Paul Feldan: "Nobody wants to do what we do."

Some OBs are requiring patients to sign arbitration contracts prior to treatment. Nursing homes are starting to do the same.


And the problems with facial expression.

Pallimed: "Unless some action is taken by hospice organizations and grass roots efforts to push back the cuts, I imagine many hospice agencies who are not making a 15% profit are going to find it hard to stay in business . . .

. . . And all this on the heels of the study that showed hospice care saves an average of $2,309 for every Medicare recipient ...


Robert Centor points to a series of articles outlining how exactly Medicare devalues generalist practice.

The downturn in the economy is hitting the industry hard. (via Tony Youn)

ABC News details their potential risk of catching disease:

While the nightmare of confinement within a restrictive sect in West Texas may be over for more than 400 children in Texas, the outside world may present them with unique health threats.

A dozen of the children have already been identified as being infected with chickenpox, and experts fear that the outbreak could be seen by the sect's members ...


John Mahon: "A well-educated patient is easier to treat. A badly educated patient is very difficult to treat."

Fat Doctor: "Today, three patients covered the mouthpieces on their landline or mobile phones and asked me to come back in 10 or 20 minutes. They know me. They know I am their treating physician. Presumedly, they are all sick enough to be in the hospital."

Is it because of caps to non-economic damages?

Want to get my take?

I have received e-mails about various topics people want me to blog about.

Instead, I'll periodically post this open thread to solicit topics. Suggest some topics and links on the comments of this post, or you can e-mail me.

I'll choose a few to put into my regular "My take" feature.

(thanks to Ezra for the idea)

Listen to MedPac

Will Medicare listen to its own advisory committee?

Health care winds up costing more when there's lots of specialty care, but outcomes aren't necessarily better. Having more primary-care docs, on the other hand, does tend to improve outcomes, a briefing document prepared for the meeting pointed out. Yet the payment system in this country tends to favor specialists, which is part of the reason fewer young docs are going ...


"Pole sign"

The number of IV poles by your bed is correlated with mortality.

Pretty cool statistical visualization.


A cult-like mentality.

Should those words be banished from the ED?

Roy Poses: "So here is another example of medical school faculty, whose titles imply that they are supposed to teach and conduct other academic pursuits as their main responsibility, instead are expected to 'support' their work with 'external funds,' in this case, derived from their own clinical practice. This leaves them with no time to actually act like faculty."

Is it feasible in America?

Dr. Wes: "The implications of what happens to an industry when price pressures mount were certainly plain to see. The 'safety checks' and maintenance of our plane had clearly suffered cutbacks."

A marketing problem

Robert Centor: "I believe we are losing the marketing competition. Each subspecialty attracts donors and advocates for their disease (or diseases). We are all familiar with the American Heart Association, the March of Dimes and the American Cancer Society. We are not flashy. We do not play solos, rather we conduct our patients' health care. We can play all the instruments, but we do ...


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