September 2009
66 posts
Acromioclavicular Joint Separations: shoulder... →
Still a controversial subject. The type 3’s are tricky: to operate or not operate, that is the question. And if you do operate, which technique do you choose? There are a ton of them. As a general rule of thumb, when there are a whole bunch of different ways of doing a particular surgery, that usually means there’s no perfect way to do it.
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Ulnar Nerve Entrapment →
Michael Crichton on Media Extinction (1993) →
“In recent decades, many American companies have undergone a wrenching, painful restructuring to produce high-quality products. We all know what this requires: Flattening the corporate hierarchy. Moving critical information from the bottom up instead of the top down. Empowering workers. Changing the system, not just the focus of the corporation. And relentlessly driving toward a quality...
Diabetes is bad for the bones...also →
Interesting new research on how diabetes weakens the bones.
Watch“Barack Obama and his aides often complain about the lack of competition in health insurance markets. So why not let insurers compete across state lines? Wolf Blitzer asks top White House adviser David Axelrod and finds that, essentially, the answer amounts to, “Uh, erm, because, well, we—Hey, look! A blimp!”
From Reason.com piece. Common Sense -1, Washington Health Reform...
Cornell University - Defense Lifts Big Red To... →
Way to go Red!
Puff Daddies →
File this one under “Huh?” Guess it was bound to happen.
For the record, drugs are bad. Just say no…that goes for you too gramps
Dr. Paul's Prescription for Reform →
“Bureaucrats and other third parties must never be allowed to interfere in the doctor/patient relationship.
The tax code, including the ERISA laws, must be changed to give everyone equal treatment by allowing a 100% tax credit for all medical expenses.
Laws dealing with bad outcomes and prohibiting doctors from entering into voluntary agreements with their patients must be...
Guest Post on Kevin MD →
Kevin Pho of of KevinMD fame published a guest post of mine today.
It’s a shortened version of a post I made a few weeks ago. Thanks Kevin.
Top 100 Highest Tax Districts in the US by Zip... →
One man's story on how he saved the system 49.5% →
“Left to their own devices, consumers of health care, like consumers of any other good, will figure out how to save money just fine on their own. Here’s an example:
One day a few weeks ago I realized that what I thought was an insect bite on my chest was probably some kind of infection. On a Sunday afternoon I went to a local clinic and within 15 minutes was seeing a doctor. Sure enough,...
Malpractice Reform: is a new paradigm needed?
If you read my previous post on some of the tough issues that doctors and patients face when dealing with clinical ambiguity and potential for malpractice, you can begin to appreciate some of the difficulties in addressing these issues. We know there are many reasons patients sue, and many have nothing to do with negligence. Some are related to their feelings about a “bad outcome.” ...
DIY...so cool →
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Medical Malpractice, Technology and Clinical... →
I did my medical school and surgical training in New York City and Philadelphia. I quickly learned that these were two of the most litiginous locales in the country. If I had a nickel for every time I heard a doctor begin a sentence with the phrase, “In this medico-legal climate…”. Others have tallied cost estimates that such a climate exacts on the system. I can speak only...
“Le Chatelier’s Principle: Complex systems tend to oppose their own proper...”
Full Disclosure →
Doctors are pretty good at following rules (how could they endure 18 years of schooling and 3-8 more years of “training” if they weren’t). The NY Times writes a story about how some doctors have heavy industry connections- bam! all doctors now disclose all industry and professional organization connections at any meeting, before any published article, before any talk.
...
I heard that James Madison was a pretty smart... →
“The practice of medicine consists of the delivery of intimate services to the human body. In almost all instances, the delivery of medical services occurs in one place and does not move across interstate lines. One goes to a physician not to engage in commercial activity, as the Framers of the Constitution understood, but to improve one’s health. And the practice of medicine, much...
Does this make sense to anyone? →
“Proloquo2Go is a text-to-speech iPhone app that’s meant to aid those with autism, cerebral palsy, ALS, Down Syndrome—pretty much anyone who has a disability that makes speaking a difficult venture. It costs $150.
But Medicare/Medicaid restrictions won’t pay for this software or the accompanying iPhone because the iPhone is not a uni-functional device. (A person with autism...
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Promising Arthritis Research →
The University of Rochester has the best orthopedic basic science program in the country. They are number one in NIH funding in orthopedics and have been doing some amazing things. My brother (also an orthopedic surgeon) did residency there. They have a large team of researchers led by 3 true clinician-scientists. They literally spend half of the year in the lab and half doing clinical work -...
