"I'm writing on behalf of the more than 60 people who took my advice and posted pictures of their illnesses and injuries . . . in the hopes that Dr. Frist might be able to diagnose us over the Internet."
Dr. Frist is coming under fire for his internet diagnosis from the LA Times and Chris Rangel.

Despite all the complaining that doctors do, this physician puts it in perspective
"Personally, I think we complain too much. All businesses have become more difficult in today's economy. My brother-in-law - in management for an automobile company - has had to work out-of-state 10 days out of 12 for the past six months. A computer company downsizes its workforce and everyone left picks up the slack. A well-respected ...

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Low blood sugar can now be used as a defense in court
"The Colorado Supreme Court has ruled that low blood sugar meets the legal definition of ?involuntary intoxication.?

The court ruling gives legal standing to something diabetics and medical authorities have known for a long time, low blood sugar can have serious affects on the way people act." (via bookofjoe)

A UK hospital told a patient she would have to wait 18 months for an MRI brain scan, but she could get the scan privately in two weeks

A cancer-stricken man has a new penis constructed
"In October 2004, the patient had skin removed from the inside of his mouth, which Bird then rolled into a tube to create a new, longer urethra. The patient was given six months to heal.

Ten days ago, doctors selected a relatively hairless part of the man's outer thigh to make the shaft of the penis . . .


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John Stossel wonders why the best sunscreen is being blocked by the FDA
"But even though dermatologists say Mexoryl is the best, you cannot legally buy it in the United States. It's illegal, because the Food and Drug Administration won't approve it. They won't even say why. The FDA is charged with making sure no drug is sold unless the government is convinced it's safe and effective. Dermatologists think ...

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Equating the competence of older physicians with older firefighters
"The sad truth was that some of the more experienced firefighters had let their skills and training lapse, feeling certain that they would continue to coast along to retirement on grass fires. Some failed to follow important safety protocols. Some positioned themselves and their equipment poorly. A few were temporarily paralyzed by fear.

The "old guys" weren't so ...

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A surgical resident rotated through four Massachusetts hospitals with active TB
"The memo states that once the woman's potential TB infection was identified by a skin test in 2004, Boston Medical Center referred her for a chest X-ray to a TB clinic run by the Boston Public Health Commission. The X-ray, which is one of the tests typically performed to ascertain whether a patient has an infectious case of TB, ...

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A woman survives a rare internal decapitation
"A near-fatal car accident this past January ended a lifelong career as a musician when the ligaments connecting the base of Greitzer's skull to her backbone were severed, internally decapitating her.

Miraculously, even though Greitzer's injuries were so severe, tests revealed that her organs and spinal cord were still intact."

The paper trail from a simple doctor's visit can be so labyrinthine that some people simply wait for an envelope from a collection agency before cutting a check
"The sequence of events goes something like this: You go to the doctor, pay the $10 or $20 co-pay on your way out, and shove the carbon copy receipt into the bottom of your purse or pocket. Later, you get an envelope ...

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A psychiatry resident talks about Tom Cruise, Scientology and its anti-psychiatric stance
Maria over at intueri: to contemplate has a wonderful blog. She writes:

If Tom Cruise has not ever personally suffered from mental illness, it is my sincere hope that he is grateful for that blessing. His faith in Scientology is steadfast, but his proselytization of the merits of his faith, particularly in the realm of (anti) psychiatry, only ...

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The most recent story in the defensive medicine series led to the following comment:

Why would a physician even consider prescribing anything other than say, birth control, over the phone? That doesn't sound like defensive medicine, it sounds like common sense.
This begs the question: Are there any diseases that can be treated over the phone?

The answer is yes. Go to your local drug store, and you will ...

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Tort reform is causing some malpractice lawyers to leave the field
"Attorneys say they have been forced to turn low-income clients away because those individuals cannot generate enough in the way of economic damages, which are not capped, to justify going to court.

Losing that business might have negative consequences for some attorneys. Several attorneys said they have heard grumbling from colleagues who are insisting they will need ...

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Patients in Australia are canceling surgery from doctors with ethnic names amid a patient backlash over the "Dr Death" scandal
"As the scandal unfolds, the Australian Divisions of General Practice has received reports of mounting concern among patients about the quality and qualifications of overseas-trained doctors.

It has reached a point interstate where patients are cancelling surgery due to the 'ethnic inflection' of surgeons' surnames, according to ADGP ...

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Grand Rounds 1:38 is up
Come get your weekly best of the medical blogosphere.

Congratulations to the medical blogs named in About.com's Weblogs of the Week
(via GruntDoc)

The fourth part of this continuing series. Defensive medicine isn't all about ordering more tests. A reader writes about this recent telephone conversation:

Patient
I have a red eye for about 1 day and awoke with crusty discharge. My son has recently been diagnosed with conjunctivitis and is on antibacterial ointment.

Doctor
Any trauma to the eye, visual changes or light sensitivity?

Patient
No. ...

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The national waiting time to see a doctor is 24.4 minutes
"When we complain (to insurance companies) that they're not paying us enough to cover our overhead, they say: 'You're spending too much time with patients. You need to move them through faster.'"

$1 out of every $12 spent on health insurance premiums indirectly pays for health care provided the uninsured
"Providing health care for the uninsured increases the annual cost of insurance premiums for the average worker by $341 and for the average family by $922, according to a study by a group promoting universal health insurance."

The USA Today says yes to DTC advertising
"However annoying, the ads have benefits. They urge people to discuss health issues with their doctors, and some patients with a stigmatized condition, such as depression or impotence, open up and get needed care.

Patients may irritate doctors by demanding the latest drug touted on TV, but it's up to physicians to decide whether prescribing it is wise. If it's ...

Read more...

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