Medical Pastiche

Paul Ryan's Plan to Reform Medicare

2011-06-06T09:10:00.001-05:00

Google Body Browser

2010-12-15T20:51:00.003-06:00

Google has released an incredible anatomy viewer for free! It is fully searchable, and can run on any computer with a WebGL-enabled internet browser (including the latest version of Google Chrome). More information about the Google Body Browser can be found here, and more info about downloading Chrome can be found here.

Google Body Browser

One Russian Hospital in Utorgosh

2010-10-16T10:25:00.007-05:00

From the original article:

Utorgosh is a hardly noticeable small town in the Novgorod region. It only has a few enterprises, local government, a school, and, of course, a hospital.

View Larger Map

Anatomical Rorschach #4

2010-09-15T21:27:00.002-05:00

Is this a weird skin lesion or just a sand dune on Mars?

1000 Awesome Things. #988: Echocardiography

2010-09-06T11:52:00.004-05:00

The ability to listen to the heart as it beats or to feel its reverberations across the chest wall has been around for the last thousands of years. Never has it been visualized. With the advent of ultrasound and its applications to almost all anatomy, you finally have the ability to see into the heart as it moves. No matter how careful your auscultation, it will never come close to the accurate diagnostic capability of seeing and measuring the heart's structures and the flow of blood through it.

You have a view of our most basic function that man has been wanting for millennia.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from Wikipedia)

1000 Awesome Things. #989: Getting an A-line

2010-08-05T19:51:00.006-05:00

How can you possibly rely on your visual sense to point a needle at something which you can not see? Welcome to the wonderful world of arterial line placement where tactile aiming is king. Extend the wrist, feel that pulse, and stab in the dark. A bright flash is all you need to know you hit the bullseye. Be careful and holster those two digits of yours, you're a sharpshooter now.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from Gare and Kitty via Flickr)

1000 Awesome Things. #990: Nailing your first intubation

2010-08-05T18:56:00.005-05:00

After dozens of successful intubations on mannequins, now is your chance to prove yourself on a real patient. Push the propofol and vecuronium, scissor-finger between the teeth, slide the laryngoscope blade in, pull forward, check out those beautiful cords, and push the tube through. It's your first patient. It's your first true intubation. You feel like a pro, but you know you'll need thousands more to be approved as a professional. That doesn't matter, because you know you're gonna love every chance you get.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from Brian McDowell via Flickr)

Heads-up Displays in Anesthesiology

2010-08-01T11:56:00.004-05:00

There are plenty of comparisons between anesthesiology and aviation, but you can add yet another: the heads-up display (HUD).

In the journal Anesthesia & Analgesia is an article titled "Monitoring with Head-Mounted Displays in General Anesthesia: A Clinical Evaluation in the Operating Room" (PDF), which showed an increased amount of time clinically monitoring the patient and surgical field and a decreased amount of time viewing the awkwardly-placed anesthesia workstation. Further research is planned to determine if this technology will actually improve anesthesiologist O.R. performance.

Example of the display shown below:

Does someone else's need make it morally acceptable to steal from you?

2010-07-30T12:52:00.005-05:00

"You Are Not Your Neighbor’s Health Care Provider", a 40-minute talk from the Ayn Rand Center.

(Image from Arenamontanus via Flickr)

Medicine in Media: Multioptipupilloptomy and Natural Orifice Translumenal Endoscopic Surgery (NOTES)

2010-07-23T16:46:00.005-05:00

Some say that natural-orifice translumenal endoscopic surgery (NOTES) is a brand-new advancement in minimally-invasive surgery, but I think the idea was known for decades and was inspired by the 1991 movie "Hot Shots". Besides pioneering transrectal minimally-invasive surgery, the movie also was the forefront of the treatment for walleye vision with the multioptipupilloptomy procedure.

Plush toy hearts and lungs and even venereal microbes

2010-07-22T10:37:00.008-05:00

Absolutely bizarre. Who would want to buy these things? If it tickles your fancy, you can get them here.

If you are interested in something more benign, check out the human organ plush toys here.

Other various microbes here.

