How Chicago can amputate abuses in medical malpractice lawsuits
"Trial lawyers are quick to point out that only 18 percent of cases that go to court result in an award to the patient. But that observation ignores the fact that 85 percent of the cases are resolved by substantial monetary settlements out of court, which are every bit as costly to physicians and insurance companies as jury verdicts."

Good ...

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Tort reform would be a great new year's resolution
I would agree with this, but clearly there are many who feel that Tort reform isn't the answer. The debate continues.

Add an E to ABCD for Spotting Melanoma
"The ABCD memory-aid used to recognize early-stage melanoma should be expanded to include the letter E for "Evolving," researchers recommend.

This would emphasize that changes often occur in melanomas during the course of the disease, according to a report in the Journal of the American Medical Association.

The ABCD acronym -- standing for Asymmetry, Border irregularity, Color variegation, and Diameter ...

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Drug Sales Visits Affect Doctors Little- U.S. Study
"The billions that drug companies spend on personal visits to promote new drugs and hand out free samples to doctors have little effect on how doctors prescribe drugs, according to a study published on Wednesday."

The "number needed to treat" so to speak, is 26 free samples to induce a physician to write one new prescription.

Sometimes, Doctors Find Answers Far Off the Charts
I like reading these cases from the NY Times. This time, the "doorknob diagnosis" leads to something more serious amiss.

Grand Rounds 11
Dr. Charles gives you the weekly best of the medical blogosphere.

Update:
Nick gives the upcoming hosting schedule.

Study: Celebrex Safer on Heart Than Vioxx
"A new study finds that Celebrex, the first in a family of stomach-friendly painkillers called cox-2 inhibitors, is safer for the heart than Vioxx, a similar drug that has been linked to cardiovascular problems."

This is a case-control study from the Annals of Internal Medicine. Those who used Vioxx had a 2.72 times higher risk of an MI than those who ...

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The Disparate Consensus on Health Care for All
The need for universal coverage is clear. The debate on how to implement it continues.

Portrayal of Doctors in Movies Serves as Public Opinion Gauge
Glenn Flores, M.D. watches a lot of movies.

Harvard Health Letter Picks 2004's Top 10 Health Stories
Nice list of the most talked about this year.

ADD Grows Up
"ADD medications are becoming a fad, and Caplan says the seductive marketing campaigns are designed mainly to sell drugs to people "” whether they need them or not.

'Doctors these days feel pretty besieged. And a lot of them are gonna say, 'I'm not gonna fight with my patients. They come in, they want something I think is trivial, I don't believe it's gonna ...

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Ten troublesome trends in TV health news
"A 2002 Gallup poll showed that many Americans consider television their most important source of news and information on health. It also showed that television is one of the least trusted sources of such news and information. I studied each of the 840 health news stories that appeared between February and May 2003 on four television stations (KARE, KSTP, KMSP, ...

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Cash-only doctors: The future of medicine?
"'Instead of paying $600 to $700 per month for insurance with a $10 co-pay when you visit a doctor's office, why not pay $150 per month for catastrophic coverage with a $2,000 deductible?' he asked. Then use some of the money saved ---- $450 to $550 per month ---- to pay cash for regular physician office visits and tests."

Exploring the feasibility of ...

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X-ray snafu cost my life
Not communicating an X-ray result leads to a lawsuit. Never assume that "no news is good news". Always followup on lab and X-ray tests.

Is It Botox, or Is It Bogus?
"It sounds like someone was cooking up some Botox in their kitchen or basement and got it wrong . . ."

Following up the story mentioned here a few days ago.

Some hospital ERs begin guaranteeing quick service
"Anyone who has spent half the night in an emergency room will welcome a trend that has some hospitals guaranteeing patients will be seen in 33 minutes or less."

Apologies for the extended downtime today. If it happens too often, I may be shopping for a new server to host the blog.

I have had a great response to the recent case discussions. However, there has been some concern regarding patient privacy. A couple of points to clarify. First, all identifying information has been removed, and the presentation changed. For instance, a "65-year old man shoveling ...

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Experts Fear Medicare Won't Work for Nursing Home Patients
"A wide range of experts on long-term care express serious concern that the new Medicare law will be unworkable for most of the 1.5 million Americans who live in nursing homes.

Nursing home residents take large numbers of prescription drugs, an average of eight a day. But many have physical disabilities and brain disorders that impair their memory ...

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More tests, less acumen reshaping medicine
"More non-essential tests are being ordered by doctors because of that fear, according to Dr. Kopjas.

'Do doctors over-order tests? Absolutely,' he said. 'Look at what happens in the ER (emergency room) and how many CAT scans are ordered there.'

The effect of not being able to rely on clinical acumen is discouraging for medical professionals, according to Dr. Kopjas.

'There ...

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Opinion: Market-driven medicine
"While it is morally and ethically a necessity to take care of those who are without adequate resources, those able should accept first-dollar responsibility for their medical costs by contributing to HSAs (health savings accounts) and purchasing high-deductible insurance. If you control where you buy care, you are more likely to see a market-driven economy resulting in reduced medical costs. Most important, take personal responsibility for ...

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