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Heard Around The Blogosphere, 12.15.08

I hope you enjoy this week’s round up of quotable quotes from the medical blogosphere…

Scalpel or Sword quotes Taiwanese hospital administrator who chose “Hello Kitty” as a new design theme for their maternity ward: “I wish that everyone who comes here, mothers who suffer while giving birth and children who suffer from an illness, can get medical care while seeing these kitties and bring a smile to their faces, helping forget about discomfort and recover faster.”

Charlie Baker on hospital financing: Calculating hospital operating margins actually draws a starker picture.  Hospitals collectively lose $30 billion on Medicare and Medicaid and earn $66 billion on commercial business, thereby generating a $36 billion gain overall on their insured patients.  They lose another $13 billion on their uninsured patients, netting out to a $24 billion – or 3.6% – operating margin.

This means private sector employers and their employees and families are paying as much as 10-11% more than they would otherwise pay for health insurance – to fund the provider operating deficit created by Medicare and Medicaid.

Paul Levy: There are two types of hospitals, the kind that have had a wrong-side surgery and the kind that will have one.

Edwin Leap: Over the past few years, I’ve observed some curious phenomena.  For instance, the raging debate over pharmaceutical companies.  Sure, bad data is bad data.  And of course, we shouldn’t have our prescribing practices ‘purchased’ by gifts, trips or cute reps.

But, what I find fascinating is the collective anger against those companies for trying to ‘profit.’  Ghastly!  Companies, publicly traded ones, in America,trying to make a profit?  What are they thinking?  I mean, considering doctors and nurses work for free, with no thought to financial benefit…right?

Let’s face it, like it or not, those huge companies make life better.  They create and market substances that keep us healthier; and of course, in some instances they offer very vanity driven products that keep us having sex longer or getting fewer wrinkles.  But on the balance, we wouldn’t want them to go away, any more than we really want oil companies to disappear.

Respectful Insolence: given the utter lack of scientific support for the vast majority of CAM modalities and the weak support for the remainder, what’s left if you’re a CAM advocate trying to prosletyize about how great CAM is?

Argumentum ad populum, of course. Otherwise known as the bandwagon fallacy or appeal to popularity, it is one of the most favorite logical fallacies of all.

Terra Sigilata: Readers often ask me and other sci/med bloggers why revered academic medical centers are increasingly offering these questionable approaches. The truth is that there is a market for them. A good market. And one that will gladly pay out-of-pocket for such things.

Never mind if the approaches are effective. Or safe. Or can delay treatment with science-based approaches known to be effective.

Smoking, abusing alcohol, using CAM: Just because a lot of kids do it, does that mean it is right for yours to do so as well?

DB’s Medical Rants: Because prices are increasing, Medicare has tried classic bureaucratic techniques to minimize expenses.  Our billing system requires extensive documentation.  If we do not document well, then we are not paid appropriately.

In an effort to pay physicians more appropriately, Medicare adopted RBRVS.  But then they made a huge mistake.  They let the AMA develop the RUC – The primary care reimbursement mess.  The members of that secret society include very few primary care physicians and many proceduralists.

Movin’ Meat: Wondering why it is that my placing a stethoscope on a patient’s chest is universally interpreted as a signal for the patient (or a family member) to begin talking.

PixelRN: The other day I was talking to a veteran CCU nurse. She told me that she worked at the hospital where the first defibrillations were studied and performed. Like many health care studies, the testing was done on animals – dogs in this case.

She then went on to tell me that one of the requirements for working in her CCU (back in the 1970’s) was that you actually had to defibrillate a dog to show that you were competent in that skill! Yes, the dogs were sedated before hand, but still.

Nurses see (and do) the craziest things.

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