Putting Physics to Work: Boosting Wireless Antenna Signal with Box Reflector

2010-07-22T09:53:00.006-05:00

When you live in the middle of nowhere, such as Russia or some Chicago suburbs, you don't have many options for broadband internet. Thankfully, Clear rolled-out their 4g WiMax network in Chicagoland last November, and so I was finally able to make the switch from dial-up internet.

However, it wasn't the best reception, displaying only 1-2 bars. I tried making parabolic dishes with some success, but overall it was cumbersome. The most effective and efficient solution was a box reflector (PDF).

A simple cardboard box, aluminum foil, and tape. Just 10 minutes later, the modem displayed 4/5 bars compared with 1-2/5 bars!

Displayed modem: Motorola CPEi 150

1000 Awesome Things. #991: Last Question of Step 2 CK

2010-07-21T23:34:00.006-05:00

Yet another Most Important Test of Your Life. The USMLE Step 2 CK is the test of all the 3rd year clinical knowledge of pediatrics, psychiatry, neurology, surgery, ob/gyn, family medicine, internal medicine. Your eyes are tired, your head hurts. But it is so worth it. You can walk out of that test center with your head held high. Two exams left, and you're a licensed physician.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from The Doctr via Flickr)

1000 Awesome Things. #992: Robbins Pathology

2010-07-21T22:49:00.005-05:00

It is the legendary 1500 page textbook of second-year medical students. You don't know why you spent the money on it as the raw size shouted impossibility and demanded enslavement. Idealism caught you off-guard.

The masterpiece of all that is grossly or microscopically wrong with the human body read like frozen molasses which thawed gradually through the third successive completion. By the sixth reading it was the sweet nectar of knowledge. And completely worth the tireless devotion.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from rula via Flickr)

1000 Awesome Things. #993: First Birth

2010-07-21T21:49:00.005-05:00

You were born once, but does it count as a first? You were zero at the time and don't remember it. In the mean time, you've gone from zero to hero: you're a third-year medical student on your obstetrics and gynecology rotation ready to catch flying babies, just like the third-year who was in on your own birthday. You have been patiently waiting for this moment ever since you decided to become a physician. The moment came after so many years, and the moment passed like the blink of an eye. Amniotic fluid spraying everywhere, blood shooting out, a cry pierces the air. Your vision blurred with the stinging sensation of tears welling up.

This is a miracle of life, and you were a part of it.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from Mwesigwa via Flickr)

1000 Awesome Things. #994: First Day of Fourth Year

2010-07-17T21:38:00.004-05:00

These are the days of bright hope for the future, the days where you can see your pre-med school dreams come to life, the days free from the constant stress of shelf exams. These are the days to enjoy before the onslaught of residency, the days where you can finally and blissfully recover from the last 2,555.

This is the final year, the fourth year, the year that M1s heard rumors about but never believed could exist. It's finally here.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from PaperPariah via Flickr)

1000 Awesome Things. #995: Finishing 2200+ Practice Questions

2010-07-17T21:19:00.003-05:00

You paid $99 for one-month of online practice questions for the USMLE Step 2 CK exam, and you knew the race was on to finish all 2200+ questions before time expired. The first five-hundred questions questioned your sanity, and the one-thousandth answer questioned your competency.

But you finally did it! You conquered the Mount Everest of practice questions, and you're as happy as those multi-racial-multi-gender white-coat-wearing USMLEWorld models.

AWESOME!

Inspired by "1000 Awesome Things".

Food MRI

2010-07-17T13:23:00.004-05:00

MRI of a tomato shown above.

Fantastic website with several examples of MRIs of foods.

How Blood is Donated in Russia

2010-07-15T13:41:00.002-05:00

It's not true that in Russia, blood donates you.

See more about it on the "English Russia" blog a here.

Can the government tell you what to eat?

2010-06-29T19:30:00.000-05:00

Justice Department declares war on doctors

2010-06-05T14:16:00.002-05:00

The second reason this is a landmark case is that the Justice Department has unambiguously stated that refusal to accept government price controls is a form of illegal “price fixing.”

