Dr. Centor outlines a fundamental reason why medical students are avoiding primary care:

Some would argue that this is really a lifestyle issue. I would argue that money drives lifestyle. Family physicians and general internists have responded to lowered reimbursement by increasing the number of patients they see each day. These increases must decrease quality of care and decrease physician satisfaction.

Shawdowfax speculates:

The most common proposal I have heard for government-funded single payor health care is something along the lines of "Medicare for all." The clear implication from this, for physicians, is that all patients would be reimbursed at the same rate. While you would think this is a good thing, I expect that many doctors would fight it tooth and nail. For a ED group that is well-managed ...

Read more...

Disturbing news coming out of China:

WHO was surprised by the report, which came not from the Chinese government but from eight scientists in a research letter in the New England Journal of Medicine.

"We will formally request the Ministry of Health to clarify this," and why it has taken more than two years to come to light, said Roy Wadia, a WHO spokesman in China.

The expert witness was shown to demonstrate "a lack of adequate subject matter knowledge", but is protected when his professional society tries to sanction him:

A Baton Rouge federal judge has issued a temporary restraining order against a national medical association, protecting a prominent local neurosurgeon who claims he is the victim of a professional smear campaign.
(via This Makes Me Sick)

Another pro-reform citation of the Studdert study:

Dr. Bret DeLone, a Harrisburg-area surgeon, disputes the association's conclusion that the system is working well. He pointed to another study, published last month in the New England Journal of Medicine, that said more than half of the money awarded in medical malpractice lawsuits went to attorneys' fees and administrative costs.

"That's where the money ends up. ... Of course ...

Read more...

This is probably done to combat the increasing use of elective colonoscopies, which is costing insurers money:

The American Gastroenterological Association issued a statement Monday charging the insurer's pending new policy on performing outpatient endoscopies "will hinder the medical judgment of physicians as to the proper setting for endoscopic procedures, based on the specific needs of individual patients." According to the medical group, Blue Cross of California, ...

Read more...

Some say they are putting lives at risk:

The member, who did not wish to be named, works at a Southampton hospital. She said mistakes over the term 'hypo" and "hyper" had already been made by overseas staff who were nowhere near the doctor concerned to clarify his dictation . . .

. . . Other blunders included writing "known malignant" instead of "non-malignant", "urological" instead of "neurological" ...

Read more...

It's based on employer mandates:

San Francisco, eager to put its own stamp on the health care debate, unveiled an ambitious plan Tuesday that would make it the first city in the nation to provide every uninsured resident with access to medical services.

When rolled out next year, the city's 82,000 uninsured residents would become eligible for a wide array of benefits, regardless of employment or immigration status. ...

Read more...

This supposed controversy should never have gotten this far:

"It saddened him to see that knowledge was twisted in such a way to play in the hands of the anti-vaccine movement and not really appreciate what vaccines are all about.

"They are about protection of individual, but also protection of the society so you achieve 'herd immunity'.

"Maurice believed in that and it really pained him a ...

Read more...

I often have patients who stop taking their statins or refuse to take them because of "side effects". This can range from muscle aches to memory loss (the latter side effect of which there is conflicting data for).

One option would be to switch to a more hydrophilic statin - like pravastatin (now generic) - which have been shown in studies to decrease the incidence of muscle aches ...

Read more...

Studies show that home games increase testosterone levels:

Two new studies also show how the hormone may especially peak before home games, and that female athletes likely experience the same hormone flux.

The first study, of male ice hockey players, found higher testosterone levels in athletes competing at their home rink, compared to playing an away game. The other, a Portuguese study of female soccer players, found that ...

Read more...

Dr. Hebert writes about his frustration.

PointofLaw.com wonders why more lawyers don't get sued after losing a case:

The fascinating thing is that lawyers are never subject to that level of second-guessing. In any given litigation, one or both sides to the dispute ends up with less than an optimal result. In any given litigation, both sides' litigation decisions can be second-guessed. Yet, even with hundreds of millions of dollars at stake, one almost never sees ...

Read more...

This is obviously causing controversy:

But the plan, which pharmacists have talked about for a decade, has some physicians worried about patient safety. Other doctors have suggested it will create a conflict of interest because pharmacists could benefit commercially from the medications they prescribe.

Nice idea, especially since many decisions in medicine are based on percentages and probability.

I was quoted today in an AMNews article talking about unnecessary testing (subscription needed). It's quite sad that despite all the evidence that the USPSTF provides, many physicians follow the ones made up by layperson juries during malpractice trials:

The real guidelines physicians follow, often unconsciously, are the ones judged to be the standard of care by jurors in medical liability trials, Dr. Anderson said.

"Medical standards ...

Read more...

Using genetic testing, they found that they had a 70 percent chance of developing stomach cancer.

It may help in rural areas:

"About 90 percent of psychiatrists and psychologists live in urban areas and about 20 percent of the population of the United States lives outside of an urban area," said Beth Hudnall Stamm, Director of the Institute of Rural Health, Idaho State University.

Dr. Tobin and her colleagues serve patients in ten counties across the state, on average each patient almost 120 miles ...

Read more...

The lawyer refers to them as "hired guns":

"These are guys who travel -- some of them travel the country -- and they fill in where hospitals are in need of staffing," he said. "Nurses do it, too.... I like to refer to it as riding the circuit. They're hired guns. They go into an area that's short of a specific specialty or need, and they fill that need."

This will be huge, as many physicians and patients will jump at the chance to use a stronger generic statin (as opposed to lovastatin):

Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital in Boston, said he has no problem prescribing generic Zocor to patients.

"It's fine," Cannon said. "It's become standard in the industry to try to use generics first."

Cannon added that Lipitor's dominance is ...

Read more...

Most Popular