BI-Deaconess surgeons in Boston have to take tests in a simulator to maintain certification:

CRICO/RMF, the Harvard-affiliated hospitals' liability insurer, is offering surgeons a refresher course at the Carl J. Shapiro Simulation and Skills Center at Beth Israel Deaconess. Surgeons will receive a $500 voucher for the cost of the test and another $500 rebate on their malpractice insurance from CRICO/RMF, Jones said.

The insurer has identified 145 surgeons ...

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Graham tries to take it on (good luck). Ignoring the health care policy points that we disagree on, he touches on the major reasons why primary care is dying: the reimbursement system, lifestyle, and paperwork.

The reimbursement system is the key element that is killing off the profession. The more that the public and politicians can understand this, the better off we would be. Graham writes:

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"Test every twinge"

This happens every day, in hundreds of hospitals across the country.

One of the more asinine things I've come across. Even more stunningly idiotic is this suggestion by the researchers:

Researchers asked doctors to estimate respiratory and pulse rates without looking at a second hand . . .

. . . The researchers asked 20 appropriately trained staff to evaluate different pulse and respiratory rates on a simulated patient without the use of a second hand.

Estimates ...

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Much has been made of the NEJM study regarding survival rates of cardiac arrests. DrRich wonders whether sudden death is good business for hospitals:

The healthcare system, on the other hand, thinks differently about people who are prone to cardiac arrest. These are typically individuals with chronic and expensive medical problems - most often they have coronary artery disease, diabetes, or heart failure - and their sudden death today ...

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The NHS is encouraging people to treat themselves in the name of saving money:

"Instead of going to a hospital or consulting a doctor, patients will be encouraged to carry out 'self-care' as the Department of Health tries to meet Treasury targets to curb spending," the Telegraph explained.

So when is a universal health care system not actually universal? When Britain's 60-year-old National Health Service can no longer support ...

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Robert Centor makes his choice, which means supporting retainer medicine.

And why you should care:

Many people who follow health care policy believe it may already be too late to save primary care medicine. At the very least we will have two tiers of medicine. Retainer or concierge practices that cater to the wealthy and nurse practitioners who deal with routine health matters. Emergency rooms will be filled with everyone else. Patients will shuffle from specialist to specialist with ...

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The narcotic cap

Guidelines in Washington recommend capping to total morphine dose per day, leading to outrage.

Vitiligo

The story of Lee Thomas, a black TV reporter who was diagnosed with the disease.

Miraculous recovery.

For starters, not ordering a CT scan is more likely to have negative repercussions for the physician:

The cancer caused by a CT scan doesn't generally show up for decades "” and there are all sorts of other intervening reasons why a patient would develop cancer "” so no one is too scared of getting sued for ordering a CT scan. Getting sued for not ordering one is ...

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Pretty harsh outlook from Macleans:

Female doctors commit fewer hours and fewer years to the medical system than males, and family duties are at least one reason why. Despite their demanding careers, women are still given the bigger proportion of child care, housekeeping and elder care, but this pressure comes with a price. "Burnout" drives many women out of medicine altogether, and with five million Canadians currently without a family ...

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Better get used to it:

Medical malpractice insurance for obstetricians and gynecologists could become so expensive that only hospitals "” and the doctors under their insurance umbrellas "” could afford coverage for birthings.

For expectant moms it means their gynecologists, after shepherding them through nine months, would hand them over to a "laborist" "” a hospital staff doctor specializing in delivering babies.

"I think it's going to compromise ...

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MICRA is doing exactly what it's supposed to in California. Want to raise or eliminate malpractice caps? Then deal with physician shortages. Pick your poison:

"Raising the MICRA cap would significantly increase healthcare costs, limiting patient access to doctors, hospitals and clinics throughout California," said Lisa Maas, executive director of Californians Allied for Patient Protection, a trade group. "MICRA protects patient access to healthcare."

San Diego ...

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The defendant hospital hires the plaintiff lawyer's brother as part of their legal team.

Disaster: "Medicare is in the paradoxical position of having unsustainable growth and too-low fees to attract providers."

Physicians are embedding videos into their test result emails. Not a bad idea.

Just say no

Saying no and denying services is the real way to fix our health care mess:

. . . making these types of hard choices is the real problem in health reform - not "play or pay", tax deductions or hard subsidies, employer or individual mandate, or all the other comparatively trivial choices.

"You are dying"

The different ways physicians express it. (via Pallimed)

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