Link

A Lesson in Self-Knowledge

2010-05-28T05:53:00.001-05:00

The plaintiffs allege that before his May 2009 colonoscopy at Parkway Regional Hospital in Fulton, Ky., Charles Harold Curtis Jr. told his anesthesia provider, Leonard Hohlbein, CRNA, that he had sleep apnea and needed to use a continuous positive airway pressure machine while sleeping. Mr. Hohlbein allegedly looked at Mr. Curtis' neck, said it looked normal and administered a reduced dose of propofol with a nasal cannula. When the patient's condition "deteriorated," the anesthesia provider tried to intubate the patient but couldn't manage, according to court documents filed in April in the U.S. District Court for the Western District of Kentucky.

Link

The (Health Insurance) Universe in a Nutshell

2010-05-04T19:00:00.002-05:00

From Take Back Medicine:

1. WWII & FDR – Feds have problems grappling with wages and prices. Health Insurance becomes a pre-tax benefit of employment. (We start to pay for our own health care with other peoples’ money, disturbing Market Forces.)

2. 1966 – In spite of AMA concerns about socialized medicine (AMA still represents most physicians), Kennedy’s assassination provides trigger for passage of Medicare, which becomes Health Insurance driver for those over 65 AND other insurers. For many years, system is ‘cost-plus’ - Medicare pays a beneficiary a stipulated amount for service ‘X’ and physicians have choice of either accepting Medicare fees (“signing up” for Fed fee schedule) or charging patients what they can afford above and beyond physician’s personal fee schedule. This works well for physicians and patients, but not for Feds. Medicare costs quickly mushroom beyond all predictions.

3. Nixon Administration – The Advent of the HMO (Health Maintenance Organization) Industry. Doctors begin to become employees instead of private, ‘shop-owner’ entrepreneurs. Formerly unadulterated Physician advocacy for patients now grapples with split allegiances. Markedly different HMO ‘Ethics’ arise (Capitation: flat fee per year for each of a doctor's assigned patients, irrespective of ANY treatment - or none. Some HMO’s recoup funds from MD’s if they spend ‘too much’ on drugs for their patients.) Brave New Ethical World of HMO’s begins to split AMA, which cannot represent both physician ‘camps.’ AMA begins to lose physician representation.

4. 1984 - Reagan Administration: “DRG” system put into place. Hospitals are paid flat fee, based on diagnosis for any Medicare admission, irrespective of length of stay or severity of condition/ services rendered. Patients begin to be discharged ‘quicker and sicker.’

5. 1990 Fee Physician Freeze - After AMA asks physicians to Voluntarily freeze their fees for one year, Price Controls are set into place by Feds for all Medicare patients. Along with these fixed fees for EVERY covered medical service/procedure, a new, lengthy, complex rule-book (a ‘Rubik’s cube’ puzzle) is developed - and mandated - for purpose of billing Gov’t. for all Medicare patients. For first time, ALL doctors are required by law to code, and submit, TO THE FEDS - all claims filed under Medicare.

Pay Attention Now!

A. In the past, a doctor could elect to "accept assignment" from the government for his Medicare claims (doctor agrees to accept Medicare payment as payment in full). For a time, doctors felt there was some wiggle room if they wanted to avoid threats of bankrupting fines for inadvertently miscoding by NOT accepting Medicare money. (At this juncture, All Medicare payments are price controlled, whether or not a doctor ‘Accepts Assignment.” Accepting Assignment just means he is guaranteed (?) to be paid by the Gov’t. with a slightly lower fee than if he does NOT accept assignment. Of course, patient pressures have obvious consequences.)

B. In the past, a Medicare Beneficiary was defined as a covered person who received payment from Medicare. Fortney ‘Pete’ Stark, head of House Way and Means Subcommittee on Health, changed the definition of “Beneficiary” to one who is merely COVERED by Medicare. The New Rules said that if a doctor didn’t want to accept Medicare money, he had to 'withdraw' entirely from Medicare (even if he hadn’t actually enrolled). If he did so, from that time forward, No Medicare patient he treated would be reimbursed one cent by the Gov’t.

So, if we wanted to see our Medicare patients, we were forced to accept Gov’t. money.

Hang on now: A Supreme Court Ruling says that if the Gov’t. funds any entity, in part or in whole, it has the right to control any aspect of that entity.

Think about this – long and hard.

