For those who don’t know, every piece of work that a doctor performs is quantified and measured.
The base unit of physician work is known as the relative value unit (RVU). Most physician salaries are determined by the amount of RVUs a doctor produces in a given year, and in most cases, can range between$35 and $45 per RVU in primary care, depending on geographic location and …
Cosmo Magazine, that bastion of reliable medical advice, declares, “An orgasm almost killed her.”
Intrigued, gynecologist Amy Tuteur reads further, and finds its about case where a woman developed stroke-like symptoms after intercourse, and was diagnosed with an embolic stroke.
The patient was taking the birth control pill, which can raise the risk of blood clots. In this case, it was also combined with the presence of …
Mariana Bridi da Costa, a 20-year old Brazilian model, tragically died early Saturday morning from Pseudomonas aeruginosa urosepsis.
How can this happen?
Miss Bridi da Costa initially presented on December 30th, and was diagnosed with kidney stones. An ultrasound, plain film, or CT scan likely would have been done to confirm the diagnosis. I assume that a urinalysis was also performed, and if …
A primary care doctor guides us through the abdominal physical exam.
He deciphers the much-written notation of “Abd: Soft, NT, Normal BS, no HSM or masses*,” and explains what physicians look for when they poke, prod, percuss, and listen to when examining a patient’s belly.
You’d be surprised at some of the things we find simply by pressing on the abdomen.
* For those who need translation, …
This is an important article to read.
Many of the incentives today encourage doctors to order more advanced imaging scans, like CTs and MRIs. This expensive practice is invariably caused by this common scenario, as “patients who are in pain often demand scans hoping to find out what is wrong, doctors are tempted to offer scans to those patients, and then, once a scan is done, it …
New England Patriots quarterback Tom Brady recently underwent repair of his anterior cruciate ligament at the Kerlan-Jobe Orthopaedic Clinic in Los Angeles. His doctor was Neal S. ElAttrache, who’s a renowned orthopedic surgeon and former team physician of an NFL team.
Unfortunately, his post-op course has been complicated by an infection. On his website, TomBrady.com, he acknowledged this and said that the original procedure was …
Most physicians and patients think that the MRI scan is one of the more sensitive and comprehensive diagnostic tests.
However, there is significant variability in reading and performing the scans, which makes having it done at a reputable institution more imperative:
Magnetic resonance machines, though, vary enormously, and not just in the strength of their magnets. Even more important, radiologists say, is the quality of the imaging …
Comedian Bernie Mac dies at age 50 from pneumonia. Sad news.
He had been recently hospitalized, and as recently as two days ago, it was reported he was stable and responding well to treatment. What happened?
There is very little medical information to go on. It was known that he had …
WSJ Health Blog: “Russert’s doctor Michael Newman said the tough-questioning but congenial host of NBC’s ‘Meet the Press’ had been under treatment for asymptomatic coronary disease, but that it was under control with medication. He was carrying excess weight, Newman observed, but he got regular exercise and he performed well on an exercise stress test in April.”
GruntDoc: “I therefore propose a new sign in …
What does that mean to you? More patients than you think are confused by drug labels:
Did that mean a total of two, or a total of four? A third of patients who were deemed literate got confused. A more clear instruction would be: “Take two tablets in the morning and two tablets at night.”
Stunning news. The Boston Globe on Flea, his trial and how his blogging ultimately led from a possible victory to settlement:
As Ivy League-educated pediatrician Robert P. Lindeman sat on the stand in Suffolk Superior Court this month, defending himself in a malpractice suit involving the death of a 12-year-old patient, the opposing counsel startled him with a question.
Was Lindeman Flea?
Flea, jurors in the case …
This article was from six years ago:
Lots of patients fork over nothing but a co-pay, the mandatory cash outlay that can be as low as $10, or even $2. “What do you value a physician at if you pay $2?” asks Stracher, who says that sometimes, for that amount, patients blithely skip even bringing along money. For two bucks, patients sometimes don’t show up. Or they get the idea …
What is defensive medicine?
Defensive medicine is the deviation from sound medical practice to avoid the threat of malpractice litigation.
According to a 2005 study in JAMA, over 90 percent of physicians surveyed admitted to practicing defensive medicine. This can range from “positive” defensive medicine, like ordering unnecessary tests, referring to consultants, or performing unneeded procedures; to “negative” defensive medicine, like avoiding high-risk patients or procedures.
Read more…
Scalpel likens nurse complaints to how lawyers consider lawsuits:
Nevertheless, it seems to me that many nurses will complain about each other and about physicians at every opportunity. They will fire off e-mails to their bosses, my bosses, or even the CEO of the hospital about any disagreement or perceived mistreatment, whether or not it affects patient care. Everyone has to walk on eggshells or we will end up …
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 …
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 …
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 …
I have written before that the physical exam is useless in American medicine:
This is why the physical exam is useless in American medicine – it cannot hold up in court. Clinical evaluation and judgment skills now needs to be supported with objective, and often expensive, tests. Here we have a case of three separate physicians who, in their clinical opinion, did not feel a CT scan was warranted. …
Much denial-blogging today. Alisha’s mother-in-law won’t accept physical limitations imposed by her cancer. Orac tries to help a patient who rejects her malignant biopsy results. What is denial, and how should we approach it? (Pause for a quick check – has the Cheerful Oncologist posted about this yet? No? I’d love to know what he thinks!) Here’s Dr. Simon Wein, MD, of Memorial Sloan-Kettering …
Man sues over “botched” testicular surgery: Another frivolous lawsuit?
“A man is suing a hospital and one of its surgeons, claiming one of his testicles was wrongly removed during surgery.
Danny Curtis claims the surgeon at Kern Medical Center did not conduct a biopsy before arranging urgent surgery to remove a testicular tumor in July 2004, according to the lawsuit filed in Kern County Superior Court.”
I …
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