An ER physician gets more than he bargained for during a family drive:

I looked over casually"¦and there he lay, completely by happenstance: Half on, half off of the sidewalk, a body contorted in a grotesque manner, coughing up blood, gasping for breath. I was completely caught off guard.

A plastic surgeon to the rescue after this somewhat bizarre post-surgical event:

This literally was a healed wound that had incurred the pressure of the fall onto one rock with the point of maximum force right over the healed scar at her right hip.

The Independent Urologist shares some trends.

Not mush surprise that academic institutions are getting into the retail clinic business. (via The Medical Quack)

Coverage without access

I have written recently that universal coverage without physician access isn't worth the paper it's written on. Don't believe me? Take a look at what's happening with the Medicaid population:

Sure, Medicaid provides patients with a "card" entitling them to care. But Medicaid also creates financial disincentives for physicians to provide the care. New York pays doctors $17 per ED visit for Medicaid patients? Our 14-year-old babysitter ...


Internist Matthew Mintz with a good summary on what's happening with Zetia and the ENHANCE trial.

The NY Times asks a medical ethicist on the issue:

In general, patients may decline medical treatment if they are informed of the consequences of doing so and capable of making such a decision.

"There are special considerations in emergency medicine because of the need to make rapid assessments," Ms. Berlinger said. "You could have an evident life-threatening injury "” someone bleeding out of a carotid artery "” ...


Althouse on Flea

Flea's breaking of internet silence has caught the attention of Ann Althouse.

Also, the National Review of Medicine publishes the transcript of their interview with Flea.

The "Wii warm-up"

Will there be Nintendo Wiis popping up in surgeons' lounges soon?

Playing computer games such as the Nintendo Wii can improve a surgeon's performance in the operating theatre, a US study shows.

Only certain games are effective - those requiring delicate movements.

The fine hand control required to play these games acts as a warm up and hones scalpel skills the Banner Good Samaritan Medical Centre team ...


Morgellons disease

Is it for real? Well, the CDC wants to definitively find out.

In cases involving trauma, a rectal exam is one way to assess for neurological damage. In our malpractice-mad society, this resulted in a frivolous lawsuit:

A construction worker claimed in a lawsuit that when he went to a hospital after being hit on the forehead by a falling wooden beam, emergency room staffers forcibly gave him a rectal examination . . .

. . . says in court ...


Ahead of the curve

PCP Dr. Rob was an early EMR adopter. Learn what he is doing next for his practice on the e-frontier.

Theoretically they are things that should never happen in the hospital. But there is some gray area.

Congrats to this news director who resigned over unethical reporting of "health news", which are simply ads for local medical institutions.

A case of crescendo angina in the office. Watch the trouble Dr. Crippen has to go through to get an ambulance for the patient.

Simple cellulitis

With a complicating twist of aspirin toxicity. Good catch.


Welcome readers from ReachMD! My interview about physician blogging is being replayed this week. The piece will air twice a day until Sunday, and the podcast can be downloaded here. Enjoy.

Poisoned . . .

. . . or something much more likely?

Something to think about before wanting that CT scan. Nice to see mainstream media tout some of the risks of overtesting.

Some of the unique issues that diabetics face in the single life

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