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Latest Posts

Should Halloween Contact Lenses Be Prescription-Only?

That depends on if you can afford to get them.  Costume lenses are all the rage for Halloween by adding an exciting dimension to the costume wearer.   But did you know it’s illegal to market them as over the counter?

Many consumers do not realize that they are FDA- regulated medical devices, and that recent legislation has made it illegal to market them as over-the-counter products. Still, they are commonly available in costume shops, beauty shops, convenience stores, novelty shops, and other places that people shop for Halloween items, as well as over the Internet.

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*This blog post was originally published at A Happy Hospitalist*

Strange Prescriptions: Tax Free In Texas

From an old HS buddy (also a Navy Man) now in healthcare:

Texas law makes almost any item with a doctors prescription exempt from
sales tax.

(most details at : RULE §3.284 Drugs, Medicines, Medical Equipment, and
Devices (Tax Code §151.313) Item 11 is the sort of catch all.

What is most odd item you have been asked for a prescription for purely for
tax-free purposes?

Sellers of the Select Comfort beds, and hot tub/spa dealers are very aware
of this law. Presciption needed for bed, letter and presciption needed for
hot tub/spa.

Oddest request received at clinic where I work: one for in ground pool,
heated and deep enough for water aerobics.

While I don’t notice it on that list, food for helper animals is exempt
from sales tax.

Interesting also, repair parts for devices are exempt, but not
*improvements*. If you replace like for like wheel on a walker, it is tax
free. Replace with improved wheel-taxable.

I’ve never been asked to write a prescription for anything like that in the ED, but I’d be willing to bet my office-based colleagues have.  Care to share?

*This blog post was originally published at GruntDoc*

Patient Bites Off Doctor’s Finger

Allegedly for “not writing a prescription”…

Dr. Paul Arnold turned his back for a moment on a patient who was upset because the doctor wouldn’t write him a prescription.

That’s when the patient, Gregory S. Powell, 45, of Fort Myers, allegedly attacked Arnold, 65, biting off part of one of the doctor’s fingers.

As my tipster says “…probably wasn’t about refusing an amoxicillin script…”.

In custody; no word on the doc, and best wishes.

Thanks to Glenn (a true homie) for the tip.

*This blog post was originally published at GruntDoc*

Physicians Under Pressure To Prescribe Narcotics

When it comes to opiate drugs, like morphine, there is a bitter debate between patients who are in chronic pain, and the doctors who are vilified for under or over-prescribing these medications.

But there are some other subtle influences that push doctors to prescribe these drugs, in some cases inappropriately. An ER physician talks about the issue, saying, “when dealing with a patient who is in pain, or appears to be, it can be impossible to sort out when a patient needs opiates for legitimate reasons, and when it is merely feeding a long term addiction. We are trained to provide comfort and relief from suffering to our patients, and we generally will err on the side of treating pain, rather than withholding addictive medications.”

There is also the pressure to provide “patient satisfaction,” and indeed, low scores in this area can place a doctor’s job in jeopardy. Taking a stand against those who inappropriately request opiates will result in low patient satisfaction scores, and “will often times result in arguments, profanity, and calls and letters to administration.”

What’s the answer? Perhaps a little less reliance on these scores, since a good patient satisfaction score is not necessarily correlated with proper medicine.

*This blog post was originally published at*

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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