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How Are Dieters Like Congress?

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I am mad at congress.

I don’t care if they are Democrats or Republicans, I am sick of healthcare being treated as a political football.  How much more of a crisis do we need before we actually start working on a solution?  Why does each party have to sit on its side of the aisle shooting spitballs at the other?  Each side has its pet issues that are tied to contributors, supporters, and lobbyists.  Each side will work to see the other side fail even if the other side is right.  Each side seems unable to do anything unless there is political value in it.  Power is more important than service, and power is a short-term project. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Is Healthcare The Engine Of The US Economy?

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Commenting on the President’s budget, an editorial in the Times on Feb 2nd juxtaposed three of our nation’s dilemmas: the deficit, jobs and health care.

“President Obama got his priorities mostly right. The deficit, compared with what it could have been, is $120B. That’s a lot of money. But it’s not too much at a time of economic weakness, when deficit spending is needed to put Americans back to work.”

“Medicare and Medicaid will cost $788B; that should be another reminder of why the country needs health care reform.” Read more »

*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*

Online Marketing And Scattered Audiences

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Nuclear weapon test Romeo (yield 11 Mt) on Bik...
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Was your company blogging ten years ago? If not then why? Google made it easy for you and now you’ve lost ten years of priceless link juice. Given the fragmentation of media in the last ten years, it’s clear now just how relatively little work you actually had to do back then. But that’s in the past. Still, I have bad news for you: what you have to do now is far harder than it was ten years ago. Let me explain.

CONTENT FRAGMENTATION AND SOCIAL DISTORTION

As the Web expands and proliferates novel media, messaging becomes increasingly diffuse and fragmented. The Web creates new opportunities and destroys old standards. It disrupts communication patterns, rattles social structures and ruptures attention spans. Ten years ago, you could leverage your audience-building skills for acquiring and retaining customers. You could even have learned and mastered a skill which traditional marketing didn’t really demand: conversational aptitude. Read more »

*This blog post was originally published at Phil Baumann*

Emergency Medicine Residency Doesn’t Prepare Docs For The Real World

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Emergency Medicine News:
February 2010 – Volume 32 – Issue 2 – p 5, 24, 25, 26

Residents training in large urban centers typically see more than 200 patients a day. They have access to all subspecialty care, typically available 24 hours a day. Residents have around-the-clock access to angioplasty, interventional radiology, hand surgeons, neurosurgeons, and plastic surgeons. Most practice emergency medicine with cardiologists and neurologists in the building or a short phone call away. Decision-making is shared, and occurs with a relative surplus of information and opinions and in a milieu of shared risk.

In reality, though, these very large and highly-specialized EDs with Level I trauma comprise less than five percent of U.S. EDs, according to the American College of Surgeons. Read more »

*This blog post was originally published at GruntDoc*

Dr. Val’s Take On The Medical Ethics Debate: America’s A Funny Place

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god-bless-americaDr. Rich recently posted a 3-part series on the shortcomings of medicine’s new ethics. While I personally find Dr. Rich’s writing style both nuanced and entertaining, there is no doubt that his posts require some focused attention. And so I thought I’d provide a “Cliff’s Notes” version for my regular readers (since Google analytics tells me they are unlikely to spend more than 2 minutes here at a time). ;-)

Advances in science and technology have provided us with valuable new treatment options for many diseases and conditions. Unfortunately, these new drugs, devices, and procedures are so expensive that we cannot (as a country) afford to make them accessible to everyone who could benefit from them. Medical technology has outpaced our ability to pay for it. This leaves us with an ethical dilemma: how do we ration access to modern medicine? Read more »

Medical Ethics Smack Down Part 3: The ACP Responds

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A few days ago Mr. Doherty (who is also the ACP’s Senior Vice President of Governmental Affairs and Public Policy), graciously agreed to engage in this discussion, and promised to do so after consulting with the ACP’s Committee on Ethics, Professionalism, and Human Rights.

DrRich had hoped that Mr. Doherty would reply with a post on his ACP blog, which (since it likely has a vastly greater readership than the CRB), would more effectively give this topic some much-needed airing - and in particular, might engage some of the ACP’s membership (specialists in internal medicine) in this important discussion. DrRich was disappointed, then, when the reply came today in the form of a comment, which was tacked on to a long queue of reader’s comments at the end of DrRich’s posting.

DrRich was also very disappointed by the content of the reply which, fundamentally, was: This is a non-issue, and even if it was an issue, it’s now a settled issue. (So go away.) Read more »

*This blog post was originally published at The Covert Rationing Blog*

Medical Ethics, ACP Smack Down Part 2: Medical Ethics the Right Way

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In his last post, and not without some little trepidation over the propriety of doing so, DrRich offered to enter into a “constructive dialogue” with Bob Doherty of the ACP Advocate Blog, regarding the important topic of medical ethics. What occasioned this offer was the fortuitous selection of each of us as finalists in the 2009 Medical Weblog Award Competition, in the category of Best Health Policy/Ethics Blog.

