A Chance to Cut is a Chance to Cure

Drug advertising results in more costly prescriptions. Few inexpensive drugs are advertised on TV. The commercials don't educate patients. Rather, they create a demand for a product based on an effective commercial rather than the patient's medical need.

The bottom line is that this article is indeed a humongous runny, stinking turd. Salon.com and Rolling Stone have let their readers down, contributed to the hysteria over a probably nonexistent link between mercury and autism, and utterly trashed their own credibility in the process. They've handed the antivaccination activists a significant propaganda victory and an article that they will be citing for years to come, frightening parents who wonder if vaccines are safe and wrongly adding to the guilt that parents of autistic children already feel by making them wonder if they were responsible for their child's condition

Interestingly, I noticed that the bill doesn't require the publication of success rates. In other words, one could find out the cheapest place for a given procedure, but not necessarily the best place. Remember, though, you get what you pay for.

In the first two hours of my shift I've done more acute-care medicine than in a literal month of shifts, and it feels good. Occasionally I wonder about my career path, and today is one of the days I'm glad I'm an Emergency Physician.

In the best of all possible worlds, newly minted surgeons would take jobs with older, more established surgeons that provide expertise and help ("mentoring," to use the current buzz word) -- here, again, I was and continue to be extremely fortunate in this regard. That is probably not attainable for many graduating residents. It is hard to conceive a situation where the RRC would mandate a certain percentage of cases to be done "open," either: can you imagine the consent form for patients at teaching facilities then ---- "if we determine that the resident helping with this operation has insufficient experience with the open technique, you'll get a bigger incision." That would be about as popular as Howard Dean at a NASCAR event.

In 2009 President Hillary Clinton will resurrect her long dead dream of nationalized government health insurance. Medicare and Medicaid will be combined and expanded into a massive program that will cover every American. It will be administered by the states and further subdivided into "managed care regions" which will act similar to the old HMOs.

The information from the analyzer was a blueprint for the exact "mechanical antibody" required to defeat Jane's virus. The recipe created the exact molecular milleu required for the assemblers in the capsule to replicate the mechanical antibody and continue to do so in Jane's GI system. These antibodies were bound to dendrimers, tree-like nanomolecules. On another branch were nutrients required by the specific virus that was infecting Jane. As the virus concentrated the nutrients, they unknowingly incorporated instructions into their own RNA that changed them from pathologic to healthful.

"That little scamp!" the old woman exclaimed to me, gently rubbing the wound on her hand that I had just finished cleaning. "I'll take all these antibiotics if you say I should, but that vicious little kitty is going to get it!"

If Tom Cruise has not ever personally suffered from mental illness, it is my sincere hope that he is grateful for that blessing. His faith in Scientology is steadfast, but his proselytization of the merits of his faith, particularly in the realm of (anti) psychiatry, only reveals his ignorance and lack of empathy for those who do not share in his good fortune and blessings.

But why not take things a step further? Include the existing academic centers and relevant community hospitals in the study. At the end of five years, certify or re-certify only the top half of hospitals to perform the procedure, regardless of whether they are academic or community based. That kind of competition could spur real improvements for Massachusetts patients.

I may have lost a patient, and drove up costs by advising a probable conjunctivitis to go to the ER, but at least there is zero possibility of being sued over this. It's a trade I'll make every time.

It didn't take a session with an IBM mainframe to place the puzzle pieces together and come up with a plan. Let's remember folks - we doctors are skilled in the art of leaving no stone unturned when it comes to finding a diagnosis. Why is that, one might ask? Well, given the menacing cloud of litigation that doctors practice under these days, one would understand with Zeus-like clarity why I rushed this patient to the emergency room. The decision was justified if one notices the overlap between my patient's symptoms and those of a major perturbation of the old ticker. Hypersensitivity reactions that are minor can be managed at the bedside by turning off the infusion and treating with Benadryl, corticosteroids, oxygen, IV fluids. Major hypersensitivity reactions (called anaphylaxis) are treated like a cardiac arrest - no head-scratching over that diagnosis, eh? My patient's symptoms were atypical for an allergic reaction, and rather than assume that the most likely diagnosis was the actual diagnosis, I checked for other serious problems that could have lethal consequences if undiscovered.

