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Waiting hours to see a doctor, and patients billing physicians for lost time

After waiting hours to see the doctor for a 2-minute visit, some patients have resorted to giving a bill to their physician.

It sounds extreme, but economist Alan Krueger writes that the cost of patient waiting, estimated to be $240 billion in 2007, is neglected when considering the cost of health care.

I’ll be the first to admit that many doctors do not appropriately value patient time, …

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Will doctors get a pay cut under a public health option?

It appears so.

The public health option is the centerpiece of a progressive vision of health reform. Some consider it a “backdoor” to a single-payer system, since in theory, a publicly funded option like Medicare should have the cost advantage when compared to its private plan counterparts.

According to some models, however, some of the cost savings will also come at the expense of physician salaries. …

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Andrew Wakefield exposed as a fraud, the autism-vaccine belief is based on falsified data

The man responsible for one of the most significant public health threats of our time has been exposed as a fraud.

Andrew Wakefield, the discredited British scientist whose study “linked” vaccines and autism, has been accused of falsifying data.

According to investigative reporter Brian Deer, “confidential medical documents and interviews with witnesses have established that Andrew Wakefield manipulated patients’ data, which triggered fears that the MMR triple vaccine …

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Does coordinating care save money, and if not, is it worth the effort?

Bad news for primary care advocates and the future of the proposed patient centered medical home.

Showing how difficult it is to coordinate care and focus on prevention, MedPage Today reports on a recent article from JAMA showing that, of the 15 Medicare pilot projects that used nurses to promote medication adherence and facilitate communication with doctors, only one reduced hospitalizations and none cut costs.

That’s a …

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Dr. Gregory House makes the medical literature

An article in the British Medical Journal accuses him of medical paternalism.

Calling Dr. House (via ScienceRoll) a “paradigm of a paternalistic physician,” who, “repeatedly disregards their wishes in order to diagnose and treat their illnesses,” Mark Wicclair of the University of Pittsburgh wonders why, at a time where American patients value autonomy, so many love the crusty, oft poor-mannered, doctor?

Too bad the full article is hidden …

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Do free sample medications really save patients money?

No, they don’t.

In many cases, drug companies like to leave sample medications for doctors to dispense. In most cases, they are for heavily publicized medications, and are often expensive or on a high co-pay tier. So although these medications may initially be “free,” when patients ask for a refill, they will eventually pay more for their treatment course.

Matthew Mintz, in his piece …

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Can a Cuba Gooding Jr. television film save anesthesiology’s image in the movies?

It’s safe to say that the former Oscar-winner has been somewhat floundering in his recent movie roles.

That said, his recent effort, Gifted Hands: The Ben Carson Story, has the thumbs up of this anesthesiologist.

After losing faith of how anesthesiologists were portrayed, ranging from cheap horror movies to cowardly behavior in Grey’s Anatomy, she is impressed with how “they bothered to show …

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UnitedHealth leading the way on the medical home?

Read it to believe it.

The traditionally physician-hostile health insurer is backing up its commitment to the patient-centered medical home with dollars. In a pilot project involving IBM workers in Arizona, they are listening to physicians, and helping small and solo practices meet the strenuous requirements that the medical home demands.

If all the goals are met, primary care doctors in the program could see a …

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How companies make money from unnecessary screening tests

Most patients think that more testing equates to better medicine, and companies are profiting from that myth.

Some offer non-invasive screening tests (via Schwitzer), often times performed in church basements, screening the healthy, general population for carotid artery disease, peripheral vascular disease, or abdominal aortic aneurysms.

The typical cost is $50 per test, or five tests for $159. The price transparency is welcome, especially when health …

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Is moral distress preventing doctors and nurses from providing good patient care?

Doctors and nurses are increasingly unable to provide appropriate patient care as they care caught between the demands of administrators, insurance companies, and even patients’ families.

Surgeon Pauline Chen writes about the phenomenon in her latest column in the NY Times, where she describes cases where medical providers are unable to do what is ethically right.

The interests of the medical staff conflict with those of insurance …

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Why do medical helicopters crash so often?

