60 percent of health care workers, including doctors, don’t receive their flu shots. Some hospitals are taking a hard line, requiring those who refuse shots to wear masks whenever in the hospital.
Should they be mandatory, akin to washing hands? Not everyone likes to be forced to take flu shots, as parents in New Jersey are demostrating.
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Reynolds’ Pentad – fever, jaundice, RUQ pain, hypotension and mental status changes – are 5 signs that can be seen in ascending cholangitis. It’s a common question used to pimp medical student. Buckeye Surgeon describes seeing it live for the first time.
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Hospitals often criticize doctors for opening physician-owned ambulatory surgery centers. “Cherry-picking” affluent, well-insured patients is often cited as a reason. However, “non-profit” hospitals should be looking in the mirror. By closing up shop in poorer neighborhoods and re-opening in suburbs, where more patients have private insurance, they’re doing the same thing.
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Most diagrams in anatomic textbooks (via ACP Internist) are of white, Caucasian males. A study observes that diagrams of the nervous system were on male figures, while those of the musculoskeletal system were equally divided: “The researcher raises the question of whether this is due to thought being considered a male attribute and nutrition a female one.”
A subtle, sexist bias at play?
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If you can’t beat ’em, join ’em. Pfizer is moving into the generic medication market. Their big-market drugs, Zithromax, Norvasc, and (soon-to-be) Lipitor are generics, and their pipeline is completely dry and marked by spectacular failure. Low-margin generics may be their only hope.
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Dr. Val interviews a 32-year old with anti-phospholipid antibody syndrome, which is present in 15 percent of the population and is normally asymptomatic. An unlucky few are predisposed to a stroke.
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Hawaii is ending universal health care for children, citing budget shortfalls. Without addressing costs, it is very difficult to expand coverage.
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We know that waiting in the emergency room can be frustrating. Threatening to file criminal charges against the hospital staff isn’t going to help.
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The probable Liberal supermajority will inevitably lead to Medicare for all, according to this WSJ editorial: “The commitments would start slow, so as not to cause immediate alarm. But as U.S. health-care spending flowed into the default government options, taxes would have to rise or services would be rationed, or both. Single payer is the inevitable next step, as Mr. Obama has already said is his ultimate ideal.”
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Here’s how primary care should be practiced, all for $12 per patient per month. The patient panel is limited to 750 however, meaning if everyone adopted this model, the primary care shortage would be even worse than it is now.
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Hilarious comment on the Stayin’ Alive CPR study (via ACP Internist): “I heard a rumor that ‘Another One Bites the Dust’ works also, but it didn’t seem quite as appropriate.”
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Peter Orszag, director of the Congressional Budget Office, suggests we need to harness the awesome power of placebo. Slides show its effectiveness in depression, angina, and knee pain. A small problem called ethics would be the deal-breaker.
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Wonderful piece by a former Chairman of the Department of Medicine turned retainer physician. He soberly writes about the decline of the hospital into “centers of excellence” focused on the financial bottom line.
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Predictably, Medicare is running into trouble in rolling out their “never events” program: “Coding and the definition of what conditions are ‘reasonably preventable’ by providers are a challenge for the federal agency.”
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Physicians are increasingly marketing credit cards to patients. The appeal is that they will get paid immediately, rather than spend time chasing patients with bills. But are patients getting a raw deal by accepting these high-interest rate cards, at times under conscious sedation or in need of urgent care?
