November 24th, 2010 by DrRob in Better Health Network, Health Policy, Opinion, True Stories
Tags: Ancillary Service Vendors, Cost of Healthcare, Doctors' Profits, Dr. Rob Lamberts, Family Medicine, General Medicine, Healthcare reform, Healthcare Revenue, Healthcare System, Internal Medicine, Less Time With Patients, Medical Justification, Medical Practice Dollars, Musings of a Distractible Mind, Number of X-rays, Primary Care, Private Medical Practice, Quality Patient Care, Seduction In Medicine, To Take Care Of People
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Hey there, big, smart, good-looking doctor…
Are you tired of being snubbed at all the parties? Are you tired of those mean old specialists having all of the fun?
I have something for you, something that will make you smile. Just come to me and see what I have for you. Embrace me and I will take away all of the bad things in your life. I am what you dream about. I am what you want. I am yours if you want me…
Seduce: verb [trans.] attract (someone) to a belief or into a course of action that is inadvisable or foolhardy : they should not be seduced into thinking that their success ruled out the possibility of a relapse. See note at “tempt.”
(From the dictionary on my Mac, which I don’t know how to cite.)
If you ever go to a professional meeting for doctors, make sure you spend time on the exhibition floor. What you see there will tell you a lot about our system and why it is in the shape it is. Besides physician recruiters, EMR vendors, and drug company booths, the biggest contingent of booths is that of the ancillary service vendors.
“You can code this as CPT-XYZ and get $200 per procedure!”
“This is billable to Medicare under ICD-ABC.DE and it reimburses $300. That’s a 90 percent margin for you!”
This is an especially strong temptation for primary care doctors, as our main source of income comes from the patient visit — something that is poorly reimbursed. Just draw a few lab tests, do a few scans, do this, do that, and your income goes up dramatically. The salespeople (usually attractive women, ironically) will give a passing nod to the medical rationale for these procedures, but the pitch is made on one thing: Revenue. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
November 23rd, 2010 by David H. Gorski, M.D., Ph.D. in Better Health Network, News, Opinion, Quackery Exposed, Video
Tags: CAM, Complimentary and Alternative Medicine, Dr. David Gorski, Dr. Jeff Rediger, Energy Medicine, Evidence-Based Medicine Evaded, Faith Healing, False Hopes, Healing The Sick, James Randi, Joe Nickell, John of God, Lack of Scientific Medical Evidence, Medical Miracles, Medical Quackery, Mind-Body Dualism, Misleading Scientific Conclusions, Monica Pignotti, O Magazine, Oprah Winfrey, Pseudomedicine, Pseudoscience, Science and Skepticism, Science And The Media, Science Based Medicine, Woo
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Several of the bloggers on Science-Based Medicine have been — shall we say? — rather critical of Oprah Winfrey. The reason, of course, is quite obvious. Oprah is so famous that if you mention her first name nearly everyone will know exactly of whom you speak.
For the last quarter century, Oprah’s daytime TV talk show has been a ratings juggernaut, leading to the building of a media behemoth and making her one of the richest and most famous women in the world. Unfortunately, part of Oprah’s equation for success has involved the promotion of quackery and New Age woo, so much so that last year I lamented about the Oprah-fication of medicine, which scored me a writing gig in the Toronto Star.
Whether it be promoting bio-identical hormones, The Secret (complete with a testimonial from someone who used The Secret to persuade herself not to pursue conventional therapy for breast cancer), Suzanne Somers, the highly dubious medicine promoted by Dr. Christiane Northrup, or foisting reiki aficionado Dr. Mehmet Oz or anti-vaccine “mother warrior” Jenny McCarthy onto a breathless public, arguably no one is a more powerful force for the promotion of pseudoscience in America, if not the world.
Truly, the ending of Oprah’s TV show in the spring is a very good thing indeed for science and rationality. Or it would be, were it not for the fact that the reason Oprah is wrapping up her show after a quarter of a century is to start up her own cable channel, so that we can have Oprah-branded and -inspired programming 24/7. The mind boggles.
