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Telling lies to your doctor, and how it can kill you

13 percent of patients lie to their doctors, and almost a third “stretch the truth.”

Chances are most doctors can see through the lies, and in cases like cigarettes or number of sexual partners, physicians already double or triple the numbers patients say anyways.

Why do patients lie? Reasons include “fear of judgment, the desire to appear to be a good patient, a lack of understanding about …

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How do you find a good doctor, and what kind of questions should patients ask?

Are some sources of information better than others?

In another stellar piece, Pauline Chen asks leaders in the field how they would find a primary care doctor or specialist.

Advice included obtaining guidance with the help of a primary care physician, or failing that, “identifying high quality medical groups or hospitals that ‘carefully monitor the quality of the clinicians affiliated with them’ and that provide ‘decision support, …

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KevinMD.com is a finalist in the 2008 Medical Weblog Awards

KevinMD.com has been nominated as the best medical weblog of 2008.

I’m honored to be in such esteemed company, including Clinical Cases and Images, Clinical Correlations, The Health Care Blog and the WSJ Health Blog.

I encourage you to vote, either for me or for the other worthy finalists.

Polls close on Sunday, January 18th, at midnight (EST).

Thank …

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A woman who should have froze to death, but didn’t

How many people walk out of the hospital after presenting with a body temperature dipping into the 60’s?

Well, this Minnesota woman miraculously survived her hypothermia (via Dr. Wes), after being found down in her driveway in the bitter cold.

Which goes to show there’s some truth in that old ER saying, “You’re not dead until you’re warm and dead.”

How doctors are at the mercy of ICD coding

What’s the difference between ICD codes 401 and 401.0 for hypertension?

Plenty, as Dr. Rob points out. It can mean the difference of whether the physician is paid for the visit or not. He points out more inane examples, such as a positive rapid strep test that gets paid when diagnosed as “pharyngitis,” but not when it’s coded as “strep throat.”

Coding is an important aspect …

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A teddy bear blood bag for pediatric blood transfusions

Making a blood transfusion as cute as can be.

(via Ivor Kovic)

Recruiting nurses in a shortage, and lavishing gifts on applicants

If there’s anything more acute than the primary care shortage, it’s the nursing shortage.

Recruiting companies are getting desperate in their search for prospective nurse applicants, giving them money and gifts. And this is a nationwide phenomenon, with recruiters across the country “offering chair massages, lavish catering and contests for flat-screen TVs, GPS devices and shopping sprees worth as much as $1,000.”

One Michigan company “lavished …

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A vasectomy, live on Twitter

Would you live-tweet your vasectomy?

I wouldn’t. But that doesn’t stop others from doing so, as this blogger gives us the play by play on his vasectomy, live on Twitter.

It’s as if you’re there.

Angioplasty in a healthy patient, and why preventive heart care is dismissed

The majority of angioplasties are performed on patients with stable coronary artery disease.

And yet studies have shown that angioplasties do not have a greater benefit than medication management and lifestyle changes in this demographic, and expose patients to the risk of an interventional procedure.

The NY Times cites Miami cardiologist Michael Ozner who says, “We’ve extended the indications for surgical angioplasty and stent placement without any …

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Can universal health care lead to a restriction of individual freedoms?

That’s what this Colorado doctor is warning.

Free market advocate Paul Hsieh writes that a “nanny state on steroids” is the inevitable result of any government-sponsored universal coverage plan.

“Any government that attempts to guarantee healthcare must also control its costs,” he writes, and says that the “inevitable next step will be to seek to control citizens’ health and their behavior.”

There is a fine …

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The unintended consequences of free HIV screening at hospitals

Select hospitals have been chosen in New York to provide free HIV screening tests.

Emergency physician WhiteCoat talks about the repercussions about this move, including the possibility of delayed treatment. He says that resources, which are already stretched too thin, are asked to shoulder the additional burden of screening. “Patients wait for stroke care,” he bluntly says, “so that we can give a free HIV test …

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Will vigabatrin for seizures be approved by the FDA?

Vigabatrin is approved in Europe and Canada for the treatment of seizures.

The medication, whose brand name is Sabril, is used as adjunctive therapy for treating refractory complex partial seizures in adults and as monotherapy for infantile seizures in children. MedPage Today reports it’s up for consideration by the FDA’s advisory committee.

Problems arise from the drug’s chief side effect, namely, a deficit in peripheral field defects. …

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Dissect a rat, warm and cuddly in knit

For those who are squeamish about dissecting real animals in biology lab.

(via Street Anatomy and Etsy)

Give me back my kidney!

A doctor demands his wife return his donated kidney.

The divorce proceedings are bitter, and now the physician is demanding his kidney back, or $1.5 million in compensation.

An ethicist who discussed the case said the demand was likely fruitless, saying “it’s illegal for an organ to be exchanged for anything of value,” and that “donating an organ is considered a gift.”

Doctors should not ignore patient intuition

Patients seem to have an uncanny ability to predict when they’re going to die.

In an excellent NY Times piece, Sandeep Jauhar (who is among the best physician-writers on the web, along with the Washington Post’s Manoj Jain and The New Yorker’s Atul Gawande) talks about how patients have a “sixth sense” about their own deaths.

We are in an era where tests and diagnostic studies …

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How will the media influence health reform?

Here’s a fascinating look at how the media will play a major role in the upcoming health reform efforts.

The public will rely on the on media to disseminate health policy information in order to obtain informed opinions. The problem is, health policy is dry, and rarely results in attention-grabbing news. This is especially relevant as many newspapers are on the verge of bankruptcy and need every …

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An early C-section risks infant complications

The magic number is 39 weeks.

MedPage Today reports on a NEJM study that looked at women who underwent a repeat Caesarean delivery. It found that infants who delivered early, defined as less than 39 weeks, had a markedly increased risk of adverse outcomes, which included “adverse respiratory outcomes, need for mechanical ventilation, newborn sepsis, hypoglycemia, admission to the neonatal ICU, and hospitalization for five days …

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President Bush, lauded by The New York Times? On health care?

Read it to believe it.

The editorial staff (via Catron) throws the outgoing president a bone, praising him for increasing American support for the global fight against AIDS, pushing through Medicare’s drug prescription plan, granting Massachusetts a Medicaid waiver to help with their health reform plan, and doubling federal financing for community health centers.

Sure, much of the praise was tempered by their left-leaning bias, but it’s …

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Recruiting a surgeon to a rural area, it takes more than money

Surgeons are often lured to practice in rural areas for large initial sums of money.

A typical package can be as high as a $350,000 salary, guaranteed for 3 years, along with a large signing bonus.

But long term, the prospects aren’t as rosy says Jeffrey Parks. First off, rural surgeons may perform procedures that they may not be trained in, such “setting minor fractures, hysterectomies, …

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Poll: Which events of 2008 most affected and will continue to affect practicing physicians?

Which events of 2008 most affected and will continue to affect practicing physicians?

Here are my top 3.

First, is Medicare’s institution of “never” events, where payment is denied for certain medical errors. In addition to uncontroversial events like operating on the wrong patient, Medicare has also included conditions where total prevention is impossible, including patient falls and hospital acquired infections. By doing so, hospitals will …

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