Here's a fascinating, and scary, video of an implanted automatic defibrillator in action. 20 year-old Belgian soccer player, Anthony Van Loo, collapsed during a match. Blogging over at MedPage Today, electrophysiologist Dr. Wes analyzes the subsequent video, giving a precise play-by-play, so to speak, of when the defibrillator kicked in, likely restoring the arrhythmia into a normal heart rhythm. As for the cause, Dr. Wes has got you covered: "In ...

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There have been plenty of stories detailing how difficult it is to treat the morbidly obese. Most of the time, the stories have centered on simply how difficult it is to transport these patients to the hospital. Once there, however, emergency physician Shadowfax talks about other issues. For instance, obtaining IV access is near impossible, and 500+ pound patients present grave challenges to securing an airway, managing ventilation, or performing ...

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This ER in Atlanta is betting that you will. Taking advantage of worsening patient wait times in emergency departments, the Emory Adventist Hospital is offering a "Hold my place in line" service. For a fee of $24.99, patients are guaranteed to be see in 15 minutes or less - or the entire visit is free. It seems to me like shrewd business, and the blatant beginning of tiered emergency service. However, WhiteCoat ...

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The Mayo Clinic has been touted by policy wonks as a low-cost, high-quality integrated health system that American physician practices should aspire to. What's somewhat less publicized is that they are also a leader in so-called "executive physicals." (via Schwitzer) These exams, which often exceed thousands of dollars, offer CEOs and other executives a battery of tests that are often not evidenced-based. These can include stress tests, cardiac CT scans, and ...

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Donald Berwick is a physician at the forefront of the patient empowerment movement. In a recent interview, he believes that medical care needs to be more patient-centered, in effect, "transfer[ring] control from doctors to the patients themselves," and, "patient preference occasionally putting evidence-based care “in the back seat." I wonder how, as a pediatrician, he's handling the anti-vaccine movement. In response to a question on patient choices that come in conflict with ...

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The fight versus anti-vaccine proponents is a losing one. Orac, a general surgeon who blogs over at Respectful Insolence, is on the front lines of the debate. In this post, he writes about how vaccine supporters are facing an uphill battle:

One problem is that vaccines have been so successful that parents rarely see the full, ugly consequences of the diseases against which vaccines defend anymore. The other problem is that ...

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There has always been an underlying tension between obstetricians and midwives. From the doctor's side, the only times they interact with midwives is when trouble arises. Or, as this article in Time puts it, "When hospital-based obstetricians see midwives and their clients it's usually because something has gone wrong . . . OBs don't see the uneventful births that proceed successfully at home [and] doctors in this position find themselves ...

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A hospital that denied a woman from visiting her dying partner at a hospital is now at the center of a federal lawsuit. Tara Parker-Pope details the case, which is sparking outrage. I won't rehash the discussion, which has been quite vigorous over at her blog. Indeed, the results of the pending lawsuit can have far-ranging effects, including "the way hospitals treat all patients with non-marital relationships, including ...

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When it comes to influence, you need not go further than Oprah Winfrey. Just ask Kentucky Fried Chicken. With the recent news that she is giving anti-vaccine proponent Jenny McCarthy prominent airtime, as well as her previous endorsement of Suzanne Somers' book on "bioidentical hormones," is she doing more harm than good? That's what Rahul Parikh suggests in a piece on Salon. Despite her soaring ratings captive audience, Dr. Parikh thinks that, ...

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A recent poll conducted by the Consumer's Union, publisher of Consumer Reports, found that only 4 percent of patients said their doctors talk with them about the cost of prescriptions. And 60 percent find out what the price is for the first time when they pick up their drugs at the pharmacy. Should doctors discuss the price of medication before prescribing it? As physicians, we’re trained to make treatment decisions without the ...

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