It’s about time

Medicare will now cover a "comprehensive physical" and the appropriate screening tests that accompany it.

The "welcome to Medicare physical'' for new beneficiaries includes influenza and hepatitis B vaccines, mammograms, Pap smears and pelvic examinations and screening tests for prostate cancer, colon cancer, glaucoma and osteoporosis, among other conditions.

It will even cover things like a routine EKG, which is not even recommended by the USPSTF.

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Shotgun lawsuits

Medpundit is guest blogging at Overlawyered, and posts this story about a potential casualty of shotgun lawsuits.

. . . of someone who does not have insurance and doesn't speak the language, getting lost in the maze of our broken health care system.

His next project will turn his attention to the world of HMOs. Should be fascinating when it comes out:

With "Fahrenheit 9/11" becoming the first documentary to cross the $100 million mark at the domestic box office, director Moore expects a smooth path on raising money to make "Sicko," his critique of health-maintenance organizations.

. . . for continuity of care.

Our surgical colleague on A Chance to Cut . . . responds to the piece on delayed weekend testing. He disagrees with my hypothesis that the savings from shortened length of stay would offset the increased staffing costs of treating a weekend like a weekday. Perhaps this should be studied next.

Given the current nursing shortage and the premium that would have to be paid to ...

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John Stossel did a fantastic piece on 20/20's "Give me a break" segment regarding John Edwards and personal injury lawyers (found via Galen's Log). Some excerpts:

In hospitals, the lawyers have bred so much fear that patients now suffer more pain, and may be less safe because doctors are concerned about being sued.

"That fear is always there," said obstetrics professor Dr. Edgar Mandeville. "Everybody walks in mortal ...

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For those who haven't been following Michelle Au's Scutmonkey Comics, they are witty and hilarious - I can certainly relate to many of the experiences. A new batch were released today, dealing with her surgery rotation. Check it out!

. . . are now encouraged to use stealth to bring their husbands in for screening tests. In this view from BMJ USA, a general practitioner warns against blindly advocating screening tests. This harkens back to a previous article advocating a balanced view on screening tests.

The "Ignorance Isn't Bliss" campaign—launched this week and run by the Prostate Research Campaign UK with support from AstraZeneca—wants me, ...

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. . . from Finland. It is suggested that the rate of stroke was lowest on Sunday, and highest on Monday. I wonder if the next step would be to see if the same applies to heart attacks.

A new study was released saying that tests are delayed on the weekends versus the weekdays.

In the study, published in the August edition of the American Journal of Medicine, researchers analyzed six procedures commonly used in emergency situations:

Purpose
Many hospital departments tend to have lower staffing levels on weekends. We evaluated the use of selected urgent procedures for emergently hospitalized patients and measured the time ...

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A thoughtful response to my piece on good business vs good medicine. The commenter argues that the fundamental problem is our dependence on the insurance system. Consequently, our health-care system is slanted against good medicine. It is the insurance companies that forces good business on our medical practice, and the physicians are unwitting pawns. Take a read:

The assumption is that somehow good business and good ...

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I regularly receive the Cortlandt Forum and only recently realized they're on the web. It's an eclectic magazine, but has interesting malpractice cases. Here's another one.

Basically, it's a patient who came in with dyspepsia. The PCP ordered an upper GI series and it was read as normal. However months later, the symptoms continued, and an EGD found terminal stomach cancer. The ...

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Here's a case where a physician and pharmacist were sued because they failed to warn about the risk of priapism when Trazodone was prescribed. Looking this up, it occurs in less than 1% of cases. Now, how many of you talk about the risk of priapism when prescribing Trazodone? Note the risk management principle:

Juries have been generally supportive of physicians in this respect and do not ...

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. . . the largest city in the nation thus far to endorse the importation of medications from Canada. Convenient timing of the announcement, one week before the DNC.

A recent comment from my Caduet post stated this:

I'm amazed at how drug reps are taught to sneak in the information about putting patients on an unnecessary drug. I'm also always shocked to see how many free clinic patients at our student clinic are put on Norvasc right away.
This is a sad reality. The reason for this is that drug reps don't leave generic medications. There ...

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. . . on the how Bush and Kerry will approach the various health-care issues. An excerpt:

. . . Kenneth E. Thorpe, an Emory University professor of health policy who has evaluated both plans, estimates that Kerry's would reduce the number of uninsured by nearly 27 million; Bush's would cut it by 2.4 million.

Besides the effect on insurance coverage, the proposals differ in two other ways. ...

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Banging on the drum

The National Coalition on Health Care called Tuesday for a rapid, sweeping reorganization of American health care. Without drastic changes, here are the resulting consequences:

Premiums for family coverage will exceed $14,500 in 2006, more than twice the cost of similar insurance in 2001.

Two million people a year will be priced out of the insurance market, with the number of uninsured growing to more than 51 ...

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. . . between physicians vs. lawyersBlogborygmi,  RangelMD and Galen all chime in with interesting and reflective analysis. 

Here's a cynical letter from an internal medicine physician found on Internal Medicine News:

The headline, "Internal Medicine Seen as Unmanageable Career Choice," hit home.  One of the last sentences, however, demonstrated that someone missed the boat:
"The initial results suggest that students respond to a structured curriculum, which gives them the sense that internal medicine is a manageable career."
 
Ouch.
 

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