The Gov’t. takes the position that seeing Medicare patients is ‘voluntary,’ even under such circumstances. Yours truly almost went bankrupt when he told his Medicare patients he would be leaving this new system. 90% of my patients said they would continue to see me, but only 10% did. For two weeks my income equaled my expenses (NO salary at all). I closed my office, moved ten miles north where high schools were still open and acne patients were once again available. I joined health plans (which I had studiously avoided) and rebuilt a practice – after 14 years – almost from scratch.

6. Clinton Era – Attempted passage of Universal Health Insurance Plan Fails. IF it had passed, it would have been illegal to use one’s own private funds to pay for services NOT covered by this plan!!

Yes, you read that right.

[Note: The AMA, having lost many physicians from its roster by this time, obtained the Monopolistic publishing rights for the Code Book used by every physician in the country for every service/procedure he or she performs for each and every patient (not just Medicare). Curiously enough, these codes are altered yearly, forcing all doctors to buy new codebooks on an annual basis. THIS is now a major moneymaker for the AMA. Is it any wonder the AMA endorsed Obama’s Health Care Plan???]

Tuesday Turnip (April 20, 2010)

2010-04-20T17:23:00.001-05:00

Turnip #1:
"Injury is the leading cause of death among children and young adults in the United States." Link

Turnip #2:
"Diabetic retinopathy is the leading cause of adult blindness." Link

Turnip #3:
"Allograft rejection is the leading cause of corneal graft failure." Link

Turnip #4:
"Rotavirus is the leading cause of diarrhea hospitalization worldwide." Link

Turnip #5:
"Streptococcus pneumoniae is the leading cause of community-acquired bacterial pneumonia and bacteremia in HIV-infected persons." Link

Turnip #6:
"Diabetes mellitus is the leading cause of organic erectile dysfunction." Link

Turnip #7:
"Cancer is the leading cause of death worldwide in 2010." Link

Turnip #8:
"Drowning is the leading cause of death related to recreational activities in Canada." Link

Adapted from Mental Floss's Tuesday Turnip.

Prosperity and Affordability

2010-03-13T10:09:00.002-06:00

If health insurance is too expensive for ordinary Americans, then ordinary Americans should be given more money to afford health insurance.

The ever-increasing prosperity of America is the basis for increased employment of its citizens, increased technological advancement, increased investment for capital expansion, increased efficiency of production, and increased income of all employed.

Increased income for employees means more money to spend on health insurance among other essentials including food and housing.

With this in mind, what better way to effectively make health insurance more affordable than to make sure America is more prosperous?

Why Not Universal Car Insurance?

2010-03-13T08:31:00.004-06:00

. . . . An insurance industry can only work to everybody's benefit if it is operating in a free market. Insurance companies must compete for clients, while the client must bear the fiscal responsibility of his actions. Making the individual liable and responsible gives an incentive to lower costs. It logically follows that government should not interfere in the market by disallowing certain suppliers to enter or by transferring responsibility from the consumer to the state. These distortions cause shortages of coverage, making those who suffer the consequences of those distortions that much poorer.

The concept of a universal car-insurance program is absolutely silly. But it is a great illustration of why social-insurance programs inevitably fail over the long run. The built-in free-market "regulations" that ultimately benefit the consumer simply do not exist outside of a free market, because the government has effectively nullified their relevance. . . .

Full article from Mises here.

I made a blog post on the subject in 2008.

Is President Obama Calling Anesthesiology a "waste"?

2010-02-27T14:57:00.003-06:00

And the real nub of this is how do we wring that waste out, that fraud, abuse, duplication, without interfering with the good care that we want every person on Medicare, Medicaid, and private insurance to get. The average citizen knows this happens. How many times, when you look at your medical bill, you've undergone a minor procedure, and you see Dr. Smith, $4,000, and you sort of vaguely remember he just waved and poked his head in the door?

What kind of doctor would patients vaguely remember as part of their procedure?

What kind of doctor medically directs or supervises other personnel involved in surgical procedures?

What kind of doctor would a patient quickly forget after receiving a bolus of midazolam?

The anesthesiologist.

Does President Obama consider the practice of anesthesiology to be "waste" and "duplication"?

