Fed up with . . .

. . . the inaction of tort reform, two towns in Illinois are taking matters into their own hands.

Other uses of Viagra

Other than erectile dysfunction, Viagra has been studied in the treatment of pulmonary hypertension. Today's Annals of Internal Medicine presents a small study showing Viagra increased exercise capacity both in normal and high altitudes, suggesting a possible use in managing acute mountain sickness or other conditions caused by low oxygen levels at the alveoli.

As I have been continually telling my patients, antioxidant supplements do not have the appropriate evidence to support their use. Today, the American Heart Association agreed.

It's been awhile since I've received any submissions for my remaining Gmail invites. I still have 3 more left. Send me any entertaining, medically-related story or article, and I'll give a Gmail invite to what I find interesting. I give preference to entries that are well-written.

This morning, I received this story from someone who works with the developmentally disabled. An eye-opener to say the ...


As screening modalities emerge and grow more expensive (i.e. take the recent studies on screening MRIs for breast cancer in high-risk patients), can our health system handle the strain?

Consider the colorectal cancer screening. We all know that a colonoscopy is one option for colon cancer screening. However, there is no direct data that screening colonoscopies reduce mortality:

The USPSTF found good evidence that ...


Looks like resident physician hours are also an issue in Britain - except their limit is 58 hours a week (way under the 80 hour per week limit in the United States).

On vacation

I'll be taking a much-anticipated vacation the next 2 weeks. My forums at Med Help International will be closed until August 14th. I'll continue to blog as interesting things come up, but will be sporadic during the first two weeks of August.

I was going to talk about it, but Bard-Parker beat me to it. I guess that's what headlines are for, but people simply read the headline ("Study Finds MRIs Better on Breast Cancer") and jump to a conclusion. Already had someone ask me for a screening MRI of her breasts this morning. It comes as no surprise that the MRI has the higher sensitivity (i.e. less ...


Med-mal in Canada

PointofLaw.com writes several interesting articles on medical malpractice, pain and suffering caps, and liability in Canada. A stark contrast to what's happening here, eh?

. . . whipping this study out when I see them next. The study suggests a 10% improvement in osteoarthritis pain scores over acetominophen (Tylenol). Of course, no mention is made of cost - 30 caps of Celebrex 200mg is $74.99. 250 caps of acetominophen 650mg at CVS is $7.49.

Lyme test overused

A report says that the serologic test for Lyme disease is overused.

"We found that a good number of Lyme disease blood tests are ordered inappropriately, primarily for patients who come in without symptoms," . . .

. . . In more than 50 percent of the inappropriate tests, the patients didn't have symptoms of Lyme disease, according to the article in the July/August issue of the Annals ...


. . . from Medpundit on Overlawyered. The first, discussing a lawsuit based on a 1 in 1.09 quintillian chance. The second on the benefits of non-economic damage caps. The last on the effects of lawsuits going out-of-control: obstetricians are leaving Pennsylvania, and some hospitals are closing their OB departments entirely.

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.


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 ...


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 ...


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!

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