Shrink Rap: "The truth is that people all have fantasies about their real life psychiatrist -- one is the supposition that the psychiatrist is a nice person who's life is vaguely in order."

Pretty cool ad campaign.

No-win situations in the ED.

Pulitzer Prize winning 2001 story from the WSJ. Tragic destruction of a physician's life and career. (via Buckeye Surgeon)

I don't wish this disease on my worst enemy. Don't click if you're eating.

Procedures

Can you blame primary care CMEs for catering to the procedure boom?

1) Americans are sharing their prescription medications more often than ever.

My take: There are a variety of reasons why medications should not be shared. Drug interactions, unknowingly harming the fetus in pregnant women, and incomplete antibiotic courses are all potential risks.

However with the cost of medications rising, I do expect this to be a growing trend.

2) "If you don't hear providers yelping ...

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In the Clinic - Dr. Chris Simpson, MD Discusses Cardiac Electrophysiology and Wolff-Parkinson-White Syndrome
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The UK's NICE loses to Big Pharma in a stunning decision:

At issue was the refusal by NICE, the National Institute for Health and Clinical Excellence, to give the companies access to the computer models the cost-effectiveness gurus used in making their determination about the utility of Aricept. The Court of Appeal ruled that was unfair.
This could be the beginning of the end of NICE. Once drug ...

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The Covert Rationing Blog: "A less well-documented result of this tyranny, a phenomenon that is just now coming into focus, is the mad scramble by diverse interest groups to promulgate their own sets of guidelines, and subsequently fight to have them accepted as "the" guidelines, thereby to gain control the medical agenda. Guidelines written by competing interest groups will often direct doctors to do very different things, and will set ...

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The perfect EHR?

John Halamka: "The web is the way. Given the 24x7 nature of healthcare, the need for physicians to be in many physical locations, and the multitude of clinician computing devices, the ideal EHR should be web-based, browser neutral and run flawlessly on every operating system."

David Catron writes about it in The American Spectator.

A Canadian emergency physician: "It's not just women. It's ALL new doctors. We're soft. We didn't train as hard as they did-- we didn't have to live in the hospital, we were allowed to be married. We got days off. We're paid. Our residency is shorter. We are protected by a union that enforces the rules and keeps us from being used as slave labour. We aren't willing to ...

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Heal Thyself



This a video clip from Heal Thyself, an upcoming documentary from emergency physician Ryan Flesher who pulls back the curtain on our dysfunctional health care system:

Dr. Flesher, driven by the altruism that brought him into medicine, with camera in hand, will pull back the curtain. In so doing, he becomes both observer and participant in this unique exploration into ...

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This is a piece that I wrote awhile back. I have used some of the article's wording in recently published op-eds. "Aren't you are going to order a urine test, chest x-ray or electrocardiogram?" The patient before me was a healthy adult I was seeing for a preventive health exam. As a primary care physician, I frequently encounter similar questions. Despite lacking studies suggesting any benefit to ordering ...

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Bipolar Disorder

In the Clinic - Bipolar Disorder - Dr. James Potash, MD
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Read why.

WSJ Health Blog: "Seven percent of Americans said that in the past year they or someone in their household decided to tie the knot mainly so one spouse would be eligible for the other's health coverage."

Orac: "That is why I am heartened to see the Neumanns prosecuted, even though it may well be an uphill battle to obtain a conviction. So great is our deference to religion in this country that I am not at all confident that the Neumanns won't get off scot-free and even ultimately regain custody of their other children to have another chance to do it again."

The Happy Hospitalist: "My biggest problem, which I think outweighs all other issues in the health care. And that is balance billing. Payment rates by our government and followed by all third party payers have decimated cognitive medicine, the exact saviour of McCain's proposed market system. Without balance billing, we will never have a market force in health care. Without balance billing, primary care will never return. Without balance ...

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