C. Everett Koop sounds off on the unacceptable amount of uninsured in the US
"I am urging America's leaders to put aside political differences and have a full and sweeping assessment of proposals to curb this crisis. This problem is too important to let politics get in the way of practical solutions. We could make insuring America a great, lasting gift to the next generation, rather than burdening them with ...

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The uninsured have a hard time seeing specialists
"American medicine is flush with specialists, experts who know particular body systems or diseases inside-out and stay on top of the most advanced treatments. For someone with insurance, access to these physicians is usually as easy as calling for an appointment.

But if a patient without insurance contacts a private doctor's office, he will typically be asked for payment upfront--in cash. ...

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A doctor in New Zealand is told to apologize for not obtaining a chest x-ray soon enough
"A doctor who failed to arrange a chest X-ray for an elderly patient, later rushed to hospital with pneumonia, has been told to apologise.

The woman's granddaughter complained to the health and disability commissioner in 2003 about the care her grandmother, a rest home resident, received.

The doctor, known as Dr ...

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Are these the "top 10 medical tests you need"?
Should you listen to a financial magazine for medical advice? Let's look at the tests that Forbes recommends. When reading this, I make reference to the USPSTF Strength of Recommendation Ratings:

1) Blood pressure screening
Agreed. This is a class A USPSTF recommendation.

2) C-reactive protein
Still not enough data to support general screening. There are some ...

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Vermont is moving closer to a malpractice crisis
"Vermont's largest malpractice insurance carrier will raise rates for emergency room physicians by 69 percent, oncologists by 46 percent and family care obstetricians 38 percent. Medical Mutual Insurance Co. of Maine will also raise rates for radiologists, urologists and surgical podiatrists more than 30 percent. Overall, the average rate increase is 19.7 percent; the new prices take effect in July . . ...

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5 out of 6 physicians in this small Ontario town are leaving

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.

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