Health Care Reform in Five Easy Steps

2010-02-07T12:47:00.002-06:00

Allow purchase of health insurance across state lines
Eliminate the unfair tax deduction for employer-provided health insurance
Allow balance billing for Medicare/Medicaid
Allow medical underwriting to incentivize healthy living
Increase tax benefits of health savings accounts

Cobra Kai: My Obstetric Sensei

2010-01-30T17:39:00.003-06:00

Medicine in Media: The Fugitive (1993), Complications from Cholecystectomy

2009-12-31T19:39:00.000-06:00

Methanol Toxicity in Antarctica

2009-12-28T16:51:00.003-06:00

An interesting piece discussing the investigation of a South Pole scientist's unusual death.

Extreme social isolation, alcohol abuse, and psychopathology bred a bizarre tale. I was reminded of the X-Files episode "Ice" involving foul-play and paranormal activity at an arctic research station.

Found via Google FastFlip.

Medicine in Media: Terrible Doctoring in "Hot Shots!" (1991)

2009-12-19T17:27:00.003-06:00

Topper: Doctor!
Doctor: What happened?
Topper: Plane crash.
Doctor: I gotta work fast, I got a lunch.
Topper: I think you're missing the big picture here, doc!
Doctor: Nurse, check his penis. Is it longer than mine?
Nurse: Uhhh, no, doctor!
Doctor: Good. Now, this is going to hurt.
Patient: Argh!
Doctor: Nurse, give me 15cc's of morphine quickly!
Topper: Do you think you can save him?
Doctor: Can't be sure. I'm not a very good doctor.
*injection of morphine into doctor's arm*
Doctor: That's good. Thank you, nurse.
(to Topper) You'll have to wait here.
Topper: You going to be alright, buddy?
Patient: I'm in a hospital! What could go wrong?

1000 Awesome Things. #996: Weekend Call

2009-11-22T17:05:00.003-06:00

Your clean wardrobe is all used up for the week, and you have to be in the hospital in an hour. It's an impossible situation until you realize it's Saturday, and you are on weekend call.

Wear those torn jeans and t-shirt to work, sneak into the locker-room to get the hospital-issued scrubs from the machine, and enjoy the bliss of working during the day at the hospital in pajamas.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from SarahMcD via Flickr)

Breast Cancer and Healthcare Rationing

2009-11-22T14:15:00.004-06:00

Breast cancer is a devastating disease, and women in the United States expect to be screened from the disease when they are at risk.

Understandably individual women were shocked when they learned that an authoritative panel is dictating that they should no longer get what they previously expected to prevent them from dying a premature death due to cancer.

This panel is the same panel which has been authorized by Obama's healthcare legislation to give official recommendations for government-approved healthcare plans. The same panel suggestions which will serve the basis for who gets what kind of treatment. A soft death panel, in Dr. Rich's words.

If the government does not approve the cost, the government will not allow it to be covered.

This is exactly how the government will work to deny healthcare coverage to millions of vulnerable Americans. Expect only more of it with Obamacare.

The nightmare of government control is alive in our open eyes.

(Image from euthman via Flickr)

"If you can find your doctor, you can keep him"

2009-11-14T21:30:00.001-06:00

Lego MRI Machine

2009-11-09T12:25:00.005-06:00

Lego MRI Machine from volume render of axial CT scan:

"Some time ago, I built a Lego MRI system as a giveaway for a pediatric radiologist and had it CT scanned later."

The original model on plain color image:
From Flickr user Voxel123.

The Woman Who Swallowed the Canteen

2009-10-29T20:56:00.002-05:00

Margaret Daalman came to hospital complaining of stomach ache - and one glance at her X-ray shows why.

Surgeons in Rotterdam in the Netherlands were flabbergasted when X-rays showed 78 different items of cutlery in the 52-year-old woman's stomach.

They rushed her to surgery in a desperate attempt to remove the dozens of forks and spoons trapped inside her body one by one.

From the Daily Mail.

Obama: Cap All Physician Pay at $100k per year

2009-10-21T15:52:00.005-05:00

WASHINGTON - In a historic move, President Obama signaled Wednesday that physician salaries will be capped at $100,000 per year.

