Charging $5 per visit is easy if youre independently wealthy Recently there was a news story about Dr. Russell Dohner, of Illinois. He charges all patients a flat fee of $5 per visit. He doesn't take insurance. This led to several online threads featuring comments such as "Finally! A doctor who cares!" Apparently, this means that doctors like me, who charge more than practically nothing, are evil and don't care. I respect ...

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The Israeli-Palestinian conflict is obviously a hot-button issue. And I'm not taking sides, nor am I proposing a solution.  But here's where it affects me. There's a Parkinson's Disease medication called Azilect. It has some unique properties, and there's no generic, or direct competitors, currently available. It's manufactured by Teva, a company that does most of their business in generic drugs. It's the world's largest generic drug manufacturer, and if you've ...

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Dr. Grumpy has lost his neurology mojo over time. Actually, I shouldn't say I've lost it, as much as it's been worn down by red tape. Yesterday I turned away a good hospital case, and told them to find someone else. The patient was insured. The patient was interesting. Not some run of the mill chronic back pain case. 28-year old guy admitted for abdominal pain and weight loss. Large mass found (possibly lymphoma). ...

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Medicine is never an easy field. People accuse doctors of not doing enough, or doing too much. There are no easy answers. We're caught between doing what's best, without putting the patient through too much, and doing what's needed to protect ourselves from legal action. Let's take Mrs. Summer. She's a nice 78 year-old lady I saw in the office last week. Earlier this month she hurt her back. So she saw ...

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The World Health Organization recently announced that cell phones "may possibly" cause cancer. Now, I'm neither a researcher or statistician, and personally think the jury is still out on this one. I'm not going to take sides. But here is what I am pissed off about. Notice that the story said "may possibly" cause cancer. But the way we think, it somehow becomes "does cause cancer," and so we panic, and hold ...

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Pharmaceuticals are amazing stuff. You can bitch and moan about their costs, side effects, or the number of them you're taking, but what they've done to extend life and improve its quality is truly remarkable. And for all the bad raps they get, I salute the pharmaceutical industry, and those who work anonymously in labs around the world, to bring us these miracles. But ...

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I mentioned having a migraine this past weekend, and was somewhat surprised by how many people commented and wrote to me, surprised that a doctor, let alone a neurlogist, would actually get migraines. What's up with that? I know this may be hard to believe, but we get health problems too. I see this odd view surprisingly often. People who somehow expect us to be beyond the health concerns of non-doctors. We may be ...

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B12. Sounds simple, huh? 1 letter, 2 numbers. One of the B vitamins. It's important in a number of body functions, particularly the nervous system and blood cell production. It's in pretty much all meats and vegetables, and multivitamins you can buy. To me, it's also a good example of what's wrong in health care. Let's take Mrs. Olde. She goes to her internist, and is complaining of feeling weak and tired. So he checks ...

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I can always use money. Regardless of what the public seems to think, doctors are generally not phenomenally wealthy. So I hate turning business away. But tonight I refused a hospital consult. Why would I do that? Because. The consult was for an 88-year old lady with advanced Alzheimer's Disease. Her sad life was reduced to lying in bed staring at the ceiling.  The patient had been seen by 2 other neurologists during ...

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"Dave" showed up at my office last week with neck pain, worsening weakness in his arms and legs, and changes in his bladder control. All signs pointed to something gone bad in his neck. His internist had already thought of this, because he'd ordered the appropriate MRIs. And they'd all been read as normal, leaving me without a cause. Here is where the problem began. Everything about Dave's exam and story pointed ...

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