HR 3200 - lawyer reads whole thing →
A constitutional lawyer read the entire bill (which of the five bills in Congress I am not quite sure. HR 3200 perhaps?). Either way, it’s a tremendous feat and he might be able to provide people with some answers about specifics…wonder if he took notes? I really haven’t looked into this article in depth so I don’t know everything he found- just wanted to pass it on in...
check out my review of the iPhone app of Frank...
orthoonc:
(http://bit.ly/43YMpS) In the personal library of many physicians, there is at least one hard bound collection of beautifully hand drawn color illustrations by Frank Netter MD (1906-1991). These drawings were the work of an immensely gifted graphic artist who, by stripping away every unimportant detail, made human anatomy even more vivid and more beautiful. Frank Netter was also a...
“Loving what you do is the ultimate hedge against failure.”
– me
I’m at the Cincinnati Bengals game right now. There’s’a strange sense of optimism in the air. Optimism is only strange at football stadiums in Cinci…ok maybe Detroit.
Don't judge a book by it's cover...or a priest by...
I met an older, white haired priest at church today. He told me that he broke his leg a few years ago while participating in one of his favorite activities…skydiving.
Real life is so much more entertaining than fiction.
War...What is it good for?
“Wars are always expensive. They are also often unpopular, which makes paying for them through tax increases politically dangerous. As a result, they are almost always financed through the ‘secret tax’ of inflation. For a nation that loses a war, or suffers revolution or systemic civil conflict, there is always the chance that its currency could become worthless. While this may not be the...
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Health Savings Accounts →
“The best system would be a well regulated “Everybody Hold Your Own Money and Pay Your Own Way System.” It would empower patients to deal directly with their caregivers without third-party interference or regulation and lead them to become sensitive to the potential benefit and the cost of their care…
…”To insure that account money was spent on effective care, and not...
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Iconic Image, Lasting Hope →
“I still have pain,” she said. “Because my nerves are really damaged. They don’t work well. So pain in one area spreads everywhere I got burned… ”The pain I consider as my protection. It humbles me, and helps me to never take my life for granted,” she said. “And to share my story.”
Kim Phuc Phan Thai, the girl in the iconic photo of the Viet...
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A Doctor's Plan for Legal Industry Reform →
No one can deny that bad legal representation may make the difference between life and death. Get innocently accused in a death penalty state and you know what I mean. This doctor turns the tables on the lawyers.
Literary constructs like the one that Dr. Rafal uses (whether you take his side or not) are great because they force you to examine some of the logical absurdities inherent to an...
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Is there a doctor in the House? →
This article is old but telling. When the country was first founded, about 10% of national representatives cited medicine as their profession. Since 1960 only 1% of Congress has been made up by physicians (I’m pretty sure that lawyers are better represented than that). Historical differences in training duration aside, those numbers alone should tell you who is driving the Washington...
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"Autobama Universal Car Care" →
As a thought experiment, David Klein a graduate of the University of Central Florida Business School and currently a consultant in the energy sector, draws parallels between universal auto insurance coverage and universal health insurance coverage. Food for thought. Analyze the parallels one by one in the linked article and ask yourself if they don’t make sense. (excerpt below)
...
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Health Care and Rights
“It’s our right!”
If there ever was a national rallying cry - like the national bird or anthem- this might be it. But do we always use it in the proper context? Chris Wood an economic and political analyst with Casey Research LLC has these potentially clarifying words to say about rights:
“Health care reform has been in the news a lot recently, and I feel compelled to...
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Paul Graham on Wealth →
This essay is by Paul Graham. It is so full of good information it is hard to know where to start. Below he clears up the distinction between money and wealth. It explains why craftsman understand this concept in a very intuitive way. Surgeons are sort of the craftsmen of the medical world - we are sometimes put down for this by our medicine colleagues - but after reading the essay one can...
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Does the State Own Your Organs? →
When I was in medical school I worked for a tissue bank: the New York Firefighters’ Skin Bank. The Skin Bank operates out of New York- Presbyterian Hospital. It was founded and continues to operate through the kind donations of the Firefighters of New York. Some truly wonderful and dedicated people run the tissue bank (Nancy, Avery, Heather - you guys are the best, keep up the good...
“Think lobbying’s awful — but smart? Think again. Lobbying’s not just ethically...”
– Four Rules for Constructive Competition - Umair Haque - HarvardBusiness.org
(via financegeek)
Beware of Men Bearing Confident Predictions →
“At its start, in 1966, Medicare cost $3 billion. The House Ways and Means Committee, along with President Johnson, estimated that Medicare would cost an inflation-adjusted $12 billion by 1990. In 1990, Medicare topped $107 billion. That’s nine times Congress’ prediction. Today’s Medicare tab comes to $420 billion with no signs of leveling off.”
…and the beat...