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I am trying an audio version of explanation for the case presented 4 days ago. I need your feedback - do you like this strategy, or should I type out the answer.
Acidosis discussion
49-year-old man, previously in good health, presents after a few weeks of progressive weakness and dizziness. He admits to polyuria. Your job is [...]
In response to a comment yesterday, for the first time I reprint a rant. This rant is so important that I consider it classic for this blog.
A reader writes:
My question: Is there a plan to move MD’s away from primary care and turn this function over to NP’s and others who will cost the system [...]
Once again a study challenges dogma - POISE Published, Debate on Perioperative Beta Blockers Continues
Publication of the landmark Perioperative Ischemic Evaluation (POISE) trial online May 12, 2008, in the Lancet has triggered another heated debate about the pros and cons of using beta blockers perioperatively in noncardiac surgery [1]. In one corner are the [...]
In other countries with government run health care, budgetary issues lead to changes in health care spending. Oops! In case we forgot, the government represents a major purchases of health care in the US. So when trying to adjust for a fiscal mess caused by natural forces (Katrina), legislators look for cuts [...]
The New New Federalism
The Oregon case will be an early test of whether the Roberts Court will continue and extend William Rehnquist’s legacy of restoring meaning and force to the notion that our system of government is one of limited and enumerated powers. For at bottom, the Oregon case turns on whether the Attorney [...]
How should we (the government) respond to successful programs? One can easily argue that we should reward success. After all, this is the meritocratic approach. However, this proposal would - by advantaging less successful programs - handicap against success! Guarding the Fight Against AIDS
It doesn’t take a degree in public administration [...]
Senate’s Leader Veers From Bush Over Stem Cells
In a break with President Bush, the Senate Republican leader, Bill Frist, has decided to support a bill to expand federal financing for embryonic stem cell research, a move that could push it closer to passage and force a confrontation with the White House, which is threatening to [...]
Due to the huge amount of spam comments that I receive, I occasionally do not approve a comment. This rarely has anything to do with content, rather browsing through 400 spam comments, I might miss your real comment.
This comment is worthy of consideration:
Tried to post this to the pay for performance post but it [...]
Senate Leader Calls for Limits on Drug Ads
The Senate majority leader, Bill Frist, called yesterday on the pharmaceutical industry to limit drug advertising directed at consumers, increasing the pressure on companies to curb such marketing.
Senator Frist, a Tennessee Republican, embraced an increasingly popular idea, a delay in advertising after a drug is introduced. He called [...]
Frist, Clinton to introduce healthcare IT bill
Senate Majority Leader Bill Frist (R-Tenn.) and Sen. Hillary Rodham Clinton (D-N.Y.) plan to introduce bipartisan healthcare information technology legislation. The bill aims to harmonize disparate healthcare data standards and remove legal barriers to IT uptake.
In a joint statement from Frist and Clinton released last week, the senators said [...]
An editorial in the April 30th issue of The Lancet has this quote:
… But, sadly, Labour, Conservative, and Liberal Democrat politicians have all failed to address the single most important factor hindering the improvement of health services—the catastrophic collapse in morale among doctors.
Doctors at all levels within the NHS are utterly demoralised. They believe that [...]
Why do we even have an FDA? Why would a Federal Judge overrule their scientific opinion?
Will ephedra products return to stores?
The judge Thursday ruled in favor of a Utah supplement company that challenged the Food and Drug Administration’s year-old ban. Nutraceutical claimed that ephedra has been safely consumed for hundreds of years.
Research shows that [...]
Two more thoughtful entries from the Bioethics Discussion Blog - If Schiavo Why Not Jones? (1)
What the Congress and presumably the President is forgetting is who is the person who deserves the actions in the best interest. It is not the President, the Congress, the court system, political or religious groups, news media, the [...]
For those with a subscription to JAMA - A Perspective on US Drug Reimportation - written by two Canadian physicians. I know the senior author very well, and greatly respect his intellect - especially as pertains to economic issues.
Since most do not have access, I will quote several key paragraphs:
Arguably, drug reimportation from Canada [...]
Road Map to a Digital System of Health Records
Yesterday, a group of 13 health and information technology organizations gave the Bush administration its recommendations for just such a road map for a national health information network.