"For too long in this great country, greed has been the cornerstone of American medicine," Obama said on the south lawn. "Doctors care less about patients' well-being than their own pocketbook."

The plan calls for sweeping reform of payment to all physicians who have ever received money from the federal government, from subsidized education loans and residency stipends to Medicare service reimbursements.

"The federal government helped these people out by lending tuition or paying for their specialty training in residency. They ought to give something back to society."

When asked by the press about the specific limit of $100,000 in yearly income, the President responded, "So these 'poor' doctors can't afford a new luxury car every year. That's not hardship." He also stated, "And besides, mom and pop in Omaha, Nebraska with their 3 kids are able to survive just fine on less than $100,000. Doctors should too."

This latest announcement is on the heels of a new White House plan to curb executive pay by as much as 90% at major banking institutions receiving federal aid, capping total compensation at $200,000.

"Greed can exist in many places, but the most critical areas today are with physicians and bankers. That is where we need to start reining it in. They are the problem, the scourge, in today's society."

1000 Awesome Things. #997: Covered Walkways

2009-10-15T17:52:00.002-05:00

There's a hurricane passing through the area, flooding the hospital campus. At that moment you get paged about a patient in the building across the street. You need to see the patient immediately, but you can't wait for the storm to pass.

You decide to take the windowed over-street passageway, which offers a view of the few brave souls at street-level getting soaked. Yours was the path more travelled, and it made all the difference. Not a single rain drop hit your head, sparing you from a damp white coat for the rest of the day.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from Arty Smokes via Flickr)

1000 Awesome Things. #998: Call-Free Weekend

2009-10-15T17:16:00.004-05:00

Q4 call. You survived the torment of the evil weekend: Saturday overnight call, Sunday post-call. Then another full week of work starting Monday.

But you can hold your head high, because you know that sometime in your near future, you will have a Saturday and a Sunday free from your hospital responsibilities. The Golden Weekend.

Turn off that pager. Get out that to-do list. Now you have time to take care of your neglected loved ones.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from Dossy via Flickr)

1000 Awesome Things. #999: Optimal Patient Load

2009-10-15T16:10:00.005-05:00

With too many patients, you feel powerless to do everything for any of your patients. With too few, you feel powerless to do anything for everyone else who might be sick in the world.

But when you hit that sweet spot, you can take care of all of your patients, serving each and every one to the best of your capability, making a difference in the world. You are happy, the patient is happy.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from benuski via Flickr)

1000 Awesome Things. #1000: Assessment

2009-10-12T05:49:00.006-05:00

You discuss the history. You perform the physical exam. Now it comes to the juicy part. All that hard work gets put together, and a few sentences can say it all.

Without it, there is no conclusion and there can be no plan.

With it, medicine works like magic.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from kurtz via Flickr)

Obama: Health Care Plan Would Give Seniors Right To Choose How They Are Killed

2009-10-07T13:55:00.002-05:00

"Let me dispel these ridiculous rumors once and for all and set the record straight: Under my plan, seniors are going to be killed the way they want to be killed, end of story," said the president, who acknowledged that "wiping out" the nation's elderly population has always been his No. 1 priority. "If your grandmother would rather be euthanized in the privacy of her own home than be gutted and hanged on a high school soccer field, she is entitled to that right."

Humor is best served with a sprinkle of truth.

From The Onion.

Obama and Car Insurance Mandates

2009-09-26T13:17:00.004-05:00

Some people, including Obama, claim that car insurance mandates are the same as health insurance mandates.

The big issue with that is that the mandates for car insurance are only for 3rd party damages, i.e. only for damages to the other driver's car. Car insurance for your own car is optional and not mandated.

If Obama continues to use the car insurance mandate comparison, he should propose mandates for health liability insurance in the event of causing sickness to 3rd parties.

Of course, that is nonsense.

Chicago Cop Arrests Nurse

2009-09-21T14:12:00.001-05:00

From Chicago:

Lisa Hofstra was the nurse in charge of the emergency room at Illinois Masonic about 4 a.m. on Aug. 1 when she said an officer named Rodriguez asked her to take blood samples from a man to determine his blood-alcohol level, according to a lawsuit filed in federal court. Hofstra allegedly told the officer the man had to become a patient first and she wanted to consult with her supervisor. The officer cuffed her and placed her in the back of a squad car, according to the lawsuit.

