http://www.medrants.com Contemplating medicine and the health care system Fri, 03 Jul 2009 11:20:32 +0000 http://backend.userland.com/rss092 en Stabilize acid-base status End-of-life discussion Nuclear medicine stress test in woman with recent NSTEMI Cellulitis which followed a traumatic amputation Hyponatremia secondary to psychogenic polydipsia and (perhaps) thiazides, presented as altered mental status Achalasia - needs myotomy Lung cancer with bony metatases - needs biopsy documentation Patient s/p below knee amputation for gangrene - awaiting rehab placement Severe ... http://www.medrants.com/archives/4633 Primary Care Wins, Imaging Loses, Under New CMS Proposal - ht to Vinny Arora who retweeted AbbieCitron - Twitter does increase the speed at which I learn about important articles. Primary care physicians are cheering—and radiologists are jeering—a new CMS proposed change to the Medicare Physician Fee Schedule that will ... http://www.medrants.com/archives/4618 I always wondered why the SGR formula accelerated so quickly. Now I understand. Medicare May Shuffle the Deck on Doctor Payments Most of the money that Medicare pays physicians is for doctor visits, medical procedures and the like. But Medicare also pays physicians directly for drugs that are administered at doctors’ ... http://www.medrants.com/archives/4616 This editorial (HT to retired doc) makes a point that many bloggers have made over the past 5 years - Socialize medical care? As I've argued before in this space, one result of this unduly heavy reliance upon third-party payers is that almost everyone who consumes medical care does so irresponsibly. ... http://www.medrants.com/archives/4601 He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all - Sir William Osler I believe most educators have known this since Osler's time. As I reconstruct my career, I strongly believe that I have continued ... http://www.medrants.com/archives/4599 Back in November I made a commitment to improve my fitness. The Thanksgiving resolution – year 3. Fortunately, this year I have had no significant injuries and I have continued my resolution all year. April and May were a bit down due to excessive travel, but this ... http://www.medrants.com/archives/4596 Those who follow me on Twitter have seen these references. Here is the rest of my story. One argument for health care reform involves comparing our health care provision (I will try to avoid the word system, because we do not have one) with that provided in other countries.  These ... http://www.medrants.com/archives/4594 I made rounds today on 9 patients. I would categorize the issues: Stabilize acid-base status End-of-life discussion Nuclear medicine stress test in woman with recent NSTEMI Cellulitis which followed a traumatic amputation Hyponatremia secondary to psychogenic polydipsia and (perhaps) thiazides, presented as altered mental status Achalasia - needs myotomy Lung cancer with bony metatases - needs ... http://www.medrants.com/archives/4590 In one of my must read blogs, Evan Falchuk cautions us over oversimplifying health care reform by using one New Yorker piece. The McAllenization of Health Care Reform When we talk about health care reform, we are really talking about dozens of different issues. Is health care reform about covering ... http://www.medrants.com/archives/4588 Had a great time talking to family physicians at the Alabama Academy of Family Physicians. One conversation with an experienced family physician included the hospitalist phenomenon. He mentioned that a significant percentage of patients left his practice when he stopped making hospital rounds. Patients are smart. They understand ... http://www.medrants.com/archives/4586