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Is Rape A Pre-existing Condition?

Charming, if true. I’m so glad we have Ben Nelson and Blanche Lincoln working tirelessly on the Hill to protect and preserve the insurance companies and their profits.

Christina Turner feared that she might have been sexually assaulted after two men slipped her a knockout drug. She thought she was taking proper precautions when her doctor prescribed a month’s worth of anti-AIDS medicine.

Only later did she learn that she had made herself all but uninsurable.

Turner had let the men buy her drinks at a bar in Fort Lauderdale. The next thing she knew, she said, she was lying on a roadside with cuts and bruises that indicated she had been raped. She never developed an HIV infection. But months later, when she lost her health insurance and sought new coverage, she ran into a problem. Read more »

*This blog post was originally published at Movin' Meat*

How ER Doctors Think: Plastic Surgeons And Wound Closure

In the comments, a question was posed from reader “Seattle Plastic Surgery on Lake Union” (an online handle that is as unwieldy as it is descriptive).  He asks:

I would like to hear your opinion on a topic that is rapidly growing near and dear to my heart…the scenario is thus:

I’m on call, the local plastic surgeon, for the local ER. You are seeing a nice family with a child that has sustained a simple facial laceration. No fractures, no missing tissue, just a simple, linear, forhead laceration.

The Mom asks that a plastic surgeon be called to come in from home and close the wound. You reply that you are able to do the closure, the child is medically stable, and that a you are qualified to close the wound. The family presses you: call the plastic surgeon.

Can you tell me, from an ER doc’s standpoint- what is the most appropriate response from the on call plastic surgeon? Read more »

*This blog post was originally published at Movin' Meat*

Pitching Tents For Pandemic Flu

I walked out the back of the ER tonight to see this in the ambulance bay:

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Uploaded with plasq‘s Skitch!

And this inside: Read more »

*This blog post was originally published at Movin' Meat*

Dodged One: Meningitis Discovered By Trusting One’s Instincts

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Saw a nine-year old with a headache today.  His dad brought him in, and explained that all the men in his family get migraines; he figured this was his son’s first one.  The kid seemed perfectly well, with a positive Cheetos sign and my gut instinct was that I would discharge him with no work-up.  But when I flexed his neck fully, he winced. Read more »

*This blog post was originally published at Movin' Meat*

How Should We Define Medical Malpractice?

Ezra kindly responds to my post from Friday with a more reasoned stance than “just don’t commit malpractice.” His response, however, boils down to two main theses:

  1. Frivolous Lawsuits are not as common as generally thought, and
  2. Standardization can reduce the opportunity for error and thus decrease the frequency of medical malpractice suits.

Well, yes, but I’m not sure that addresses the typical physician’s complaints regarding the current med-mal system.

For example, the “frivolous” moniker is a pretty ambiguous term, especially to doctors’ loose understanding of legal terminology. To a physician, a “frivolous” case is one in which there was no error — where the standard of care was met, but perhaps the outcome was bad. Or to put it another way, doctors tend to feel that when they are vindicated in court, it’s prima facie evidence that the case was frivolous. This conviction is bolstered by the little-recognized fact that physicians win the vast majority of cases that actually go to trial, and the vast majority of claims filed do not result in a financial settlement. Read more »

*This blog post was originally published at Movin' Meat*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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