Obtaining pre-auths for generic medications is the latest growing, asinine trend. I recently had to do one for the generic NSAID etodolac. Maria writes about her frustrations with getting generic bupropion approved.

Reforming the physician reimbursement system is a recurring theme here, as the perverse incentives of a fee-for-service system is a primary driver of health care costs.

Any talk about comparing US physician salaries with those abroad has to be accompanied by the context of the larger medical school debt and malpractice insurance that American physicians face.

So, would you accept lower physician salaries in exchange for a fully ...

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Here's how not to do it.

According to DrRich:

Whatever success may be enjoyed by the rational and humanitarian Canadian healthcare system - as tenuous as that success may be - is largely dependent on the continued existence of the irrational, unfair, wasteful American healthcare system.

A "lack of strategic thinking". (via Dr. Wes)

Guess the EKG

A classic EKG of an uncommon condition.

Robert Centor is going to tackle what ails our health care system over the next few weeks. He starts by identifying the problems.

Treat the obesity, and you treat the diabetes.

Medicine in Taiwan

There are reports of rampant drug prescribing by physicians in Taiwan. I wonder if stories like these are commonplace:

My blunt and honest boss said in passing "it's so doctors can make money from the pharmaceutical companies". Scary. Medicine is cheap in Taiwan, not that I really have a good gage being Canadian, but I know Americans glow about how cheap medical care and medicine is here.... but doctor's ...

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Steven Levitt has postulated that abortion rates are linked to future crime rates:

The logic is simple: unwanted children have an increased risk of growing up to be criminals, and legalized abortion reduces the number of unwanted children. Consequently, legalized abortion lowers crime in the future.
So, what does today's declining abortion rate mean to crime in the future?

One issue I have with the three Democratic proposals is giving patients the option of a government-run, Medicare-style plan. To be frank, this is the single troubling aspect that is preventing me from being enthusiastic for any of the Democratic proposals. By using the government's bargaining power, they can undercut premiums from private plans, leading to a catastrophic Medicare-for-all scenario. A universal Medicare is no different from having ...

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ENHANCE and Zetia

A hospitalist perspective from Dr. RW, which summarizes recent blogosphere discussion on the topic.

A vocal, pie-in-the-sky medical student wonders why physicians are so frustrated with the NHS. Dr. Rant eloquently retorts.

This happens Stateside as well, with the AMSA-brainwashing machine really doing a disservice by insulating medical students from what it's like to really be a physician in the real world.

Naive idealism is understandable in medical students - after all, the academic world is partially shielded from ...

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How the infiltration of alternative medicine in academic medical centers is damaging both their credibility as well as the evidence based medicine movement.

What to make of the Vytorin debacle and their terrible commercials. (via the WSJ Health Blog)

Meet the "revision plastic surgeons", a whole new field to deal with plastic surgery complications. (via the WSJ Health Blog)

This is what you get for cutting physician reimbursements:

Scott says spine surgeons and some other specialists have already stopped taking Medicare users, mostly because they can't afford to see "low-margin patients."

General practitioners and internists may soon follow suit if a new reimbursement formula isn't implemented, he says.

State Sen. Robert Singer (R-Ocean County), who sits on the Health, Human Services and Senior Citizens Committee, says low ...

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And it's not a hemorrhoid.

In a "pioneering" effort to solve the reimbursement issue, a major Massachusetts health insurer proposes the following:

Blue Cross and Blue Shield of Massachusetts wants to stop paying doctors and hospitals for each patient visit or treatment, a common arrangement that most experts agree has led to unnecessary, inefficient, and fragmented care that is sometimes harmful to patients.

Instead, they want to pay doctors and hospitals a flat ...

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Must you be a specialist to have any credibility?

. . . one of the knocks on generalists is that in the rush to save money, system players have forgotten that their purpose was to foster the distribution of resources in a manner consistent with the best population health outcomes. In so doing, we have devalued our generalists to the point that GP's in the US must be specialists for ...

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