Code, in words

Brian Fletcher: "Every doctor knows -- from intern to resident to attending -- that if a very sick patient verbalizes that they're going to die, you'd damn well better listen."

(via Eric Turkewitz)

Canadian health care

Similar to the worst possible HMO?

Reaching a doctor

Can sometimes be impossible, as communication is disincentivized in our health care system.

Hopefully this will set a precedent:

Gary Gibson, FACP, sued MEDCO Health Solutions of Columbus North, Ltd., in Trumbull County Court to collect on the time he spent filling out two or three prescription inquiries a week, each taking between six and 10 minutes to complete. He told MEDCO in December 2005 that he would bill $150 an hour to fill them out, and when MEDCO said they would not ...


The newest trend? A down payment to hold your specialist's appointment.

Chastising Big Pharma on the evidence, yet promoting woo.


(via Dr. RW)

Your credit score.

Lamp oil

Keep it away from babies.

A terrible diagnosis.

Dr. Wes: "If re-used instruments are being used in a laboratory, I believe that patients should be made aware and have this included in their informed consent, with any potential risks spelled out. Further, if a patient knew they could apply some of the cost savings of re-processing toward their procedure costs, then perhaps they'd be more willing to agree to the practice."

Spiriva and the FDA

Matthew Mintz: "The FDA release give such little information that your doctor will not likely be able to tell you much more, and may suggest stopping it simply because he or she is too worried about getting sued."

Daniel Carlat: "But a funny thing happens on the way to CME programs: even with full disclosure, they continue to be commercially biased. Why is that? Why doesn't disclosure solve the problem?"

One of Graham's suggestions to fix primary care:

Pay primary care doctors for their paperwork"“and I think it would pay primary care doctors better, allow them to provide better care for their patients, and encourage more medical students, residents, and other already-trained doctors to go into the field.

Allergic to water?

Jeffrey Benabio: "The allergy is a rare condition called aquagenic urticaria. People who have it develop intensely itchy, even painful hives when their skin comes into contact with water. The itchy wheals or hives develop within minutes of exposure and can persist for hours afterward."



Are going into dermatology:

The vogue for such specialties is part of a migration of a top tier of American medical students from branches of health care that manage major diseases toward specialties that improve the life of patients "” and the lives of physicians, with better pay, more autonomy and more-controllable hours.

"It is an unfortunate circumstance that you can spend an hour with a patient treating ...


1) Marcia K. Flesner responds to my op-ed, commenting that I "failed to give a solution" and how nurse practitioners are the answer.

My take: Perhaps she neglected to read the section after I wrote, "How do we fix this problem?"

Our nurse practitioner colleagues play a vital role in health care delivery. Asking them to take over primary care as a permanent solution is not the ...


Congrats Shadowfax

Bald for a good cause.

Suicide attempts and emergency treatment.

Medical school debt

Graham Walker: "Maybe we make it a choice. You can choose to pay full price, or pay no price, with either a guarantee that you make less money for life or have required service time for the country."

If you have good credit, and balls of steel, many a medical student have engaged in credit card arbitrage (i.e. shifting loans between 0% promo-rate credit cards) for 0% interest on ...


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