TeleDoc: Damn the physical exam

I’m pretty sure the first malpractice case will kill them off:

But David Karp, a risk management consultant in Cloverdale CA, thinks TelaDoc’s physicians could face some potential liability. “Of course, some minor conditions can be diagnosed over the phone,” says Karp. “In fact, doctors do this all the time. But when you take away the ability to see the patient, to palpate the body, check the skin color, evaluate …

Read more…

Epidural overdose: An anesthesiologist responds

Tragic event, but as usual, news reports raises more questions than answers:

The drugs used in labor epidurals are usually a dilute local anesthetic and a small amount of narcotic. Using both types of drugs in combination allows lower concentrations of each individual drug to be used, hence improving the margin of safety for each. In labor epidurals, our goal is relieve pain without causing significant weakness. That is why …

Read more…

A cruise doctor is sued over a methadone overdose

The physician was faulted for not having the antidote on hand during the emergency:

According to the suit, at about 1:45 p.m. the next day, Ginsburg ran into the hallway screaming for help.

A nearby volunteer firefighter heard and started CPR on Ashley. Ginsburg called 911.

A nurse arrived at the cabin at approximately 2:10 p.m. Ginsburg told her that five of his Vicodin pills were missing.

Read more…

How pain patients are treated like criminals

A responsible narcotic-using pain patient writes:

I no longer go to emergency rooms for help with any pain. They might fix my broken bone but then ask, “How many hospitals do you go to to try to get extra drugs?” One ER doctor told me to “go home and play your little drug games.”

Problem is, for every responsible narcotic user, you have another hundred who play the drug …

Read more…

Breast lumps and unnecessary testing

Sid Schwab talks from a surgeon’s perspective:

In a nutshell, it comes down to this: when there’s a lump you can feel, diagnostic imaging (Xrays, ultrasound, etc.) is a waste of time and money. OK, that’s a bit over the top: you get needed information about the rest of the breast, and the other side, which will come into play at some point. But getting a bunch of studies …

Read more…

You can’t sue a doctor for a medical bill

Some patients think they can sue doctors for anything. Like this story over medical bills:

Out of the blue, we received a bill for $300 from a collection agency from the former neurologist. I recently wrote to the doctor and told her what had transpired and how we felt we owe her nothing.

We know we could have pursued a medical malpractice claim but choose not to, but …

Read more…

Dr. Anna Pou on 60 Minutes

The Attorney General sounds pretty ignorant to me during the piece. Dr. Pou responds:

Asked if she murdered those patients, as the attorney general alleges, she says, “No, I did not murder those patients. Mr. Safer, I’ve spent my entire life taking care of patients. I have no history of doing anything other than good for my patients. I do the best of my ability. Why would I …

Read more…

Morphine, Versed and Ativan: The Anna Pou case continues

As previously stated in the comments, the combination of morphine and ativan is a poor choice to induce death:

Morphine and Ativan, one of the drug combinations that a Foti witness says were administered to the patients, is an extremely unreliable way to induce death, pharmacologists and forensic pathologists say. It is used to relax agitated patients and to relieve severe pain.

The experts contacted for this story …

Read more…

The "Disney" approach to health care

This non-concierge clinic offers amenities not commonly found:

“I love everything here,” said Laurie Wheeler, who came with sons Justin, 10, and David, 12. The boys couldn’t wait to play their favorite video game. Wheeler, if she wants, can check her e-mail in the patient library/computer room.

A surgeon removes a kidney instead of the gallbladder

It took 3 days before the mistake was noticed:

A physician assistant and a nurse present during the surgery said the surgeon “was working in the exact location you would expect…(the gallbladder) to be located,” according to the DPH’Â’s investigation report.

However, the patient had a lot of internal inflammation and an unusual internal anatomy, which made the surgery more complex, Muller said.

“From a medical standpoint, absolutely …

Read more…

Dr. Anna Pou: Here comes the lawsuit fallout

People are going after the hospitals:

The deaths at Uptown’s Memorial Medical Center during the stifling, dark hours after Hurricane Katrina have spawned more than the highly publicized arrests of a doctor and two nurses on murder charges. A predictable thicket of civil lawsuits has also sprouted, records show.

Two suits filed at Orleans Parish Civil District Court concern the deaths of five patients at Memorial, some of them …

Read more…

A former colleague comments on Dr. Anna Pou

Due to intense interest in the Anna Pou story, the following post will be republished to stay current.

Original post date: 7/19/2006

Waking Up Costs offers his support:

I just learned that a former colleague and friend has been charged with second degree murder in the death of four patients at a New Orleans hospital after Katrina. I worked with Dr. Anna Pou in the operating …

Read more…

The hypertension conspiracy

Dr. Crippen thinks Big Pharma is to blame:

Dr Crippen’Â’s old fashioned” treatment for blood pressure costs a few pence a month, and the drugs he uses (such as beta-blockers and diuretics) have been around for years. They have a proven safety record. They are not going to produce any surprises. The only problem is that they do not offer any profit to the big drug companies.

The science behind home-field advantage

Studies show that home games increase testosterone levels:

Two new studies also show how the hormone may especially peak before home games, and that female athletes likely experience the same hormone flux.

The first study, of male ice hockey players, found higher testosterone levels in athletes competing at their home rink, compared to playing an away game. The other, a Portuguese study of female soccer players, found that …

Read more…

Why doctors order unnecessary tests

I’m happy that this study is getting some play in the media. Essentially, many of the “routine” tests done on a physical are not recommended (the whole concept of a “routine physical” is controversial – but that’s for another discussion). Merenstein concludes:

# 37 percent of checkups included a urinalysis.

# 9 percent of checkups included an electrocardiogram.

# 8 percent of checkups included an …

Read more…

423
pages

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories