Specialist

A pediatrician was sued for prescribing medication without seeing the patient

“Dr. Gustave Kreh is doctor at Pediatric Associates of Savannah. He’s treated kids like Gabrielle for almost 30 years. He used to think nothing of calling in a prescription for something minor, but not any more.

‘It has to be a case-by-case basis, but we will be very hesitant to call in a prescription without seeing a …

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A cardiologist implanted a pacemaker he bought on eBay

“Advanced Cardiac Specialists, a statewide physicians practice with offices in the East Valley, bought two pacemakers on eBay for $411, according to Sacramento, Calif., police and medical board records. The devices are worth about $6,000 each.”

A patient in the UK with crippling back pain has to wait 68 weeks to see a specialist

“What happens if he says I need a back operation and I have to go on the waiting list for that?”

Physicians’ use of e-mail and instant messaging is starting to grow as reimbursement for these services continue to improve

Sure, there are plenty of challenges ahead for internet-based consultations, but as a more computer-literate generation of physicians enter the workforce, sites like the Ask a Specialist program at Harvard Pilgrim Health Care and Med Help International (both of which I am affiliated with) will become more common.

Blog Plugging

My alter-ego, The Cheerful Oncologist, has written a little post on the first and most important responsibility of the cancer specialist. To find out what this is, point your mouse here.

After you read it, feel free to commit floccinaucinihilipilification.

Not guilty – the case against Patricia Duletsky comes to an end

This was discussed a few weeks ago. An interesting observation:

Brown argued that by agreeing to treat Martens, Duletsky was held to the same standard of care as an obstetrician or an infectious disease doctor.

Meanwhile, the defense concentrated on showing that as a family practice physician, Duletsky acted as she is trained. She called …

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Don’t stress Alzheimer’s patient, or yourself, on a holiday visit

Good holiday advice from a geriatric medicine specialist.

For paramedics, doctors and nurses, Christmas sees miracles, tragedies and quiet

“All too often, tragedy strikes on Christmas, local emergency workers said. And the searing memories linger not only for grieving families, but also for medical personnel.

‘It’s your job to fix things and help people,’ said Rich Lynn, a paramedic for Pittsburgh EMS. ‘When you can’t, it creates a whole different aura for that holiday.’

Most people …

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Add an E to ABCD for Spotting Melanoma

“The ABCD memory-aid used to recognize early-stage melanoma should be expanded to include the letter E for “Evolving,” researchers recommend.

This would emphasize that changes often occur in melanomas during the course of the disease, according to a report in the Journal of the American Medical Association.

The ABCD acronym — standing for Asymmetry, Border irregularity, Color variegation, and Diameter …

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DEA Withdraws Its Support Of Guidelines on Painkillers

“The Drug Enforcement Administration has reversed its support for a set of negotiated guidelines designed to end a controversy over the arrests of hundreds of pain specialists who prescribed powerful narcotics for their patients. The agency took the document off its Web site earlier this month, less than two months after announcing it with great fanfare.”

This seems to be …

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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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Coming soon to a Wal-mart near you

In our instant gratification culture, this is an inevitable trend. Fast-food style medicine. These so-called “Minute-clinics” are being placed in department stores for walk-in urgent-care visits, which also serves to drive traffic into these stores. I think the underlying problem of poor primary-care access is certainly contributing to the demand. People are growing tired of waiting several weeks for appointments, and endless hours in …

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Patients use the ER for a second medical opinion

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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One-fifth of patients coming to the ED did not have conditions requiring emergency care

As a follow-up to what I wrote last week on the ER stories near Boston comes this report. Most of it we know already, but it’s nice to see some concrete data:

One-fifth of patients coming to the ED did not have conditions requiring emergency care, and another one-fifth had urgent conditions that could have been treated in a primary care setting, the report shows.

Uninsured …

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Longest wait for specialists in Boston

I trained in Boston so I periodically keep tabs on the medical scene there. In the same vein of the previous entry I wrote today, comes this story from the Boston Globe.

. . . new patients in Boston wait an average 37 days to see a cardiologist, 45 days to see an obstetrician-gynecologist, and 50 days to see a dermatologist “” the longest waits …

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A normal PSA can miss prostate cancer

The mainstream press has caught wind of the NEJM study that was discussed here yesterday. Here are some quotes from the article:

. . . “This study adds to information that perhaps the PSA threshold may be dropped to 2.5 or so,” said Gomella, the Philadelphia urologist. “The number 4 may not be the, quote, normal that we look at anymore.”

. . . Some …

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