It can present in many ways. After reading this, I don't blame ER physicians for having such a low threshold to scan patients presenting with RLQ pain.

Someone should tell this to Dr. Varipapa.

Medicare and routine exams

For those who may be used to more preventive services than necessary, keep in mind that Medicare's preventive services coverage is less that one may be used to.

Physicals are only covered once, and as TBTAM points out, pap smears and breast exams only every two years.

Now, guidelines state that in most cases paps don't need to be done annually. But patients who are ...


Well said. Only if people are willing to accept "no" will single-payer or any other radical health reform be a reality. I just don't see that happening anytime soon in this age of entitlement.

Guess who comes out ahead when it's all said and done? And it's not even close.

Is starting to hit plastic surgery:

The slowdown was a hot topic at the meeting of the American Society of Plastic Surgeons in Baltimore this fall. One breast-implant maker sees hints of a slowdown in demand. The number of vision-correction surgeries appears to be falling as well. "This whole mortgage credit crisis is making people think twice," said J. Peter Rubin, a Pittsburgh plastic surgeon. "It's something I've noticed ...



Atul Gawande on the power of a simple checklist in medical care. (via Wachter)

You have to start listening to The Happy Hospitalist. Here's his first suggestion:

1. Remove failure to diagnose as a legal basis for a lawsuit.

To spend billions on testing "just to make sure" when your medical training says you already know the answer. The testing that is the result of that 0.5% chance you are wrong. No matter how much we try, we will never get it right ...


. . . the drug companies listen.

Tips from The Angry Pharmacist.

Cool medical animation

type="application/x-shockwave-flash" data="" height="267" width="400">
medical animation - from mark mazaitis on Vimeo.

(via Street Anatomy)

MRSA and body odor

Can the connection be that simple?

Who speaks for doctors?

The AMA. State medical societies? God forbid, the pharmaceutical industry? See what Richard Reece thinks will be the future.

Malpractice systems

Charlie Baker asks "What's the alternative?" to our current tort-based malpractice system.

No-fault insurance, arbitration, health courts, and global medical standards would be four things off the top of my head that would be better than what we have now.

Jay Parkinson follows up the controversy with a thought experiment.

EMR exuberance

EMRs are being promoted as the Holy Grail. But, no one is willing to put money where their mouth is. Another example of sticking it to physicians:

Also, one wonders, say, why airline pilots are not forced to purchase, out of their own pockets, computers in their cockpits designed to prevent pilot error or collisions, but that in testing actually often doesn't work, or just makes piloting ...


Physician excellence

What makes a great doctor?

I have to admit, I'm somewhat enjoying this. Anyone, from the left no less, who takes on Paul Krugman bears watching. Obama just moved up a few notches in my book.

Sore loser

A plaintiff's lawyer loses a malpractice case involving stroke care. The pre-trial screening panel found for the defense, which was admissible in trial:

The panel's findings aren't binding, but lawyers can cite a unanimous finding as evidence at trial. In [this] case, the panel had found in favor of the doctors, defense lawyers told jurors.
Now that the defense won, the plaintiff attorney says they should be abolished:


Interesting Obama take

Obama is under fire for the lack of an individual mandate in his health care plan. Is it political brilliance?

Flush with cash? Bob Wachter speculates.

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