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Are Patients Charging Their Doctors For Time In The Waiting Room?

Patients are starting to bill doctors for making them wait, reports CNN.

“When he keeps patients waiting more than 15 minutes, Dr. Timothy Malia, a primary care physician in Fairport, New York, hands them a $5 bill. If patients in Eugene, Oregon, wait more than 10 minutes to see Dr. Pamela Wible, they receive a handmade soap or a bottle of lotion. When Dr. Cyrus Peikari, an internist in Dallas, recently had to miss a day of work because of a family emergency, he gave the patients whose appointments he canceled $50 at their next appointment.”

I’ve been kept waiting at doctors’ offices. I’ve been kept waiting as pharma reps walked past a full waiting room bearing plates of food. But I’ve also been kept waiting as doctors have handled other patients, undoubtedly more complex cases than mine.

Practice administrator and blogger Brandon Betancourt sums up the point nicely, and further extends the idea to every delay faced in life, such as toll booths on turpikes tied up with traffic.

I’ve also been squeezed into the schedule for emergency appointments, undoubtedly making someone else wait. And I’ve also been treated by phone on nights, weekends and holidays, and I’m not so sure that my primary care physician gets reimbursed for that.

So, kudos to those few physicians who respect their patients’ busy schedules enough to reward them. But I’m Read more »

*This blog post was originally published at ACP Internist*

Coffee And Prostate Cancer: The Quality Of News Reports Varies Significantly

We simply don’t know why more news organizations can’t do an adequate job of explaining the limitations of observational studies – most notably, that they can’t prove cause and effect.

Yes, they can show strong associations. But they can’t prove cause and effect.

NBC Nightly News, as one example recently, inadequately explained the latest suggestion that coffee consumption can lower the risk of prostate cancer. In the anchor lead, Brian Williams framed this as another case of flip-flopping science, lightheartedly talking about what they say about “all those medical studies…if you don’t like the findings, wait for the next study.”

The story seemed puzzled at how the same “lab” 30 years ago reported that coffee was linked to an increase in pancreatic cancer. NBC said the researchers later said they got it wrong. This time – with the prostate cancer link – they say they got it right. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

The Autism-Vaccine Fraud: The Difference One Journalist Can Make

The BMJ’s statement this week that the 1998 article by Andrew Wakefield and 12 others “linking MMR vaccine and autism was fraudulent” demonstrates what a difference one journalist can make. Journalist Brian Deer played a key role in uncovering and dismantling the Wakefield story.

(Of course, others recently have said something similar about The Daily Show comedian Jon Stewart’s role in focusing on the health problems of 9/11 first responders.)

CNN’s Anderson Cooper had a segment worth watching, including a new interview Cooper conducted with Wakefield via Skype:

Unfortunately, journalism played a key role in promoting Wakefield’s claims. The “Respectful Insolence” blog referred to one journalist as “CBS’ resident anti-vaccine propagandist.” Around the world there were many other examples of journalists’ unquestioning acceptance of the vaccine scares.

The BMJ reminds us that “the damage to public health continues, fuelled by unbalanced media reporting and an ineffective response from government, researchers, journals, and the medical profession.”

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Going Against Medicine: Courageous Or Foolish?

Every once I awhile a story catches my eye as I scan the news websites. There was one this morning on CNN with this catchy title: “Mom Defies Doctor, Has Baby Her Way.” The article describes a story where a mother was going to have her fourth baby. Her previous three were born via C-section. Mom did not want another C-section done, and “defied” her doctor’s order for the procedure. “You’re being irresponsible,” the patient was told.

The middle of the article talks about the current thinking and statement of the American College of Obstetrics and Gynecology saying that “it’s reasonable to consider allowing women who’ve had two C-sections to try to have a vaginal delivery.” Of course, there’s risks with proceeding with a vaginal delivery and risks of another C-section.

What’s always interesting to me are the comments following the article. I applaud the physicians who are fighting back the anti-physician sentiment and those who are pushing (no pun intended) the only home birth agenda.

In the article, this person is being held up as a hero — as someone who defied the paternalistic medical establishment and did it her way. Good for her — or is it? What if that 0.4-0.9 percent possibility of severe complication occurred and there was a problem with mom and/or the baby? What would happen then? Read more »

*This blog post was originally published at Doctor Anonymous*

Making Circumcision A Crime?

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*

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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