Hostages in the ER

In a reminder that an emergency room can be dangerous place, this story reveals how desperate some patients are to continue their prescription drug abuse:

A man apparently distraught at not being able to see a doctor immediately held two hostages for 20 minutes at Frisbie Memorial Hospital Wednesday. . .

"They were able to get a doctor to respond to the emergency room," Officer Mike Allen said. ...

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With former President Clinton's successful CABG, this NY Times article cites the higher than normal mortality rate for this procedure at Columbia-Presbyterian:

The hospital where former President Bill Clinton awaits bypass surgery has the highest death rate for the operation in New York State, according to the state's Health Department. While the death rate is quite low - fewer than 4 percent of all bypass operations - it is ...

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The final word on South Shore ER

Today the Massachusetts Department of Public Health came down with its decision on South Shore hospital, just south of Boston. I have written about the situation previously and followed up here.

The Department of Public Health report, released yesterday, ends review of a dozen complaints about the pace of care in South Shore's emergency room since last year. It found that emergency room staff at the ...

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The future of primary care

The New England Journal published a sounding board piece on the future of primary care in the United States. The authors suggest that one paradoxical reason is the increased exposure to primary care in residency training:

But an additional possibility, albeit an apparently paradoxical one, is that the decline is due in part to the successful efforts by medical schools to increase students' exposure to primary care practice. ...

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Winning Gmail entry #4

It's been awhile since I've received any submissions for my remaining Gmail invites. I still have 3 more left. Send me any entertaining, medically-related story or article, and I'll give a Gmail invite to what I find interesting. I give preference to entries that are well-written.

This morning, I received this story from someone who works with the developmentally disabled. An eye-opener to say the ...

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A trio of articles . . .

. . . from Medpundit on Overlawyered. The first, discussing a lawsuit based on a 1 in 1.09 quintillian chance. The second on the benefits of non-economic damage caps. The last on the effects of lawsuits going out-of-control: obstetricians are leaving Pennsylvania, and some hospitals are closing their OB departments entirely.

Our surgical colleague on A Chance to Cut . . . responds to the piece on delayed weekend testing. He disagrees with my hypothesis that the savings from shortened length of stay would offset the increased staffing costs of treating a weekend like a weekday. Perhaps this should be studied next.

Given the current nursing shortage and the premium that would have to be paid to ...

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John Stossel did a fantastic piece on 20/20's "Give me a break" segment regarding John Edwards and personal injury lawyers (found via Galen's Log). Some excerpts:

In hospitals, the lawyers have bred so much fear that patients now suffer more pain, and may be less safe because doctors are concerned about being sued.

"That fear is always there," said obstetrics professor Dr. Edgar Mandeville. "Everybody walks in mortal ...

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A new study was released saying that tests are delayed on the weekends versus the weekdays.

In the study, published in the August edition of the American Journal of Medicine, researchers analyzed six procedures commonly used in emergency situations:

Purpose
Many hospital departments tend to have lower staffing levels on weekends. We evaluated the use of selected urgent procedures for emergently hospitalized patients and measured the time ...

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I regularly receive the Cortlandt Forum and only recently realized they're on the web. It's an eclectic magazine, but has interesting malpractice cases. Here's another one.

Basically, it's a patient who came in with dyspepsia. The PCP ordered an upper GI series and it was read as normal. However months later, the symptoms continued, and an EGD found terminal stomach cancer. The ...

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