The myth of July syndrome

The NY Times today writes about the so-called July syndrome - the time when the new house staff start at teaching hospitals across the country. There is no data to support worse patient outcomes in July - although I can certainly remember the potential for disaster.

My very first day was being the night-float intern at the former Boston City Hospital. This meant cross-covering every ...

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A sign of things to come?

We have concierge practices, now people can pay extra for "priority access" at emergency rooms:

The 95-year-old financially ailing Southampton Hospital - the only serious medical emergency center on the South Fork - is offering a plan aimed at wealthy summer visitors whose primary doctors are back in Manhattan and out of reach, presumably along with the hospital's sense of propriety. For $6,000 per family, or $3,800 for individuals, ...

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The Atlanta Journal-Constitution editorializes on how capitalism is one of the driving forces behind our broken health care system:

We now have a health-care system whose primary mission is not delivering health care. Instead, insurance companies, pharmaceutical companies, medical device manufacturers and, in fact, many hospitals exist to make money. That's their first priority, and also their second and third priority. The product they sell happens to be improved ...

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For those who have been following the incidents at the South Shore ER, written here earlier this month, the Boston Globe writes about the status of the investigation. As an aside - an 82-bed ER is bigger than some of the hospitals that I round at.

Medpundit has commented on the ER (mis)use piece written earlier this week, emphasizing the convenience ("In fact, you don't even have to walk to your tests. You get rolled to them in a wheelchair or gurney." - how true). Perhaps people are willing to wait the 5-6 hours in exchange for a second opinion, or in some cases a specialist evaluation. Beats waiting months. ...

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Here's a link to the story that was discussed earlier today. It's gaining some steam around here. I'm sure this happens at every ER - this particular hospital was unjustly singled out.

More on ER waits . . .

The story where the woman had to dial 911 from the ER to receive care seems to be getting a lot of play here. The ensuing forum is bringing out more "complaints" against this hospital - it seems that people do not understand that the reason why ERs are so overcrowded is beyond the physicians' control. There are many reasons for this (too many uninsured, poor access to ...

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Hospitals and gourmet food

They sure don't have this kind of food at the hospitals where I work at.

Harvard Medical School is planning a medical campus in the United Arab Emirates. Some interesting points:

. . . there are enormous hurdles to fostering US-style health care in a region where medicine is so spotty that the 100 million Persian Gulf residents spend $25 billion a year getting treatment elsewhere, according to Dubai Healthcare City officials. Many medical school students enroll straight out of high school and ...

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IBS is one of the more frustrating diseases to treat. Increased fiber intake, antispasmodic agents, and Zelnorm (for constipation predominant disease) are among the treament choices. However, in many cases, these treatments aren't enough and many patients unfortunately remain symptommatic. In the GI forum that I moderate, there are many who report refractory IBS symptoms.

Today comes a study from the American ...

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Medpundit and DB has chimed in on the mainstream coverage of the deficiencies of PSA screening for prostate cancer that was discussed here on Tuesday and Wednesday.

Medpundit writes:
Beware of organizations made up of hospitals and urologists who call for lower thresholds for treatment. They have much to gain from the increased number of biopsies such lower thresholds would produce. Unfortunately, it's far from clear ...

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Toxic neckties?

This story caught my eye - guess I'll think about dry-cleaning my ties from now on:

A small study of neckties worn by doctors at a Queens hospital found almost half the 42 ties tested harbored microorganisms that can cause illness.

Of the 42 physician neckties sampled, 20 contained one or more microorganisms known to cause disease, including 12 that carried Staphylococcus aureus, five a gram negative ...

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The VA hospital has always been special to me. My very first clinical rotation as a medical student was inpatient wards at the Jamaica Plain VA Hospital in Boston. Today, I still do occasional shifts in the VA emergency room, and see first hand the work and effort that is put in every day caring for our veterans, despite serious shortages in money and personnel. Today's Boston ...

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Just noticed this headline as I was drinking my diet soda. I'll have to see the actual study myself to come to any conclusion, but here are the salient points from Reuters:

A team at Tata Memorial Hospital in India found a strong correlation between the rise in per capita consumption of carbonated soft drinks in the past 50 years and a documented increase in rates of esophageal ...

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The ACP released a paper today focusing on uncompensated care for the uninsured. This paper coincides with Cover the Uninsured Week taking place from May 10-16:
In 2001, for instance, the American health care system provided close to $99 billion in care to uninsured patients, $35 billion of which was uncompensated.

Hospitals provided $24 billion of that care while physicians volunteered about $5.1 billion in uncompensated care, including ...

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I recently saw a case of a young lady for shortness of breath. No other medical issues, only medication was oral contraceptives. No family history of blood clots. Chest X-ray clear, no desaturations on room air. My pre-test probability for pulmonary embolus was quite low, however she was concerned and asked to be "checked for a blood clot". With such a low index of suspicion, ...

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Herbal viagra frauds

Reuters:
"Herbal" Viagra and other so-called natural alternatives for treating impotence advertised on the Internet and in men's magazines are often contaminated with real drugs and could kill those who take them, researchers said on Monday.

"These are being marketed as being safe and natural products," said Dr. Neil Fleshner of Princess Margaret Hospital in Toronto, Canada. "It is plausible that deaths have occurred or could occur."


Like ...

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AMNews:
A family sued their infant's pediatrician, an emergency department physician and an on-call pediatrician at the hospital for not ordering a CT scan. To the doctors, the 11-month-old boy appeared normal and in no need of the test.

But after the infant had more serious injuries resulting from an incident at his babysitter's home a couple of weeks later, the parents faulted the physicians for not ordering ...

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Last year, there was a study done by the Royal Society of Medicine that suggested that patients forget up to 80 percent of what a physician tells them during an office visit:

"While you might not recall everything your doctor tells you, you're pretty confident you remember most of the information. Right?

Probably not, new research contends. Most patients forget as much as 80 percent of what their ...

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