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Threat Of Medical Malpractice Is The Only Force Opposing Healthcare Rationing

DrRich’s conviction that covert rationing is the engine that drives many (if not most) of the bizarre behaviors we see in the American healthcare system leads him to take positions on certain contentious issues that do not endear him to either his progressive or his conservative friends.

One of these issues is malpractice liability reform.

DrRich wrote about this some time ago (here and here), and as a result managed to alienate more than a few of his readers, especially the ones who are doctors. So if he were smart, DrRich would leave it alone. (After all, a lot of readers have long since forgotten precisely why they do not like DrRich, and merely harbor toward him a vague sense of unease and distrust. This, DrRich finds, he can live with.)

But a couple of things prompt DrRich to take up this topic once again.  Read more »

*This blog post was originally published at The Covert Rationing Blog*

A Nurse Asks: What Are You Doing For Your Midlife Crisis?

congo-nurse1Nurse Andrea Bartlett is literally having a meltdown. She is in the midst of her midlife crisis. Nurses like her are easy to spot. She’s having a hot flash, note the hand to her forehead and the look on her face that says, “Crap, I’m going to pass out,” and she’s reliving her hippy Peace Corps days by working as a Congo nurse. I bet she is kicking herself for leaving home, especially at her age. After all, who in their right mind would give up their Mac computer and iPhone.


It’s official. I’m having my midlife crisis. I knew I had hit crisis mode the day one of my patients tried eloping from the unit. I saw the patient racing down the hallway towards the door, and my brain said, “Run, catch the patient,” and, after a few strides, my joints started screaming, “Brain, we hurt. Go to hell.” Fortunately, the techs and a few nurses, all of whom are youngsters, ran right pass me like little gazelles and effortlessly caught the patient before he bolted off the unit. I felt like a relic. I wanted to cry all day long.

debchair3If anyone over the age of 55 tells you that they aren’t going through their midlife crisis, they are in denial, or they are lying through their teeth. I started making some changes at home after that fateful day at work. I can’t afford a facelift, a tummy tuck, or a red sports car, so I started redecorating my living room, a la Peter Max. I said goodbye to my Martha Stewart country living room by replacing everything that was made from gingham and lace with burgundy silk pillows, hand blown glass bottles, and Bakhtiari carpets. I even scored this 1960s leather chair, matching footstool, and hoop lamp from one of my best friends. Yeah, they’re groovy. I can’t wait for my husband to finish off my bookshelves. Maybe I’ll start a new hookah collection when he’s done.

Having a midlife crisis isn’t just about getting gray hair, saggy boobs, and a wider girth. It’s about getting to know who you really are as you hit the midpoint of your life. This midlife journey is especially bewildering and fear provoking for nurses. Everyone is in a big hurry to get an advanced nursing degree before “it’s too late.” Too late for what? I see nurses frantically checking out school websites, and exchanging information about online classes. Some nurses want to expand their knowledge base so they won’t have to work as bedside nurses anymore, while others want to go back to school because of a mandate put out by the ANA. The ANA doesn’t recognize anyone without a nursing degree as a professional nurse. The ANA can kiss my ass. I’m not going back to school, and I refuse to burst one brain cell over a class assignment that has no relevance in my life.

beatlesstereo2God willing, I have at least twenty-five years before I check out of the world and I plan to have some fun before I head for the Pearly Gates. My short-term goal is to buy the new Beatles Boxed set in stereo and to finish redecorating my house. I’m going to light up some incense, play my tunes, and party on. My long-term goal is to make love, not war, get on the peace train, and to follow the sun.

Can you dig it?

*This blog post was originally published at Nurse Ratched's Place*

How Do Doctors & Patients Find Out About Food & Drug Alerts?

I recently created a focus group survey of physician bloggers to determine how they (and their patients) typically receive food and drug alerts. Twenty people responded. The results to 5 key questions are displayed below.

My most interesting take home messages:

1. Most physicians surveyed first receive drug alerts via eNewsletters from companies like MedPage Today and Medscape. (This is consistent with the large number of page views achieved by these sites/month).
2. Most patients find out about recalls via mainstream media – TV and newspapers.
3. EMRs, ePrescribing tools, coaching programs, and social media networks (like Twitter) are perceived to be the most valuable means of disseminating targeted recall information to the right person at the right time.

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The Friday Funny: “Preferred Providers”

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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