Still, my dislike for how Oprah promotes New Age mysticism and pseudoscience on a distressingly regular basis aside, I actually did think there were limits to how low she would go. I actually thought there were limits to how egregiously vile a quackery Oprah would endorse. The operative word, of course, is “did,” which now needs to be struck off after last Wednesday, which is when Oprah did an entire show entitled Do You Believe in Miracles? (Guess what answer was implicitly, if not explicitly, endorsed.) Featured prominently in that episode were several segments on the faith healer John of God. Read more »
*This blog post was originally published at Science-Based Medicine*
November 23rd, 2010 by Happy Hospitalist in Better Health Network, Health Policy, Humor, News, Opinion
Tags: Anti-Circumcision Activist, Baby Boys, Children's Health, CNN, Happy Hospitalist, Infant Genital Mutilation, Islam, Judaism, Lloyd Schofield, Medical Crime, Medical Humor, Newborn Care, Outlawing Circumcision, Parent Preferences, Parenting Behavior, Pediatrics, Religious Tradition
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Have you heard? First San Fransisco bans toys in Happy Meals. Now CNN is reporting there’s a circumcision ban proposed in San Fransisco as well.
To recap: Anti-circumcision activist Lloyd Schofield has drawn up a proposal outlawing all circumcisions, even for religious reasons (circumcision of boys is traditional in Judaism and Islam.) The punishment would be up to a year in jail or up to a $1,000 fine.
Boy, oh boy. What a hot-bed topic circumcision is. Mandating a ban against all circumcisions is like mandating a requirement that all boys be circumcised. Nobody is right. Everyone is an expert. You’re either for it or against it. But making circumcision a crime? I don’t know. Read more »
*This blog post was originally published at The Happy Hospitalist*
November 23rd, 2010 by GruntDoc in Better Health Network, Opinion, Research
Tags: Dr. Allen Roberts, Dr. Graham Walker, Evidence Based Medicine, General Medicine, GruntDoc, Medical Ratings, Medical Recommendations, Medical Reviews, Medical Summaries, Numbers Needed To Treat, Online Tools For Medical Professionals, TheNNT.com
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I think I blogged this before, but didn’t describe it much. Allow me to rectify that mistake.
The NNT.com (“Number Needed To Treat”) is an ever-expanding website which boils down high-quality reviews of medications and interventions and presents its recommendations in a much more approachable green-yellow-red “warning triangle” format rather than some ratio.
While I won’t use this as a single source to change my practice, I’m going to have to do some more research on some of the [questionables] of our age (i.e. Octreotide for variceal bleeding, PPI infusions for upper GI bleeding, etc.) — just two of the studies that fly in the face of current practice.
An aside: While inhaled corticosteroids for asthma aren’t beneficial in the review, what it doesn’t tell you is that the Feds think they are, and will grade your asthma care on how many of your asthma patients get a prescription for them, so be aware.
Graham Walker, M.D. is behind this, and good for him.
*This blog post was originally published at GruntDoc*
November 22nd, 2010 by EvanFalchukJD in Better Health Network, Health Policy, News, Opinion
Tags: Best Doctors, Employee Health, Employee Protection, Employer Healthcare Contributions, Evan Falchuk, Future of Medical Practice, General Medicine, Health Insurance Companies, Healthcare Incentives, Healthcare Reform Law, New U.S. Healthcare System, See First Blog, The Future of American Healthcare, Workers Compensation System
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There’s a country with an unusual healthcare system. In it, you often spend about as much time with your lawyer as you do your doctor. There are special courts set up to decide what kinds of treatment you are allowed to have. And doctors have to be careful that they don’t say or do the wrong thing, or else they risk being blackballed by insurance companies.
The country: The United States of America.
You may not realize it, but if you hurt your back at work you end up in a different healthcare system than if you hurt your back at home. Sure, you may end up with similar doctors or hospitals, but your experience of healthcare will be completely different. Here’s why.
If you get hurt at work, you’re covered by the “workers compensation” system. That system has its roots over a century ago, when employers didn’t do much to take care of workers. So the system is based on laws that mandate employers to take care of injured workers, often for the rest of their lives. In exchange for this very comprehensive coverage, employers and their insurers get a great deal of control over what care workers get and where they get it.
Does the workers compensation system represent a model of how a future American healthcare system might work? It might. Read more »
*This blog post was originally published at See First Blog*
