Some doctors are refusing to give immunizations as insurers are reimbursing them at below-cost
"If lots of pediatricians adopt this policy, we're going to have a
major problem in Palm Beach County from a public health standpoint."

Waning about the perils of alternative or desperation medicine
"A heralded, retired Boeing engineer dying of prostate cancer went to a West Columbia alternative medicine doctor last year believing unconventional therapies would prolong his life.

Instead, what Mike Bate received from Dr. James M. Shortt was a treatment that might have fed his cancer, instructions on how to find and use an illegal cancer drug, a false assertion he ...

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Copland comments on Merck "putting profit before life"
"I must admit I get angry when I keep hearing the 'putting profit before life' boilerplate. As Ted pointed out after the Ernst verdict came down, Vioxx and other COX-2 inhibitors save lives because they do not cause the stomach problems associated with non-steroidal anti-inflammatory drugs like aspirin and ibuprofen, which take 16,500 lives per year. The question is whether the ...

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The Star-Ledger is blogging the second Vioxx trial
(via PointofLaw.com)

The harms of overtesting

A reprint from a commenter below. This is the best explanation I've seen as to why we shouldn't scan everyone who comes in with abdominal pain. It also explains why not doing a scan and occasionally missing a diagnosis in low-probability cases should not be construed as medical malpractice.

However, will the juries buy such an explanation? Will prosecuting lawyers understand this line of ...

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Will Vioxx make a comeback in the wake of the Texas verdict?
"After August's $253 million verdict against Merck & Co. in the nation's first Vioxx-related civil trial, Lisa Stringer is worried that the loss will stop the company from bringing the only painkiller that gives her relief back to the market.

Stringer, 38, of Chicago, suffers from a spinal condition that causes nerve pain, particularly in her hands. ...

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Texas' largest medical liability insurance provider is reducing rates by 5% in 2006
They have reduced rates 3 straight years since non-economic caps were passed.

An ER doc is being sued for missing a bowel obstruction in a 4-year old

Money talks: 80 percent of government doctors in the Philippines are now enrolled in nursing schools nationwide so they can land higher-paying jobs as nurses overseas
"In the South African country of Namibia, the alliance said a junior physician earned $1,161 monthly while a Filipino counterpart here had a salary of between $300 and $400."

"The crisis is already here."
"We know our patients as friends and acquaintances in the community, as the parents of children in school with ours. We're privy to their secrets and personal problems. Our profession enables us to aid the sick and preserve the well. Yet despite all the nobility, honor, and privilege of our profession, we're under siege from every side."

Four cases to test your malpractice IQ
I will highlight one case:

Early one afternoon, you examine a 4-year-old boy who has abdominal pain. His parents fear appendicitis, yet they report no fever, nausea, or vomiting. Your physical exam reveals no rebound tenderness or guarding, and the white count is normal. You conclude that it's an upset stomach, but the worried parents aren't satisfied. They want a referral to ...

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A mother writes about the onslaught of promotional baby material even after her tragic stillbirth

The UK is bemoaning the long approval process for drugs
As long as medications like Vioxx are mired in litigation - and with juries wanting to "send a message" to drug companies - expect the approval process to be longer, not shorter.

Tennessee recognizes the need for tort reform
"If you smoke and need surgery, there are several dozen doctors in Memphis willing to crack your chest, but you can only see the best guy if you're a veteran.

Cardiothoracic surgeon Hammond Cole is the only doctor of his type in Shelby County who specializes in lung tumors, but when his malpractice premiums went up 60% in one year he ...

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Grand rounds 52 is up at SoundPractice.Net
Come get the weekly best of the medical blogosphere.

It is alleged that TennCare's drug limit contributed to a patient's death
"An East Tennessee man's lack of needed medicines "” which had been capped by TennCare "” was a contributing factor to his death last month, his doctor found, noting it on the death certificate.

James Bryant, of Rutledge, Tenn., was a very sick man, with a hereditary bleeding disorder similar to hemophilia, hepatitis C from blood transfusions, ...

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Vioxx trial update: "Just one day of Vioxx is risky"



"Intermittent use of Vioxx or even a day's use of the painkiller could be enough to cause a heart attack, a prominent heart and medication expert testified Monday on behalf of a man who is suing the maker of the drug, claiming it caused his heart attack.

Vioxx breaks down so slowly in the body that ...

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Planned Parenthood is running a promotion where pledges are accepted for each protester that shows up
"We will place a sign outside the health center that tracks pledges and makes protesters fully aware that their actions are benefiting PPSP." (via kottke.org)

Some heartbreaking pictures of the Japanese encephalitis outbreak in India




"An encephalitis outbreak has killed nearly 1,000 people _ almost all of them children _ in India and neighboring Nepal, as too few doctors struggle to care for thousands of sick children in outdated hospitals . . .

. . . Japanese encephalitis, closely related to West Nile virus, is found only in Asia, where ...

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Stay or go? The NY Times looks at the plight of hospitalized patients in New Orleans

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