Surgical Videos from the 1930s

2009-09-17T16:54:00.005-05:00

Cesarean Section:

Prefrontal tuberculoma:

Ovariotomy:

Fractured clavicle:

Aseptic technique:

Tonsillectomy:

Indirect inguinal hernia repair:

No American Should Have to Choose Between Health Insurance and Alcohol

2009-09-11T13:40:00.000-05:00

Obama selects Trial Lawyer to head Tort Reform

2009-09-10T16:04:00.002-05:00

There are credible estimates that serious tort reform could save the country between $100 and $200 billion annually in wasteful spending, as doctors practice defensive medicine to preempt lawsuits. … Now Obama says he’s going to study the issue. “I am directing my Secretary of Health and Human Services to move forward on this initiative today,” he said.

That would be Secretary of Health and Human Services, Kathleen Sebelius, whose resume includes eight years as director of the Kansas Trial Lawyers Association.

So Obama has chosen a former industry lobbyist to run tort reform.

Why are people cynical about health care reform?

From the Weekly Standard.

Glass Microbiology

2009-09-08T20:31:00.003-05:00

Glass Microbiology.

SARS coronavirus pictured above.

Stossel: Moral Hazard in Health Insurance

2009-09-02T18:08:00.001-05:00

Destruction of the Great American Experiment

2009-09-02T06:15:00.003-05:00

DrRich explains the destruction of the Great American Experiment.

. . . So when the healthcare reform process began, yet again, with the presentation of a 1000+ page bill and the exhortation to pass it immediately - don’t bother reading it - on account of the dire crisis confronting our healthcare system, DrRich had seen enough. When that “pass-it-quick-it’s-an-emergency” strategy failed for once, and people began reading the monstrosity and reacting to it (as the Constitution provides that they may), and when in response our leaders accused them of being fascists, terrorists, mobsters, and other disturbing things, DrRich had seen enough. When DrRich read big parts of the reform bill himself, and realized that it is an intentionally ambiguous document whose effect will be to turn over the re-shaping of our entire healthcare system to appointed functionaries, czars, and other unelected bureaucrats, DrRich had seen enough. . . .

The Economic Fallacy of Government-created Wealth

2009-08-31T15:53:00.002-05:00

Thanks to Carpe Diem.

"Stridor" in Lord of the Rings

2009-08-30T09:26:00.003-05:00

The Lord of the Rings character "Stridor" is known for his high-pitched expiratory wheezes. What a dangerous fellow he is.

[YouTube]

Involuntary Medical Servitude

2009-08-26T18:47:00.004-05:00

To claim that any government plan now proposed could give people more choices requires that the listener ignore the fact that a vast destruction of options has already occurred and that one's choice is limited to what is left.

Insurance companies are not the villains. No insurance company today has the power to limit the availability of care. An insurance policy for healthcare is a contract between an individual and the policyholder to provide payment for care. It cannot ration care. The coverage and types of policies available today are limited by government requirements, not by the free market.

Over at the Mises Institute.

Decreasing Costs through Tort Reform

2009-08-19T05:41:00.004-05:00

If Obama were truly serious about decreasing healthcare costs, he would enact tort reform overnight.

Unfortunately, he is not. And he will not.

Liberal Health Reformers versus Conservative Health Reformers

2009-08-14T13:30:00.002-05:00

Why is "health care reform" equated with socialization of medicine? If I am against socialism, does that mean that I am an opponent health care reform?

Why has the vocabulary of debate been so narrowed that the phrase "health care reform" is equated with a single radical proposal developed by the Obama Administration?

Health care reform can be many things.

It can mean reforming Medicare and Medicaid to reduce the perversion of markets that they cause.
It can mean reforming and eliminating the tax benefits of health insurance provided by employers which has resulted in the absurd obligation of health insurance being tied to a particular employer.
It can mean reforming and eliminating price-fixing by the federal government which has resulted in cost shifting onto private insurers.
It can mean returning to a system where individuals more closely realize the costs of treatment, thus reducing moral hazard.
It can mean legalizing medical underwriting so that individuals who engage in risky behavior and poor habits more directly realize the costs of their personal actions.
It can mean decreasing the burden on inefficient government bureaucracy, allowing individuals and employers to have more income, and more money to spend taking care of themselves and providing for the health of their families.

