"Stop misleading the public. Tell the truth."
Simple, yet difficult to enforce, in direct-to-consumer advertising. The FDA made this bed, it's their mess to clean up. Easier to ban DTC advertising outright.

Grand rounds is up this week - Da Vinci style
Come get the weekly best of the medical blogosphere.

151 people were wrongly given a diabetes drug, instead of simethicone for stomach complaints
The diabetes drug was a sulfonylurea. Simethicone is given for bloating and gas. Death from hypoglycemia can occur with the diabetes medication.

With caps coming, Illinois' lawyers are racing to chase ambulances
"Down the stretch they come.

Attorneys are furiously filing medical malpractice lawsuits in Cook County in a race to beat Gov. Blagojevich's signature on a bill that caps awards in such cases.

Since legislative leaders announced a deal on caps last Wednesday, 58 medical malpractice lawsuits have been filed in Cook County -- three to four times the ...

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Is giving Viagra to a sex offender akin to giving a gun to a convicted murderer?
This sex therapist says no: "In my clinical experience, healthy sexual encounters are actually a key part of a sex offender's successful recovery. They teach the sex offender to refocus his desire on an appropriate subject. Some convicted sex offenders have been in treatment for decades, with no recidivism. To deny them access to ...

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Reading these comments got me thinking - Where in the spectrum of waiting are you?

Are you, fellow physicians, the type who is always on time, every 15 minutes? Or do you spend as much time as it takes with each patient?

Do you, as a patient, want a physician who runs on time, every time? Or do you mind waiting 1 hour for a ...

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How HIPAA is interfering with health care quality
"In a paper published in the Archives of Internal Medicine, researchers from the University of Michigan Cardiovascular Center report how their research on heart attack care has been hampered by the national medical privacy regulations under a law known as HIPAA, which took effect two years ago last month.

In all, they write, the changes needed to comply with HIPAA have ...

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Malpractice caps: Both sides can show data that they're right
Illinois is the latest state to enter the cap fray: "Now that Gov. Rod Blagojevich and state lawmakers have agreed to try caps to contain the rising costs of medical malpractice insurance and keep doctors in Illinois, even the most optimistic say there is not much to do but hope for the best."

A surgeon had his certification revoked after he sold test answers on eBay
"The Philadelphia-based board, which has certified tens of thousands of surgeons nationwide, found out last summer that 86 questions used on its 290-question multiple-choice exam were listed on eBay. Questions used on the exam are rotated from a large pool each year."

More people are using walk-in clinics for primary care
"'People are much more consumerist today,' Dr. Lo said. 'No one wants to wait two weeks to see a doctor. In fact, no one wants to wait an hour in my waiting room. People are much more concerned about getting things done on demand, and they have difficulty finding a primary care doctor who will see them promptly.'"

Sounds like primary care physicians are going through the same pains in Canada
"Family medicine is a tough sell. Patient needs are more complex than ever. They're older and not coming through their doctor's door with one ailment. Some have diabetes and heart disease. Others have had a stroke and are now battling cancer. These aren't patients that can be seen and sent on their way at the end of ...

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A doc in Canada gives up - and lets us know all about it
"You start to realize some patients don't give a s---.They don't
appreciate you or what you have to go through. I'm busting my butt, working all hours and getting called at 4 a.m. I have people crying on my shoulder and I have to stick my finger up people's butts -- and for what? . . ...

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Blindness and Viagra
"The Food and Drug Administration said yesterday that it had received reports of partial vision loss in 38 men taking Viagra, the impotence drug, and among 4 men taking Cialis, a newer competitor."

It has long been known that Viagra can affect vision in 1 to 10% of cases - mainly color changes, or blurred or increased sensitivity to light. Blindness caused by Naion ...

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Some patients and lawyers are using the subjective findings of postconcussive syndrome to their advantage
"The vast majority of postconcussional syndrome symptoms -- like headache, dizziness and memory loss -- are subjective, which makes it hard for doctors to distinguish feigned or dramatized complaints from legitimate injuries . . .

. . . 'It's a tool for lawyers basically,' he says. 'Patients think they will get a pot ...

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How skyrocketing malpractice premiums can shutter physician practices
"To illustrate the mathematics, Al-Aswad disclosed his personal finances: His practice earned about $830,000 last year. Out of that came his insurance costs, rent, utilities, staff salaries and, lastly, his own salary, which was in 'the low $200,000-range.'

He hasn't had a payout for a malpractice claim in 15 years, yet his insurance costs are high — just below what obstetricians ...

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A doctor banned "Dr. Death" from operating on his patients
I've never quite heard of anything like the stories that are coming out down under: "Miach said that around June or July 2003 he decided to ensure that his patients never received surgery from Patel. He said he told Patel he was banned from operating on his patients. Nurses kept vigils over patients to ensure Patel performed no procedures on ...

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The BMJ suggests a "money-back guarantee" for medications
"A large percentage of all prescribed drugs do not have the desired effect on patients' problems. The many influences on this poor outcome include wrong choice of drug, genetic factors, interactions, non-compliance, and poor drug quality.

A no cure, no pay approach can counter these problems by optimising the effect yet still making the treatment economically feasible. If the drug ...

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A UK company launches an in-car toilet



"The company says that the chemicals break down waste into a 'sweet smelling, inoffensive liquid', which can be disposed of at the end of a journey."

Big surprise - ER visits reach a record high
"At a time when the number of hospital emergency departments has been cut by 14 percent, visits to the ER reached a record high of nearly 114 million, according to Centers for Disease Control and Prevention data for 2003, the most recent data available . . .

. . . Many of the ER visits were made by elderly ...

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"Our lawsuit-inspired culture is quickly destroying the medical profession. Instead of focusing on treating patients, doctors must now spend their day focused on dodging lawsuits."
A mother's plea to her son continues: "To those lawyers who see doctors and malpractice-insurance companies as bearers of deep pockets, blame is key. If you can make people believe that an imperfect outcome is somebody's fault, well then you've just won the lottery. Doctors ...

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