retired doc with more insight, as always:

Dr. Brett does not elaborate on what the process would be to decide which interventions are or are not effective but one can assume that would not be done by the individual physician in consultation with the individual patient.Those decisions would be made by committees appointed by the one party payer (which Dr. Brett favors) either directly or indirectly. Ironically, the egalitarian ...



An orbital blowout fracture that is. (via Radiology Picture of the Day)

Two Women

A single-payer cautionary tale.

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Statin box office

WSJ on the statin wars. Lipitor is in the lead, but losing ground. I normally prescribe simvastatin (for a potent statin), or pravastatin (if there is a history of muscle toxicity) first. Lipitor comes a distant third.

Groopman on Colbert

Jerome Groopman was on The Colbert Report earlier this week.

Why can't they get it right? I guess it's better to have too many than too few.

Too bad physician-unfriendly UnitedHealth is a major part of the problem.

Fearful of liability, some hospitals are restricting the use of birthing balls. Patients lose again:

. . . [the nurse] took things one step further, telling her she can't use a birthing ball because she might fall off, and it's a liability issue . . .

. . . "Instead of simply risk-managing the things that might help women in labour, surely what we really need to ...


The new ad campaign for Metamucil:

"Just add Metamucil to your already diva-conscious diet, and your insides will be haute, haute, haute," say the print ads that will start this spring, featuring a young, slim model with the caption, "Drop-dead gorgeous guts."
(via Dr. Wes)

Finding a solution is infinitely harder. Until fee-for-service is completely revamped, the problem will never go away:

The problem is not that doctors don't know that the system is poorly run. The problem is not that the hospitals don't like to be organized. The problems with healthcare stem from a multitude of self-interested parties who are all fighting for their part of the pie. The money in healthcare is huge ...


Lawyers see opportunity.

Dr. Crippen has come to terms with supermarket medicine and has accepted his fate:

There will be losses. In particularly the management of chronic disease will not be so good. The management of the dying patient will be much worse. The old fashioned family doctor "“ like me, and most of my generation "“ will be gone in ten or fifteen years. And we will be gone because most of ...


Sam Blackman is dealing with a nosebleed in the pediatric stem cell transplant floor, and noticed he's being broadcast on the web.

Dr. Wes on his jury duty experience.

AMA vs UnitedHealth

The AMA files a complaint against United's blatant attempt at monopolizing health insurance in Nevada. However, U.S. Attorney General Alberto Gonzales is probably tied up at the moment.

Big Pharma web sites

Many patient information site are in fact sponsored by Big Pharma. Take a look at all the websites controlled by Johnson and Johnson. (via the WSJ Health Blog)

Physician Ben Brewer on his family's eating habits.

Parking lots.

Adsense-funded EHRs

Google's approach to electronic health records:

Start-up electronic health record vendor Practice Fusion has struck a deal with Web search giant Google to provide a full-featured EHR for free, the first time such a product has been available to physicians at no cost as an on-demand Web service.

Advertising sold through Google's system will finance the service, said Ryan Howard, chief executive officer of Practice Fusion. The company will ...


A gastroenterologist opines on the increasing regulations that we all have to endure:

This can be quite absurd. I am a board-certified gastroenterologist. I used to be able to check patients in the hospital for occult bleeding with a simple rectal exam, putting a small stool sample on a test card and developing it at the bedside, looking for a color change. This is important information, easily obtainable. But no ...


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