This economist hits the nail on the head: "Most businesses are based on a scaleable model of sales. However the product of a doctors office can only be created by the doctor and delivered by the doctor. In essence, it is a one employee enterprise and everyone else in the office is ancillary staff. In fact, it could be argued that the doctor actually works for the employees and not ...

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Anti-dumping rules are in place in California. But sometimes it places hospitals in a difficult situation when patients don't want to leave:

In hospitals, patients have a "nice, warm bed, three meals a day and maybe even a television and people waiting on them. They are literally saying to us, 'I don't want to go. If you discharge me, I will call the L.A. Times.'"
The health care crisis ...

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BusinessWeek looks at how Big Pharma influenced Medscape's CME offerings.

This story was originally broken by psychiatrist Daniel Carlat, in another example where physician bloggers can tip off mainstream media.

A hospital CEO was fired for not disclosing his prior crimes.

Roy Poses suggests that CEOs have as much, if not more, influence than physicians in health care. Doctors go through exhaustive licensing and credentialing procedures.

Hospital executives are placed in positions of similar authority, and should be vetted just as thoroughly:

Leaders of health care organizations, from hospitals to drug companies, have as much if ...

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Two doctors from Toronto speak out against it. Short-sighted advice.

Rather than saying "no", academia needs to find constructive ways to embrace to medium. Blogging gives physicians a prominent voice in the health care debate, which will be essential as health policy changes in the United States.

Mainstream media regularly reads physician blogs, and they can be used to shape messages and provide rapid ...

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Health media watchdog Gary Schwitzer takes a look at their overhyped, non-critical coverage of prostate cancer therapy and being a tool for drug company propaganda.

Negative news does not garner ratings, which is why national health reporting needs to be viewed with a skeptical eye.

Vytorin and cancer

The link suggested in a recent study did not reach statistical significance.

But that did not prevent politicians using the speculation to their advantage.

Medicare is wading into dangerous territory here. Instead of further scrutinizing the current conditions on the no-pay list, they're aggressively expanding it.

Policy makers should be aware of the unintended consequences of certain pay for performance measures.

A poorly thought-out no-pay list will lead to similar circumstances, paradoxically increasing costs and patient harm:

For example, even with the best treatment, blood clots remain relatively common in ...

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Staying human

Sage advice: "I encourage all medical students to set some non-academic goals for their medical school years. I knew students who ran marathons, raised families, volunteered for their churches. Non-academic personal goals are important in medical school; they help keep you human."

I second that. It is very easy to become engulfed by medical training. Having a non-academic outlet is essential. This is especially true ...

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The following is a reader take by The Happy Hospitalist.

All for one and none for all. That is the state of the current government program called Medicare. The entitlement program that threatens the financial security of our nation. On March 25, 2008 the Boards of Trustees released their Annual Report of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. ...

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Medical blogs are featured in the LA Times. This blog, along with GruntDoc, Dr. RW and OB/Gyn Kenobi were linked and mentioned.

The piece talks about Grand Rounds, and re-iterates the familiar concerns about patient privacy and product endorsement.

As the medical blogosphere, or "new media medicine" (thanks, Dr. A), continues to grow, there will be controversy on how to deal with these ...

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In the Clinic - Dr. Larry Sperling, MD, Discusses the Use of the Stethoscope
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Innovative idea from Boston's mayor. Subsidized housing as a means to lure primary care physicians into the city.

Similar forward-thinking ideas from our politicians are needed.

It looks like it.

Maggie Mahar is right, voters are powerful and can offset the lobbying force:

Voters still have tremendous power. And as we head toward Medicare reform -- and eventually toward national health reform"”legislators are going to have to weigh the power of the vote against the power of the lobbyists' dollar.
Physicians need to align themselves with the voters, as they did with seniors in passing the recent Medicare bill.


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OR boucebacks

Knowing when to take a patient back to surgery can save their life.

A grim future lies ahead for medicine: "How many doctors are telling their children to go into medicine? How many doctors are taking courses to administer Botox, eliminate varicose veins, or perform other cosmetic services not covered by insurance? How many tests are being ordered as part of defensive medicine because of fear of a malpractice suit? How come the number of uninsured or poorly insured persons are increasing at ...

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A neurosurgeon testifies to the House how difficult it is to adopt electronic records:

It took about 1,000 hours to set up the system and a year to purchase and configure the equipment. And he noted, the cost was "fairly significant."

He told the committee that moving to the new system was particularly difficult on the staff and not everyone was pleased to move to this new practice paradigm. ...

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You win. (via PointofLaw.com)

Excellent piece in Boston Magazine detailing the primary care crisis:

According to the MMS, in 2007 just 42 percent of patients were able to get an appointment with their primary care doc in the space of a week (down from 53 percent a year earlier). Those patients who didn't already have regular doctors had it much harder. The average wait time for them was 52 days, and that was assuming ...

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