I feel it is very important for men to be examined regularly, so I'd like to take this opportunity to walk everyone through the process I just completed in the hopes it will lower the barriers of fear surrounding this very necessary medical procedure.

It is truly medical scaremongering to report the results of badly designed studies; or to report the results in a manner designed to frighten people. The only possible purpose of such studies is the self-aggrandizement of the authors and publishers--who hold their press conferences and intone seriously about the "risks" posed by this or that. In the case of vaccines, more people will die and suffer because they didn't get the vaccine, than the opposite.

Fellow Wilmington obstetrician Dr. Joshua Vogel said though she was considered too set in her ways or a renegade by some doctors, he admired her talents to deliver naturally in situations when other doctors would have automatically pushed for a c-section. "She was a valuable asset for patients," he said.

The first letter, written by Dr. Cobern Peterson, chairman of the Professional Review Committee, stated "concerns" regarding her practice. They include higher than average infant birth weights, much lower than average c-section rates and later than average gestational age of neonates at delivery.

The letter states "the main concern reiterated several times was an overall practice attitude rather than any individual case."

I don't disagree. It is challenge. It's a challenge to tell a woman that her baby has Trisomy 18. Or Trisomy 13. Or a hypoplastic left heart. And the authors message is constructive. But does it require federal legislation? On the basis of 141 respondents to a survey, we need federal legislation because, in essence, we are not doing our jobs? Am I understanding this correctly?

One of the bedside tests we do of memory is to give someone a series of digits, after which the person is supposed to repeat the sequence. Most people can repeat a maximum of 7-9 digits without making a mistake. What this should give you is a sense of how much information anyone can handle moment-to-moment; it's not much

It's as if just including the phrase "evidence-based" adds a patina of respectability (and superiority) to the title of a paper or a policy. There's also no denying that sometimes including this phrase conveys an attitude of being holier-than-thou. It's like saying "Hey, I'm evidence-based, so you can't say anything against me." Never mind that in many cases this phrase is used very loosely and quite differently from the original intent behind it.

In the last 10 years, the Philippines exported close to 90,000 nurses overseas.

In the last four years, 3,500 doctors left the country to take on nursing posts abroad.

The number 1 course choice here is now Nursing. I have friend lawyers, engineers, and yes, doctors who are all shifting to nursing to work abroad.

So what does the staff of Asclepius symbolize? Dr. Blayley speculates the image's origin might arise from the practice of removing subcutaneous parasites. The worms would be pulled from an incision and wound around a stick -- the practice was so common that doctors may have come to advertise their services by depicting this procedure.

After a lot of deferred gratification (4 y med school, 3 y residency, 2 y internet startup, 2 years pre-partner busyness) i'm now able to split my 40 hours/week into 3 shifts, 2 X 18 hour ones and one shorter 5-10 hour one. The rest of my time i spend at home with the kids, swimming, or going out to our preschool co-op, or parks, or playgroups.

The phrase "no room for her last week in hospitals in Toronto, London, Hamilton and Kingston" is disturbing and probably an indication that the current system is already functioning at maximum capacity, i.e. no room for another baby. It's not exactly clear why there isn't public outrage. Sending patients to another facility is common and understandable. Sending patients to another country because there's "no room at the inn" means that the entire health care system is deficient

I'd like to pose a question for the two, in hopes that they keep this debate going. Don't you have to recognize the non-mortality benefits of medical care? Medicine doesn't always make us live longer, but it can make us live better. Preventing a lot of non-fatal heart attack may not change average mortality that much, but it sure makes life quality better. And then there is psychiatry, which can provide a lot of benefits at virtually no decreases in mortality. And what about plastic surgery, arthritis, orthopedics and physical therapy, dentistry; the list goes on. Same thing. When you actually sit down and separate all the fields of medicine and health care, very few sectors are actually even aiming for improved quantity of life. A good portion of surgery and pediatrics and a smaller part of internal medicine (mostly cardiology and nephrology) have shown good headway by this measure. But to ignore the marginal benefits of quality of life brought by some health care sectors underestimates the overall marginal benefits. In other words, life expectancy gains aren't everything.