An man who married without telling his bride he was impotent must pay damages for abusing her "right to sexuality"
"The man had failed to fulfill his conjugal duty and deprived his wife of the chance to be a mother, Italy's Supreme Court said.

His wife had already had the marriage annulled on the grounds of non-consummation."

A physician vents against the insurance companies
"One very effective way for insurance companies to control physicians was through extensive documentation requirements. Keep the physician busy with paperwork so that he or she will not have time to fight back. This policy has worked. Using preventive medicine as their battle cry, insurance companies demand an ever-growing list of documentation."

Obese employees are being paid at a lower wage than workers of normal weight
"We view this as evidence that the higher expected expense of obese people is being passed along in the form of lower wages."

"Me too!": A jackpot jury award causes another to up their request for damages
"If a Portsmouth man can win $800,000 in damages because someone left a towel inside him after a surgery three years ago, then a 69-year-old Courtland woman who endured the same thing might deserve an equal award . . .

. . . BrownÂ’s medical malpractice lawsuit, expected to be heard by a jury later ...

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One reason that "House, M.D." is so successful is that some people relate to the main character's chronic pain and narcotic use
"House's hardship is all too relatable for viewers.

'Approximately 1 in 5 Americans suffers from chronic or recurrent pain,' reports ABC News, which was partnering with USA Today this week in a project called 'The Fight Against Pain.'

Time magazine addressed 'The Right (And Wrong) Way ...

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A hospital stay can make the elderly more likely to commit suicide
"A study in the May edition of the Journal of the American Geriatrics Society indicates that suicide in persons age 80 and older is more prevalent among those who have been hospitalized than in those who have not."

A pregnant woman addicted on Oxycontin, is having trouble receiving appropriate prenatal care while in an inpatient treatment program
"Outside of court, Michael Lowe also expressed his frustration. His wife wanted help, but instead has been pulled away from her family, and is allowed only limited contact with the people who support her.

He's also concerned about her medical care. Although she's been seen by a psychiatrist and is ...

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"When a doctor's treating pain, if he thinks OxyContin is the most effective thing he can prescribe, we don't want him prescribing extra-strength Tylenol because he thinks if he prescribes OxyContin, DEA's gonna open a file on him."
Pain management is the theme today. ABC News with a nice article on the obstacles to treating chronic pain. It includes a story of a law student who was ...

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More pain management woes part II: Another doc is under fire
"'That's the motive in this case: When the patients are addicted, that return visit is guaranteed,' Assistant State Attorney Lev Evans said. 'This case is about a drug dealer with a prescription pad.'

Luyao's attorney, Joel Hirschhorn, told the jury during opening statements he'll present evidence that will 'clearly exonerate' Luyao "” a 63-year-old grandmother of four "” ...

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More pain management woes: A doctor sues a newspaper over an investigative story
"Gutman, a specialist in pain management, said his reputation was damaged enough that he has not been hired as an expert witness in two years."

Nearly 1 in 5 women go without a Pap test
"When asked why, about half of women who hadn't gotten the test said they simply hadn't thought of it. And of those women who had been to the doctor within the last year but had not gotten a Pap smear, 88 percent said their physician had failed to recommend the test."

No excuse for this. The current recommendations ...

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Kevin, M.D. in the BMJ
Thanks for the kind words in the BMJ's Netlines section:

Web logs or "blogs" are personal journals that are a burgeoning internet phenomenon, and many medical ones are springing up all the time. The "Kevin, MD Medical Weblog" is an enjoyable and frequently updated collection of reflections from a US based primary care physician. It has great links to various source materials.

Doctors are failing to provide Americans with the best care due to a revolving-door system of medicine in which doctors are rewarded for sacrificing quality to see patients as fast as they can
Bingo. We have an increasingly fee-for-service based reimbursement system. That means that physicians are paid for every service they do: i.e. more patients/procedures/tests = more revenue.

This differs from the capitation model, where ...

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News flash: A study commissioned by the Illinois State Bar Association says the tort system is not the cause for dramatic increases in doctors' malpractice insurance premiums
Big surprise there.

Some common-sense advice when you go to the ER with chest pain

A physician in the UK claimed to see more than 540 night calls a month, while working 2 hours during the day
2 hours in the office during the day, 18 home visits at night makes him the UK's most expensive GP.

A teacher died from meningitis after 3 docs missed the diagnosis
"Hannah Kemp, who taught in Lanarkshire, had been seen by her GP and visited at home by two other on-call doctors before an ambulance was called.

However, the 56-year-old died while she waited to be taken to hospital."

I would say after the patient needed the second doctor, she should have been transferred to the hospital. ...

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$23.8m award in childbirth lawsuit
"Jurors took less than four hours Monday to find two Mass. General obstetricians negligent in the delivery in 1996 of Julia McLaughlin, who was born suffering from large bruises on her head and bleeding on the tissue around her brain.

Lawyers for the McLaughlins argued that the obstetricians, Mary Ames Castro and Alessandra Peccei, neglected Maria Lynn McLaughlin while she struggled to deliver her ...

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A case where defensive medicine harmed a patient
This NY Times story details a case where a patient wanted antibiotics for lyme disease, against the advice of her doctor: "A week after starting the treatment, she developed inflammation at the insertion site. The intravenous catheter had to be removed. As we discussed the next step, she told me she didn't want additional antibiotics. I confess to a longish moment ...

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Grand Rounds is up at Azygos this week
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