"You are dying"

Why is it so difficult to say?

. . . one of the reasons why we eschew the "D" word when talking to patients about their prognosis is to avoid upsetting them with the use of such blunt terms since they are already in distress as it is. Another explanation is that we doctors find it awkward or unpleasant to bring up such bad news, which the author believes is ...

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Remember, you read it here first:

The presidential candidates are fighting over who would do the most to increase the number of Americans with health insurance and expand access to care. But their plans don't ensure that there will be enough doctors and nurses will treat all those new patients, argues a report expected to be released later today . . .

. . . And, as the ...

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How can something like this happen?

Oxygen ignited inside a special hood worn by a newborn infant in a hospital, burning the boy's head and face and leaving him in critical condition . . .

. . . The baby was wearing an oxygen hood, a device that fits over the face to supply additional oxygen, when something caused the gas to ignite, the statement read.

Take a look at what's happening in Long Island:

"I'm scared that we're just going to have people simply stop practicing," he said. "It has been noticeable that the physician community has been quiet "“ it hasn't spoken up, and I tend to think there's too many people planning, saying'you know, four more years and my kids are out of high school, and I'm going to move.'" . . .

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Adult vaccines

Apparently most think they're just for kids. They couldn't be more wrong. Find out which vaccines you need.

How that's a change that goes against the grain. Here's why:

Now don't get me wrong"¦I was once a hospitalist. I think the concept is good. I think that their are plenty of hospitalists out there who are excellent, and communicate with PCPs . . . But that's not the majority. As of this time the majority do not call PCP's on admission or discharge. The ...

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Concierge medicine

Why physicians are gravitating towards this route, and why this approach may not only be for the wealthy.

Freakonomics uncovers some nuggets, some of which we already know:

Events are revealing that many pharmaceutical companies, along with their consulting academic physicians, have engaged in practices that obscure or misrepresent information about their products . . .

The best kept secret by the retail pharmaceutical industry is the obscene profits made on generic drugs by the large chain stores . . .

What a lot of ...

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The Urban Paramedic

A Boston EMT gets a nice write-up in the Globe about his blog. I just found it, it's an exciting read. I wonder if his employer is aware of the blog.

"She’s a DNR"

Dr. WhiteCoat watched someone die last night in the ER.

A generic-switching incentive program is coming under fire. Costs are clearly cut when patients are switched generic medications:

An HMO owned by Blue Cross Blue Shield of Michigan ran one such program and the insurer says it made $2 million in payments to docs but saved $5 million in drug costs. Patients saved $1 million on lower co-payments for the generics.
You can talk about professionalism all you ...

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Apparently, thinking and information aren't highly valued by the Google-raised patient:

There is so little respect for the mind these days, and medical education in general. When you can Google your health and play doctor in your mind, that some how extrapolates to a dumbing down of the cognitive physician.

It's almost as if the patient believes that since they "know" what's going on, or ...

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An ER shift

How many cases are real emergencies?

Lips

Everything you ever wanted to know about your lips.

I've grown wary by the run of inane commentaries by Ph.D.'s taking over the NEJM, but this one is actually not bad.

We've been talking about how the American health care system is on the brink of "collapse" for the last 40 years. What's holding it together? Lawrence Brown says it's the oft-ignored network of safety nets:

The problem with this analysis is that the U.S. ...

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And so it goes . . .

Maryland is confronting a growing, statewide shortage of practicing primary care and subspecialty physicians, a trend that could lead to much longer waiting times in physician offices while increasing emergency room visits for minor afflictions and ailments.
The solution of "increasing the number of residency slots" isn't going to work. Primary care residencies don't fill anyways. The key is incentivising medical ...

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Rather than focusing on the uninsured, McCain rightly tackles health care costs. Key ideas include going back to capitation for physician payments as well as medical malpractice reform.

We'll see if any of this flies, but I agree with his approach emphasizing cost control over universal coverage.

The analysis itself is a little hard to read (due to the frequent use of bold), but well worth it.

Scrubs

Surgeon Sid Schawb on the attire behind the gown.

Bizarrely fascinating:

So were these master artists of the Renaissance trying to hide images of anatomically correct brains in their religious work? Why would they do it? Were they trying to put science into religion without getting caught? Or is this just one big coincidence?

Panda vs Graham

I tend to come down on Panda's side for the majority of these social justice debates. Something that I'm truly curious about is if Graham, or any other medical student for that matter, would maintain their idealistic views after a grueling residency and taste of real-world medicine. Some do, most don't.

#1 Dinosaur analyzes why their argument will continue on and on.

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