"When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov
''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.'' -Robert Ehrlich, drug advertising executive.
"Opinions are like sphincters, everyone has one." - Chris Rangel
New World Errors: More evidence that those wonderful computers that are supposed to do so much to eliminate medical errors may create more. posted by Sydney on
11/06/2006 08:07:00 AM
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Serendipity: An ornithologist moves to Utah and discovers the lice he studies won't grow on his birds in that dry climate. The result? Louse Buster for people. posted by Sydney on
11/06/2006 08:04:00 AM
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“A very disabled child can mean a disabled family,” it says. “If life-shortening and deliberate interventions to kill infants were available, they might have an impact on obstetric decision-making, even preventing some late abortions, as some parents would be more confident about continuing a pregnancy and taking a risk on outcome.”
It isn't entirely clear why infanticide would be a better choice than late term abortion. But one advocate makes it clear that infant euthanasia is part and parcel of the logic of abortion:
The college’s submission was also welcomed by John Harris, a member of the government’s Human Genetics Commission and professor of bioethics at Manchester University. “We can terminate for serious foetal abnormality up to term but cannot kill a newborn. What do people think has happened in the passage down the birth canal to make it okay to kill the foetus at one end of the birth canal but not at the other?” he said.
Fever Fines: Taiwan is having an outbreak of Dengue fever, and the authorities are not pussy-footing around. Doctors who fail to report cases are being fined:
Individual doctors will face fines of between NT$90,000 (US$ 2,734) and NT$450,000 while hospitals face fines of up to NT$1,500,000.
According to Chou, patients sometimes ask doctors to keep their status hidden to avoid the hassle of being tracked and having sanitation teams come to spray their homes.
Speeding up emergency-room triage to get patients faster treatment. And offering restaurant-style pagers so not-so-sick patients don't feel stuck in a crowded emergency waiting room.
Shortening waiting times is part of a nationwide move toward empowering patients, reducing medical errors and improving health care.
First of all, I would argue that shortening waiting room times for all emergency room visitors regardless of the nature of their illness does not necessarily improve healthcare and reduce errors. It has the opposite effect. The emergency room doctors and nurses and clerks feel the pressure to get people in and out quickly and as a result take short cuts. Short cuts in medicine translate into missed diagnoses.
The article mentions the case of the Illinois woman who died of a heart attack while waiting to be seen for chest pain. Chest pain is a symptom that should never be left in the waiting room. In this case, the mistake was made during triage, and it's such a basic mistake that it makes one wonder about the level of training of the person who did the triage. Did the hospital have to hire more people for triage duties in order to improve their waiting room time, and in so doing, did they have to reach for people whose training was less than optimal?
Here's a better solution to emergency room overcrowding - have a doctor or experienced registered nurse do the triage and if the condition of the patient is such that he can be handed a beeper as if he were waiting in the lobby of Red Lobster, send him home instead with instructions to see his doctor in the morning. Keep the emergencies in the emergency room and the minor illnesses in the doctor's offices and clinics. posted by Sydney on
11/05/2006 09:28:00 AM
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Online Etiquette: Or lack of it. I've always wondered about those online guestbooks that are attached to obituaries these days. Even the printed obituaries in the newspaper often have instructions to "sign the online guest book at ...." Knowing how the physicians on the email discussion listserves stoop to name calling and prickly insults, one would think that inviting people to comment online about the lives of others would be an invitation to vitriol. It is, according to this story. Those online guest book companies devote 30% of their budget to deleting lines like this:
"I sincerely hope the Lord has more mercy on him than he had on me during my years reporting to him at the Welfare Department."
"She never took the time to meet me, but I understand she was a wonderful grandmother to her other grandchildren. "
“Reading the obit, he sounds like he was a great father. His son Peter.”
Those are the milder (and funnier) ones. Some accuse the dead of molestation or accuse the living of being responsible for the death. The internet - the great revealer of what truly lies in the hearts of men. posted by Sydney on
11/05/2006 09:09:00 AM
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Price Wars: Remember when gas stations used to compete with one another to see who could sell the cheapest gas? The phenomenon is happening now with drug stores:
Giant Eagle announced Thursday that it will provide 56 generic prescription antibiotics and cough medicines for free for a limited time in all 93 of its Ohio stores.
