Innovative health plan overwhelms Tennessee
The public, completely unaware of how much medical care costs, will fight and sue with lawsuits whenever health benefits are taken away. It's all take and no give. However, now that the system has collapsed, what are they left with? Nothing.

Shades of the Vioxx Case for Another Drug
Interesting dilemma. Right now, they need a prospective study to determine the risks of Bextra - however, it will be several years before the results are in. So, what to do in the meantime? I probably wouldn't prescribe this in those with cardiac risk factors - we may be going down the same Vioxx path.

Once a Model, a Health Plan Is Endangered
The NY Times on the TennCare failure. What seems to be lost is the fact that little discussion is being made on getting to the root of the soaring costs. Raising taxes and rationing care has been met with resistance - but someone has to pay for the care.

Half of people with diabetes don't know they have it
How true. Diabetes is certainly a disease you want to treat early. The USPSTF recommends screening for type 2 diabetes in adults with hypertension or hyperlipidemia. It is recommended that the fasting blood glucose (FBG) test (>126 mg/dL) be used for screening because it is easier and faster to perform, more convenient and acceptable to patients, ...

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Additions

In addition to the recently added Tagboard, there are some small additional enhancements to the site. First, I've been reading good things about BlogExplosion and have added it to the sidebar (welcome new readers!). Also added are buttons for SpamPoison to fight spamming robots, as well as doing my part to spread Mozilla Firefox.

2004 Medical Weblog Awards Nominees
The current nominee list (updated regularly). EchoJournal.org is accepting nominations until December 29th, 2004. Many thanks for nominating Kevin, M.D. in the Best New Medical Weblog category.

Treating insomnia
Beware of the DTC advertising on sleep agents, such as Ambien:

Although initially promoted as superior to benzodiazepines in terms of daytime sedation, dependence, and withdrawal, the Z drugs (ed note - aka Zolpidem (Ambien)) have not delivered on several fronts. On the quality of evidence, of the 17 randomised trials with a total of 1284 patients, all were industry funded, outcomes were poorly and often ...

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FDA scientist details problems of five drugs
Dr. Centor and medpundit chime in.

Insurer launches anti-lawsuit contest
"Michigan's largest malpractice insurer has launched a contest offering
rewards to doctors who head off lawsuits by adopting office practices
that deliver quality care."

Rare Blood Infection Surfaces in Injured U.S. Soldiers
The bacteria in question is Acinetobacter, which can be resistant to many antibiotics.

Male docs hit with more malpractice claims
"Roughly 31 percent of the state's physicians are women, but only 16 percent of the doctors hit with malpractice claims and settlements over the past 10 years were women, the state Board of Registration in Medicine found."

The 2004 Medical Weblog Awards
EchoJournal.org is accepting nominations for the best in the medical blogosphere.

Heart Scanner Stirs New Hope and a Debate
A discussion on the latest and greatest - multidetector CT scans (MDCT) for coronary artery disease, along with all the controversy of an emerging technology: "Depending on which way the scanning market goes, the nation could save a fortune on diagnostic tests, and medical care could be improved. Or expenses could soar and patients could be harmed. The question is, how, ...

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The DTC Debate
Trent responds to my articles on DTC marketing yesterday. I've read and appreciated his prior articles detailing the economic impact of DTC marketing. He writes:

Anyway, the other point that needs to be made is this: even if you think that direct-to-consumer advertising of pharmaceuticals needs to be restricted, it is extremely disingenuous for physicians to make these claims. For they are direct beneficiaries of ...

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New study finds low-fat beats low-carb
Further emphasizing the fade of low-carb diets. That being said, Hardee's is going against the grain with a 2/3 pound, 1,420 calorie burger with 107 grams of fat.

Malpractice costs level off
"Malpractice attorney Marc L. Breakstone attributed the drop in settlements partly to President Bush's highly publicized efforts to cap malpractice awards, suggesting that his many speeches criticizing excessive malpractice payments may have tilted juries against people who claim they were injured by medical mistakes."

Smart or Misguided? The Proactive Doctor
Are you a "seeker" or a "waiter"?

Grand Rounds 8
DB's Medical Rants is hosting this week's best of the medical blogs. shrinkette is hosting next week.

Uptdate:
Previous Grand Rounds are archived here. If you are interested in hosting future Grand Rounds, you can email Nick at Blogborygmi.

Get your million dollars from Vioxx lawsuit
Can't say that I'm surprised (via Overlawyered).

US FDA Tells Pfizer to Pull 'Wild Thing' Viagra Ads
"Pfizer Inc. has been asked to pull two television advertisements for its Viagra impotence drug by U.S. officials who say the "wild thing" ads make unsubstantiated claims about a return of sexual desire."

A reader kindly alerted me to this. All I can say is THANK GOD - of all the ads for erectile dysfunction, this campaign was ...

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