The group’s report suggesting the principles that should guide the creation of such a network made an emphatic call for [...]
Some politicians see a potential harvest - Idea of Drug Safety Office Is Already Hitting Snags, but others view the problem realistically.
Despite calls from medical experts and a prominent Republican senator for an independent office to monitor drug safety, the idea, prompted by the Food and Drug Administration’s handling of the painkiller Vioxx, is already [...]
Daley Hints at Change for Ill. Drug Laws
“This is absolutely a big deal,” said Andy Ko, director of the Drug Policy Reform Project for the American Civil Liberties Union in Washington state. “You’ve got a mayor in a major American city … coming out in favor of a smart and fair and just drug policy.”
What [...]
Kerry Faults Bush Over Opposition to Drugs From Canada
Hitting hard on an issue of deep concern to older voters, Senator John Kerry on Wednesday promised an overhaul of the Medicare prescription drug law, saying President Bush had personally “stood in the way” of importing drugs from Canada, which advocates say would significantly reduce costs.
“George Bush [...]
Liability Matters
Litigation in the United States has become a subtle form of regulation. Courts can be no less coercive than Congress, and yet their rulings are far more arbitrary, with deliberative juries substituting for the deliberative process of legislation. Neither is perfect, but juries in the last 50 years have become predictably punishing toward anyone [...]
Health-care fantasies
The platform maintains that those Americans who pay for their own health care “pay too much.” It also says that their employers pay too much for health care. The solution? “We believe that health care is a right and not a privilege.” If those who pay nothing for health care have a “right” to [...]
Hopes Now Outpace Stem Cell Science
But for all the promise, and for all the fervent hopes of patients and their families that cures from stem cells will come soon, researchers say many questions in basic science remain to be answered. And experts with ethical objections to the destruction of human embryos for such research say [...]
I rant and rave consistently about the Democrats’ attitude towards malpractice reform. I may well have to rant and rave about the Republicans’ attitude on this issue. U.S. “Patients Rights” Debate Moves From Supreme Court to Congress
The Supreme Court’s decision Monday to limit the ability of states to allow patients denied medical care [...]
Bush and Kerry, healthcare foes (warning - this link will give you the latest Kondracke column - thus if you are reading this in the future, you will have to search back through his columns to find this particular column).
If you or a loved one suffers from cancer, heart disease, diabetes or [...]
2 Cancer Drugs, No Comparative Data - this title is misleading, because the drugs are really anemia drugs, used both with cancer patients and with Chronic Kidney Disease patients.
Medicare officials sought the study, hoping to see if Aranesp, a drug made by Amgen that costs about $1,300 a vial, is superior to Johnson [...]
This article does not explicitly address medical issues. However, I believe it does a nice job emphasizing the costs of any benefit. One can take these principles and apply them to malpractice suits, drug benefits, marijuana laws, and many other issues that we address regularly. Goodies cost us
There are no [...]
Or how inconsistent our politicians are. This column documents the Democrats’ inconsistency on Medicare. I am not implying that the Republicans are any better when it comes to the political process. Patient welfare will always remain secondary to political gain. Medicare hypocrisy
What’s wrong with the new Medicare bill? Nothing that [...]
Frist Expects Congress to Try to Expand Health Coverage
Dr. Frist, a principal architect of the new law to provide prescription drug benefits to the elderly, accused Democrats of waging “huge campaigns to discredit” the law. He expressed concern that their criticism might sway voters. “Democrats right now are out banging this thing [...]
Yesterday I linked to Sydney Smith’s piece on Edwards. One of my most frequent commentors - Bernie - had this to say:
I read the article you linked to and it had lots to say about defensive medicine as a consequence of malpractice litigation and little to say about Senator Edwards’ supposed misconduct as [...]
Despite New Law, the Fight Over Medicare Continues
Democrats, denouncing the arm-twisting tactics used to pass the bill in the House, vowed Monday to rewrite the law to reduce the role of private health plans, to increase drug benefits and to authorize the government to negotiate drug prices.
Unless we elect a Democratic [...]
Our legislative process has great flaws. The bills they construct make a camel look normal. Almost any observer can find flaws with any bill. Each bill contains something which makes great sense. Most of you know the expression - there must be a pony in here. Perhaps this is [...]
I agree with this editorial. O Canada, O cannabis
