Hanging out

In the ED?

Futile care in Canada

Doctors in Canada are closely watching the outcome of this case:

The debate revolves around Samuel Golubchuk, an 84-year-old man whose doctors say has limited brain function, can't walk or eat, breathes only with the help of a respirator and, barring divine intervention, is unlikely to recover. His family says it's a violation of their Orthodox Jewish faith to remove him from life support, and their lawyer, Neil Kravetsky, argued ...

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Wearable dialysis

A big jump in convenience if it catches on.

It's ransom-note style is drawing controversy:

It emphasizes a lot of negative aspects. To say that autism or bulimia has kidnapped a child suggests that these conditions are part of a criminal element. I'm not saying it's easy to have an autistic child, but it could be framed in a more positive way.

The gap between EHR programmer and physician needs has never been wider:

The systems that I have seen are so non-intuitive, so counter-productive, and so blinking difficult to navigate that they make other business world programs seem so advanced that they were given to us by time travelers who had spent time with Captain Kirk. Some of them have the feel of a potpourri programs forced to work together ...

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It's a pretty good list.

In their efforts to decrease patient waits, ERs may end up losing more money:

The fad of the day in the ER is some form of Provider is triage, Rapid Medical Screening or whatever name admin can come up with. In their endless search to increase business we are now catering to the very business that is bankrupting us, the med-i-caid or indigent self-pay people that rarely pay their bill.

Shadowfax opines on the broken malpractice system, and proposes some solutions.

Dr. RW juxtaposes different views on physician salary. AMSA fellow Paige Hatcher wonders what the fuss about money is about:

If we discuss the disparity in incomes between the specialists and the generalists in these terms we reinforce the entitlement that medical education endows inappropriately on new physicians. The annual starting salary for the lowest paid group, pediatricians is 140,000. On what planet is that not enough ...

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The DIY endoscope

"Disgustingly effective." (via Graham and Boing Boing)

Panda with more on futile end-of-life care:

My European friends, some of them physicians, are amazed at the measures we take to keep patients alive who have absoutely no quality of life and no chance of recovery. The Europeans may have cradle-to-grave socialism but they have a fairly well-defined idea of when to let the patient go to their grave. In the United States it seems sometimes that ...

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Clearly the DTC ad king.

Because of the judge:

. . . a New York state appeals court has thrown out a $14 million medical malpractice verdict, holding that a Brooklyn Supreme Court judge's inappropriate conduct, including presenting the brain-damaged 4-year-old plaintiff with a box of candy in front of the jury, denied the defense a fair trial.

Something else to consider after completing gastric bypass. Plastic surgeon Suture for Living explains.

The frequent flyers

This pretty much sums it up.

Nothing new to regular readers here, but an intriguing idea is proposed:

. . . primary care physicians should be paid for the services they provide, multiplied by a coefficient that appreciates the patient's burden of illness (or severity) and then multiplied again by a coefficient that appreciates that physician's willingness to engage downstream providers as the patient's fiduciary. This is an entirely different role than "gatekeeper," and would require ...

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End-of-life care

A significant reason why health care costs are so high. How do we handle it?

Dictation translation

What a doctor really means when a patient is described as "challenging and loquacious".

Gamesmanship and quality

When P4P becomes widespread, the games maximize quality reporting will only begin.

The FDA says no to Merck for the third time.

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