Shi**y care

What happens when you expect staff to do more with less.

Useless HIPAA

Dr. Wes: "Why the heck do we even have HIPAA when insurers can play this game with our most private healthcare information?"

Perhaps you need to take the Fake Bad Scale, a subset of the Minnesota Multiphasic Personality Inventory.

Or do they?

Penile cancer

And how an artist deals with it.

A reason why nursing homes perform so poorly in tourist-populated areas:

The kinds of people who might take unskilled jobs in the retirement home have plenty of employment alternatives in the tourist industry.

The opportunity cost of these workers' time is high; given the low wages that the retirement home pays, it typically attracts a less skilled, less able group of workers than the other homes my wife ...


Why some patients think generics "don't work":

In a provocative 82-patient study, researchers at MIT found that a dummy pill carrying a $2.50 price tag eases pain much more effectively than an identical pill that patients believe costs just 10 cents.

Charles King: "I practiced with my wife"”also an internist"”and we tried to practice exactly as the ABIM proposes. Eventually, we were forced to retire and leave patients whom we had taken care of for as long as 39 years. We practiced preventive medicine and tried to protect our patients; our motive was only to help them, and we chose never to compromise those ideals. We never treated a patient differently ...


Ted Frank: "Malpractice litigation does change doctors' incentives, but only with respect to short-term results. Because doctors won't be sued for long-term consequences of defensive medicine, there is a substantial risk of overexposure to radiation in the course of defensive CT scans "” a problem identified in a study in the latest issue of Annals of Emergency Medicine, finding that standard trauma treatment "” 1005 chest X-ray equivalents "” results ...


Dr. Rob with a must-read patient post.

"Availability" tops the list.

Abigail Zuger: "When it comes to drug ads, we are used to actorly actors, with full heads of hair and such appealing charisma that we want to be near them "” or to become them ourselves. Or conversely, we expect real doctors "” our own doctors, with our own individual best interests at heart, despite that Lipitor pen protruding from their pockets.

And such was the confusion engendered ...


Pulmonologists have the option of doing critical care at the hospital, or seeing consults in the office. Guess which pays more?

A miracle. Look at how mediation has brought the two sides together.

Turns into an ethical challenge.

1) The AMA says that the financial benefits of office-based electronic medical records systems are not worth the cost to doctors.

My take: The primary reason why adoption of electric records is so low. The physician takes a tremendous financial risk for little, if any, return on investment. A poor business investment if there ever was one.

Taking the financial hit for the sake of future ...


And why it's dumb to indiscriminately do so.

Don't do this.

Panda Bear: "If we but charged the families a small fraction of the cost for futile care or, more diabolically, had payment garnished from the patient's estate upon their death, the families would be looking for the plug, especially in the cases where the ICU serves as an expensive funeral home where families can meet to see the body. If the family ever says, 'We want to keep Uncle ...



Another trauma patient at the Stanford ER.

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