Why I blog

From time to time, people ask me why I do this. For sure, it's a significant time commitment, in addition to managing a full-time primary care panel.

I've previously stated that I intend to "pull the curtain back", to expose what goes on behind the scenes at the physician's office and the hospital. I wrote the following on my About page: "By shining a light on ...


It'll look something like this.

A trauma story

Burns, fractures, eye penetrations, and gang activity. Another exciting read of a trauma in the ER. This time, it ends with a sad twist:

Later I found out that the guy, unfortunately didn't have insurance...and the ortho procedure he required involved a series of operations, close follow-up, and specialized equipment. And because orthopods don't work (much) for free...especially when the patient is a high risk patient (high ...


Not surprisingly, it's about the money.

Those fighting over implementing individual mandates or not are losing sight of the bigger picture.

Again, the focus on universal coverage takes attention away from cost-containment - which is the more serious problem.

Managing physicians

I'd be the first to tell you that managing physicians can be difficult, as doctors have a pretty strong independent streak. The Physician Executive is starting a new job, and getting to know his new crew.

Congress is getting into the act, wondering if Robert Jarvik is qualified to pitch Lipitor:

"In the ads, Dr. Jarvik appears to be giving medical advice, but apparently, he has never obtained a license to practice or prescribe medicine," John Dingell (D-Mich.), chairman of the committee, said in a press release.

The WSJ Health Blog asks that hard question, and gets an interesting answer.

Hospitalist Bob Wachter comments on the recent NEJM study:

. . . the study once again highlights the perpetual neglect of the med-surg patient. Even though such patients make up the biggest cohort in virtually every hospital, the fact that they are heterogeneous, often scattered around the building, bring in relatively low reimbursements, are in a comparatively low tech environment, and lack powerful advocates (namely, surgeons and proceduralists) means that ...


Defensive radiology

Is the threat of lawsuits causing radiologists to by gun-shy in their impressions? Dr. WhiteCoat explains.

He once again invoked her name during his concession speech last night. I again ask Mr. Edwards whether any other nationally-run universal health care system would have approved the same procedure.

His exploitation of the Sarkisyan case is no better that the right's handling of Terri Schiavo. Jim Sabin comments further.

I am flattered that Kevin, M.D. has been selected as a finalist in the Best Medical Weblog category.

Polls close on Sunday, January 20, 2008 (PST).

Vote here.

That’s pretty freaky

(via Street Anatomy)

An ER physician rants:

. . . I hate it that they act like I owe it to them. What happened to the'good ole days' when the doc would say to the poor farmer'Just pay me when you can'. Or maybe,'I know you're on hard times now, so don't worry about paying me. Consider this visit a gift. Even if they couldn't pay, at least they knew they owed something for ...


My Q&A with the WSJ

It's primary day in New Hampshire! Jacob Goldstein of the excellent WSJ Health Blog asks me a few questions about what I think of the race.

I briefly alluded to this, but health care costs should take precedence over the uninsured. Maggie Mahar seems to agree:

Rather than focusing on the uninsured "“or the fact that insurance companies sometimes deny care to the insured"” we should focus on those who are insured, and remind them that as the economy slides (while the nation's health care bill continues to rise), their employers are going to ...


Is stress from blogging a factor in the heart attack of this high-profile blogger? (via Clinical Cases)

#1 Dinosaur makes that proposal, and Robert Centor comments.

I don't know how many studies are needed to disprove the myth. There will always be people who will never be convinced.

Glenn Beck

Glenn Beck's hospital horror story is getting some attention. Apparently, he had a surgical procedure with marked post-op pain. As physicians tried to control his pain with increasing doses of narcotics, he suffered adverse reactions as a result.

A couple of thoughts:

Fentanyl is not just an "end-of-life drug". It is simply another form of narcotic, and its use in the post-op setting is ...


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