Medical Board. In light of this, you should ...

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. . . and how anti-depressants saved his life:

Before Katrina, I would have called somebody like me a wuss. Not to my face. But it's what I would have thought, this talk of mood swings and loss of control, all this psychobabble and hope-dope.

What a load of crap. Get a grip, I would have said.

And that's exactly what I did, through a door ...

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Controversy involving hard-line Muslims and whether their wives can be examined by male gynecologists:

France's leading gynaecologists have challenged hard-line Muslims to bow to France's secular, "modern" rules of society, and to stop insisting that their wives are examined by female doctors.

The heads of the French National College of Gynaecologists and Obstetricians issued a public declaration, rejecting any moves to undermine the principle that public hospitals are ...

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It’s the system

Graham responds to the primary care negativity on this blog:

Not to turn all single-payer on you, and I realize this is just one woman'Â’s story, anecdotal and all, but I honestly believe that a big part of the problem is our system. It'Â’s so mind-numbingly complex and wasteful (administratively and diagnostically) that by tolerating the system for so long, doctors have allowed it to become 15-minute office visits with ...

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Failure to communicate

A lab fails to notify a doctor of an elevated PSA. Guess who's paying the price:

But Lamantia had no way of knowing Gaytan needed further care, her lawyer said. The protocol at Kaiser is for the lab to notify doctors of abnormal tests, Iungerich said. When the lab does not call, doctors are not aware there is a problem, he said.

"In this case, there was a ...

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