Ever since the inception of the Covert Rationing Blog (and even before that, in his book) DrRich has taken strong exception to the new code of “medical ethics for a new millennium,” formally promulgated in 2002 by the American College of Physicians and several of its equally respected sister organizations (a grouping DrRich has termed the Millennialists). And when he saw that the ACP Advocate Blog (an official publication of a principle component of the Millennialists) had become a co-finalist for a Weblog Award in the category of medical ethics, DrRich could not resist offering to engage in a discussion over same. Read more »

*This blog post was originally published at The Covert Rationing Blog*

DrRich Initiates A Medical Ethics Smack Down With The ACP

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Yesterday, DrRich noted (with his usual affecting humility, modesty, self-deprecation, &c.) that the Covert Rationing Blog has been named a Finalist in the 2009 Medical Weblog Award Competition, in the category of Best Health Policy/Ethics Blog. He now calls to his readers’ attention the fact that, among the other two finalists - both of which are of very high quality and undoubtedly are more deserving of this award than DrRich - is none other than the ACP Advocate Blog.

The ACP Advocate Blog, written by Bob Doherty, is a publication of the American College of Physicians, and its purpose is to explain, elaborate on and advocate for the ACP’s positions on important matters related to health policy and medical ethics that affect its members, namely, internal medicine specialists.  Doherty - who DrRich does not know, but of whom he has heard many very complimentary things - is an insightful analyst of matters related to healthcare policy, and to boot he is an excellent writer. DrRich is a loyal reader of the ACP Advocate Blog, which in fact has habitually led off DrRich’s blogroll.

Here’s why this is interesting. While both the ACP Advocate Blog and DrRich’s blog are finalists in the medical ethics category, it so happens that DrRich and the ACP are far apart on that very issue. Read more »

*This blog post was originally published at The Covert Rationing Blog*

Reflexive Doubt: The Psychology Of Misguided Scientific Beliefs

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Those of us who study, practice and write about medicine cherish the hope that explaining the science behind medicine (or the lack of science behind “alternative” treatments) will promote a better understanding of medicine. Certainly, I would not bother to write about medical topics if I did not believe that promoting science based medicine would lead to increased understanding of medical recommendations and decreased gullibility in regard to “alternative” remedies. Nonetheless, lack of scientific knowledge is not the only reason for the current popularity of “alternative health. Indeed, many advocates and purveyors of “alternative” health are impervious to the scientific evidence. What else might be going on? Read more »

*This blog post was originally published at Science-Based Medicine*

Are You A Slave To Patient Satisfaction Scores?

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I am very blessed.  The hospital where I practice, while concerned with patient satisfaction, does not worship at its altar.  That is, so far our administrators seem to understand that people will occasionally be angry or unsatisfied, and that such dissatisfaction is within the realm of real life.  We still have people storm out of the emergency department, prattling on about lawyers and lawsuits, promising to go to another hospital in the future (which we heartily encourage).  On the whole, we do a bang-up job of keeping the right people happy, and an adequate job of making the right people unhappy. Read more »

*This blog post was originally published at edwinleap.com*

Latest Interviews

The Secret To A Long And Healthy Life: CBS News’ Dr. Jon LaPook Reports

If you want to improve the health of Americans why not look around the world for places where people live the longest healthiest lives and try to copy whatever it is they’re doing That’s exactly what Dan Buettner has done. He is the author of The Blue Zones Lessons for…

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Heart Disease Awareness And The Four Hottest Controversies In Cardiology

Audio http getbetterhealth.com wp-content uploads billkussmaul.mp…

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Latest Book Reviews

Book Review: The Immortal Life of Henrietta Lacks

This past weekend s international science communication conference ScienceOnline also saw the first final hardback copies of Rebecca Skloot s long-awaited book make it into the hands of the science and journalism consuming public. Moreover an excerpt of The Immortal Life of Henrietta Lacks has just appeared in the new…

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Book Review: FDR’s Deadly Secret (Malignant Melanoma)

Earlier today I wrote a short article which resulted in correspondence with one of the authors of the new book FDR s Deadly Secret by Steven Lomazow and Eric Fettmann. Dr. Steven Lomazow sent me a copy of his Archives of Dermatology article with Dr. Bernard Ackerman this photo and…

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Book Review Of Coppola: A Pediatric Surgeon In Iraq

War can paradoxically bring out the best in people. Despite the violence tragedy and pain there are moments of kindness compassion and brave camaraderie. Soldiers band together as brothers and sisters under terrible circumstances to offer their lives in support of a nation they deem just and vulnerable. Often they…

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