There have been a rash of news lately on tragic medical helicopter crashes, with 35 deaths since February 2008.

Who’s to blame?

MedPage Today
reports on the National Transportation Safety Board hearings, where witnesses suggested that pilots were “not taking proper safety precautions, inadvertently flying into severe weather, and becoming disoriented at night.”

Several interesting questions were raised, including whether medical flights were overused rather than …

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How banning pharmaceutical gifts to doctors may be hurting the economy

Massachusetts is considering implementing some of the toughest laws in the country regulating the pharmaceutical industry from giving gifts of any kind to doctors, and restricting drug company funding.

MedPage Today (via Dr. RW) reports that one unexpected consequence is that many major physician conferences are pulling out of the city.

For instance, the American Academy of Allergy, Asthma & Immunology pulled its 2015 convention out …

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Poll: Do we need to hang up the white coat to limit infection?

Even more than the stethoscope or the black bag, perhaps nothing symbolizes the medical profession more than the white coat. Medical students enter the profession with a “white coat ceremony,” and patients see a doctor in a white coat as a trusted authority.

Historically, doctors wore white coats to act as a barrier against disease and infection. However, that assumption has been contradicted recently, by numerous studies showing …

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Chickenpox parties and the risk of natural immunity

A byproduct of the anti-vaccination movement is chickenpox parties.

“My 7-year-old daughter has been to six of these parties. Unfortunately, we have not caught the pox yet, but I’m keeping my eye out for more parties,” says a concerned parent.

Some believe that natural immunity produces a higher level of antibodies, and thus, longer-lasting immunity. Which is true. However, they fail to realize the …

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Will the government delay comprehensive health reform?

With the economy worsening, health reform appears to be taking a back seat.

Or is it?

Bob Doherty sounds the alarm, citing the contentious opposition to reauthorizing SCHIP, which once enjoyed bipartisan support.

Several outlets are also reporting that prominent politicians, including Pete Stark and Max Baucus, have privately admitted that comprehensive health reform will be pushed back until 2010.

MedPage Today somewhat concurs …

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Max Baucus on single payer: "I’m not going to waste my time"

I find it interesting that single payer supporters are so inflexible in their vision of what health reform should be like.

Progressive blogger Ezra Klein says that the opponents of single payer supporters actually are moderate Democrats, rather than the right. “Their enemies are on the left,” writes Mr. Klein. “Their targets tend not to be those blocking reform, but those promoting the wrong type of reform.”

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Why Americans fear radical health care reform

Despite faring poorly in metrics that compares the American health care system with other countries, the public may fear the unknown that radical change brings.

Prominent economist Uwe Reinhardt (via The Health Care Blog) provides some insight in a recent interview.

There is little question that the United States provides the best specialist-based care in the world. As Mr. Reinhardt says, “people imagine having …

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Should patients be treated as customers, and if so, are they always right?

More patients are being referred to as consumers, and some don’t agree with the connotation.

“That puts a bigger emphasis on how much profit the patient can make a company, which can lead to less-than-optimal decisions on behalf of the patient later on,” says diabetes blogger Manny Hernandez.

However, patients are now encouraged to advocate on their own behalf, and entities like high deductible health plans and health …

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Will integrated systems become a reality in American health care?

Many of the country’s large-scale health systems, like Kaiser Permanente, the Mayo Clinic or the VA, operate at a greater cost-efficiency when compared to a traditional practice.

Currently, however, they are an exception to the norm. Most doctors are affiliated with small-group practices, with little interaction between each other. That is one reason why care is so fragmented, with only a minority of doctors using electronic medical …

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Should Darvon be withdrawn? The implications of banning propoxyphene

The FDA advisory committee voted to ban Darvon, generically known as propoxyphene, in the United States.

MedPage Today reports on the 14-12 vote, which was prompted by numerous fatal overdoses, and non-fatal complications, as well as questioning its efficacy.

Anti-pharmaceutical crusader Sidney Wolfe made his presence felt, as he presented data claiming that in 2007, according to data gathered from emergency departments, “503 deaths were ‘related’ …

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