The 64-slice cardiac CT

Turf war ahead. Like virtual colonoscopies, these CT scans has its sights aimed at cardiac catheterization. Questions about radiation dose and mortality benefit remain. Like any new diagnostic study, these uncertainties need to be communicated clearly with the public.



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What an x-ray.

A miraculous story of how a fetus survives multiple abortion attempts.

Many don't after a missed reading, as they don't have a relationship with the patient:

When the radiologist has performed his or her duties by interpreting the film, to whom is the radiologist professionally related? The patient? Or the physician who ordered the X-ray or other exam? And what if later it is found that the radiologist has made a mistake or missed a critical diagnosis..has, for example, made ...

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47 million uninsured

A critical look at this oft-quoted number:

If 10 million of the disingenuous "47 million uninsured" are in fact illegal immigrants, are we to understand that all of these candidates are actually calling for nationalized health care coverage for illegal immigrants? Perhaps, in our beneficence, we should pay for healthcare for anyone worldwide who comes to our country. If this is what is being suggested in using these numbers, ...

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An EpiPen stuck in the finger. Here's what happened next. (via ERnursey)

DNRs and being sued

Defensive end-of-life care?

I saw doctors overturn patients DNR's when the family asked (when the patient was not able to speak for themselves) because they were afraid to get sued. I've participated in the intubation, insertion of multiple invasive lines and tubes in people with severe heart disease, diabetes, multiple amputations and strokes confined to a nursing home in their 90's for god sakes because the family "wanted everything done."
Sad.

"What's the deal with the ED being used for second opinions?"

Well, patient's don't like waiting. In the ED, you can get a CT scan, MRI and a consultant/ER physician opinion all in one visit.

Problem is, they "have never developed humility in the face of disease":

It is easy, for example, for your acupuncturist to promise a perfect cure because they're not really treating anything, just some nebulous mumbo-jumbo like a dysfunction of your ability to receive pure qi from the heavens. Side effects? None, of course. It's perfect medicine because, despite being based on a completely imaginary idea of physiology ...

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Munchausen by Proxy

A mother fights the stigma of this misdiagnosis.

Which is why medical students are staying away in droves:

Medical students, burdened with $200,000 in debt are voting with their wallets, choosing gastroenterology with it's $200 13.5 minute colonscopies, or cardiology, with it's unlimited access to procedures (echo, ekg, cath, stress test, pacers, ICD's and on and on). Money is currently being made by procedures,not cognition. And there is no relief in site. In fact, Congress is proposing dropping ...

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It's all through documentation, and can be easily manipulated:

You can see how statistics lie. Doc B may be an "inferior" doc, but knows how to play the system. Doc A maybe a doctor's doctor but won't play the documentation game, just practices good solid medicine. His published actual vs expected mortality data will pop up as an outlier for a doctor to avoid, when in fact, he could be ...

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Are they turning this drug-resistant infection into a public joke?

Unapproved abbreviations

Striking back at JCAHO.

Ok then, let's see you play doctor. A survey hosted by WhiteCoat Rants.

Robert Jarvik

"As ubiquitous as Verizon's Test Man."

Dominic Carone writes about the "secret" that the attendings don't perform all the surgical procedures in teaching hospitals. Not uncommonly, they supervise residents who are performing the actual procedure.

But if every patient were to opt for an attending, how are doctors supposed to learn?

A hole in the palate

A scary side effect of using this illicit drug.

It's the only way to entice new graduates into the field:

I have written before about these specialties being grossly undervalued in our society. At the very least, it is time to recognize this and ensure that primary care specialties, with the the cognitive and coordinating value they bring, are reimbursed on par with procedural specialties. This is the only way young doctors will choose these specialties.

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