The Pittsburgh-based grocery store chain also is permanently slashing the price to $4 for a one-month supply of another 292 commonly used generic prescriptions.
Why would they do that? Because it's a better deal than people are getting at WalMart:
Giant Eagle's move follows last week's announcement by Wal-Mart that it is lowering its prices on 314 commonly used generic prescriptions to $4 for a month's supply at all of its Wal-Mart and Sam's Club stores in Ohio. Rival retailer Target matched the deal in all of its pharmacies statewide.
Only the really big chains whose real mission is to sell things other than drugs are doing this. They get the customers in the door for drugs and hope that they browse around and make other, more purchases while they wait for their prescriptions.
The less generous part of me always wonders if this isn't the reason the Ohio Pharmacy Board is so hostile to electronic prescribing. They say they're worried about drug diversion, but if that were the case, they could just prohibit e-prescribing of controlled substances. By making it difficult for prescriptions to be sent ahead to the pharmacy, they improve the chances of browsing and spending behavior by the pharmacy customers.
I suspect this is why Target, WalMart, and Giant Eagle all make it difficult to phone in and fax prescriptions. Chains that are historically primarily drugstores rather than superstores or grocery chores, such as CVS and Walgreen's, are much more accomodating when it comes to faxing in prescriptions. They have their own forms for refills that they fax to physicians that can be faxed back. I wonder how they'll compete with these $4 and under generics? posted by Sydney on
11/05/2006 08:41:00 AM
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Wednesday, November 01, 2006
Pulse of the People: Less than a week until election day, and you can feel the excitement in the air. I've received two doctor's voting guides from two area professional organizations, both of which highlight the pro-tort reform candidates and judges of restraint. The Cleveland Diocese handed out voting guides at mass a couple of weekends ago. They were careful not to endorse any candidates, but they did print every candidate's response to a series of Catholic-oriented questions. And last Sunday, despite prohibitions from the pulpit about such behavior, someone left lists of pro-life candidates on the windsheild of every car in the church parking lot.
While the national media are giving much attention to the gubernatorial and senate races here in Ohio, neither seems to be much on the minds of the people (that is, my patients). Not that they're apathetic. Not by any means. One of my patients pointed a finger at me after I told her she needed to be admitted to the hospital and said, "Just get me out by next Tuesday. I'm voting no matter what." I didn't ask which way she was voting, or which race she felt so strongly about that she would drag herself from her sick bed to make it to the polls, but if the other patients are any indication, it's mostly the local and state issues that are driving them.
We will we be voting on whether or not to raise the minimum wage. That will pass. Most people are employees, not employers. They see the minimum wage as a reflection of their wages. If the minimum goes up, so will theirs. (Though I suspect it won't quite work out that way.) We will also be voting on two smoking bans. One bankrolled by a tobacco company, the other the project of anti-smoking groups. Clever tobacco companies; if both pass, the less draconian tobacco company sponsored amendment wins. People who read the newspaper know this, and they aren't amused by the antics of big tobacco. Even the smokers expect the totalitarian ban to pass. I've had an upswing in people asking for pharmacological aids to quit smoking because "they're going to be social pariahs in a few weeks."
Why the silence on the race for governor and the Senate? Well, the average voter isn't as partisan as the political activists who feed the stories to the news media. Truthfully, there isn't much difference between Mike Dewine and Sherrod Brown. They are both a politician's politician. The only difference is that Dewine is pro-life, and Brown is not. Brown's fortunate that the average voter doesn't know the company he's been keeping on the internet. It will be close, but it will go to Dewine. His incumbent advantage will save him.
And the race for governor? It's between a cipher and a nut. I'm voting for the nut, but expect the cipher to win just because he's white. Racial prejudice still runs silent but deep in this state, especially among older voters. Oh, well. At least the cipher keeps his distance from the nutty internet wing of his party. posted by Sydney on
11/01/2006 09:58:00 PM
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