Gorking Grandma

Almost a third of nursing home residents are on antipsychotics:

And patients can be given the medicines, whether they are psychotic or not. The drugs are often used to calm demented patients, some with Alzheimer's disease, and to help maintain order in nursing homes, which are often understaffed and reluctant to use physical restraints. But the FDA hasn't approved the drugs for these uses, compounding the ethical questions.

The blogging hospitalist talks about a somewhat surreal appearance in 2004.

To no one's surprise, the internet and medical studies have helped lawyers find potential plaintiffs:

Using an advanced Google search strategy, we determined the number of Internet "hits" for websites soliciting plaintiffs for medicolegal action before and after publication of a study that highlighted the risk of dysglycemia among patients taking the antibiotic gatifloxacin. We found that early online release and print publication were associated with an immediate and ...


I am consistently baffled at why single-payer pundits want to put our health care in the hands of the government. People like Ezra Klein and Paul Krugman simply don't know what they are asking for, and have zero insight into how restrictive Medicare really is for a practicing physician.

Their ridiculous reimbursement decisions, rules and restrictions are far, far worse than any private insurer. Roy Poses ...


CT scans will go on

Despite the recent media attention on the association between CT scans and cancer, they will continue to be ordered unabated. With the current litigious climate, physicians are caught between a rock and a hard place:

"In addition, the fear of lawsuits is another reason CT scans are conducted by many physicians. Multiple successful lawsuits have been won against physicians for not performing CT scans, and the nation needs ...


Pressure to order tests

Almost a third of physicians surveyed will bow to patients' wishes if an MRI is demanded. With patient satisfaction and physician ratings becoming more important, expect this number to rise:

"There's a lot of pressure on physicians to keep their patients happy," Blumenthal says. "Part of the problem with the American health care system has been that there is no throttle on test-ordering."

Pay physicians peanuts, they will stop accepting insurance. Watch what's happening in California.

Stand up and applaud these physicians who have taken a stand and dropped insurance plans. Doctors are tired of being extorted by third-party payers and won't take it anymore:

It's hard to say exactly how many local doctors have stopped accepting insurance because it's a private business transaction that isn't tracked by government agencies. About ...


Dr. Wes in the news

Cardiologist Dr. Wes makes the Chicago Tribune, with a story on medical blogs. Thanks for the shout out!

Personal DNA tests

A "waste of money". I completely agree. The supporting data isn't there yet.

The next ADHD

It's called sensory processing disorder (SPD), something that physicians haven't heard of, but I'm sure the drug companies will be correcting that soon:

Never heard of it? You're in good company. Neither have many pediatricians, neurologists, psychologists and teachers. But in the parallel universe of occupational therapy, which focuses on the more primal "occupations" of life--dressing, eating, working, playing--SPD is commonly treated.

John McCain so gets it

Senator McCain just received the Union Leader's endorsement, and he's on a roll with his straight-talk on the need for tort reform. Bravo:

"In every other industry when technological advances are implemented costs to the consumer decreases. This is not the case in healthcare."

"Because of the need for health care reform, medical malpractice reform is at least my second highest priority."

"Every time there is ...


And winning a few of them:

Three Ohio courts in six months sanctioned plaintiff lawyers for pursuing unsupported claims against three doctors. Judges awarded the physicians their legal expenses. In New Orleans, the 5th U.S. Circuit Court of Appeals upheld a similar award to a Mississippi doctor Nov. 13.

The courts chastised the attorneys for wanton behavior including: suing the wrong doctor; refiling a claim against a physician even ...


Double trauma

In one room. Must have been tough to concentrate.

"Felt like I'd done 5000 benchpresses. My damn chest hair hurt for 3 days!"

Completely unethical:

These nurses, however well intentioned, should not perform unproven therapies "” if these are unproven; opinions differ passionately "” on unwitting patients. To do so is to tell a kind of lie to patients, who reasonably assume that their care meets hospital standards. And while the placebo effect can be beneficial, that is insufficient reason to routinely deprive patients of pertinent facts. Patients cannot give informed consent ...


Medical centers often pay local TV stations to air "breakthrough news".

An uncommon but serious complication from this diagnostic test using methylene blue.

Why would physicians start chemotherapy in this patient?

Why would cancer specialists agree to give induction chemotherapy for acute myelogenous leukemia to a patient whom they knew could not survive the treatment? Such a decision, to proceed with intensive chemotherapy in a patient who is likely to die due to his refusal to accept blood transfusions, seems to me to be a splendid example of medical myopia, if not pretentiousness.

CT scans and cancer

Will patients care and start to decline scans? Probably not:

My guess is that a few patients will say no, but most will shrug and sign, favoring current certainty in their anxious moment-of-truth over a tiny risk somewhere beyond a distant horizon.

"Bring a few good books," says Dr. WhiteCoat:

. . . some Georgia patients with psychiatric problems are waiting in the emergency department for up to three days before they can be transferred to receive appropriate care. The psychiatric patients get "housed" in the emergency department until a psychiatric facility is able to take them. In other words, the patients are forced to lay in an ED bed for ...


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