Health reform can be many things, and there are right ways and wrong ways of going about it.

Why do some claim that socialism and big government are the only options for reform?

I am a proponent of health care reform. I just do not believe that socialism is the answer.

Amputations for Profit

2009-08-14T06:04:00.003-05:00

According to Obama, surgeons are paid $30,000-$50,000 for a single amputation.

"If a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that's 30,000, 40, $50,000 immediately the surgeon is reimbursed. But why not make sure that we're also reimbursing the care that prevents the amputation? Right? That will save us money."

From the American College of Surgeons:

“Surgeons are not paid $30,000 to $50,000 to amputate a diabetic’s foot. Medicare pays a surgeon, on average, from $541.72 to $708.71 for one of two procedures involving a foot amputation.”

Rationing, according to White House Adviser Dr. Emmanuel

2009-08-10T17:15:00.003-05:00

From a paper by Dr. Ezekiel Emmanuel, adviser to President Obama.

Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multi-principle allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years.
We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles.

Dr. Obama: The New Face of Clinical Decision-Making

2009-08-10T14:44:00.005-05:00

Does this week's Time Magazine cover insidiously mock Dr. Obama's absurd desire to decide clinical matters for patients with special consideration for what is best for the federal government, or does it daftly intimate Time magazine's illogical support for such a ridiculous plan to ration healthcare via government bureaucracy?

August 10, 2009.

Please Report Any Criticism of Healthcare Reform!

2009-08-06T07:43:00.003-05:00

From the White House.

There is a lot of disinformation about health insurance reform out there, spanning from control of personal finances to end of life care. Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov.

If there has been any criticism of President Obama's healthcare reform, even from this very blog, please email the White House directly.

Your efforts will ensure that only a single, unified voice is heard so that the reform process can proceed without caution.

It is extremely important that there is no debate in such a critical issue as the upheaval of our $2.4 trillion healthcare system.

Is Home Ownership a Right?

2009-08-05T06:50:00.003-05:00

Is home ownership a right?

Is an Ivy League college education a right?

Is air conditioning a right?

Is winter heating a right?

Is a 4-door-sedan a right?

Is a pediatrician's medical service a right?

Is an appendectomy a right?

Is having a job a right?

Is making $20/hour a right?

Is a paid 2 week vacation a right?

Is a retirement account a right?

At what point is it right to take someone else's property to secure any of the above?

The Path to Socialized Medicine in America

2009-08-04T12:27:00.001-05:00

Obamacare's Future and Cash for Clunkers

2009-08-03T18:30:00.004-05:00

The "Cash For Clunkers" program, with a budget of $1 billion, exhausted its funds 13 times faster than expected. It went bankrupt last week, yet was expected to last until November.

Limited budget. Limited supply. Massively-unexpected demand.

Massive shortages.

Rationing.

This is the future of healthcare in America under Obama's Public Option.

If the government can not handle a $1 billion program, how can it handle a $2.4 trillion segment of the economy?

Saying one thing, doing something else

2009-08-03T17:10:00.002-05:00

Government-based Medicine

2009-07-24T05:21:00.004-05:00

We wanted to make sure that doctors are making decisions based on evidence, based on what works. That's not how it's happening right now. Doctors are forced to make decisions based on a fee payment schedule that's out there. So they're looking... if you come in with a sore throat or your child comes in with a sore throat, has repeated sore throats, a doctor may look at the reimbursement system and say to himself, "I'd make a lot more money if I took this kids tonsils out." Now that might be the right thing to do, but I'd rather have that doctor making those decisions based on whether you need your kids tonsils out or whether it might make more sense to change, uh, maybe they have allergies or something else that would make a difference. So part of what we want to do is free doctors, patients, hospitals to make decisions based on what's best for patient care.

Translation:

Obama prefers the government, not the physician, deciding who should get what medical treatment. All physicians do not have their patients' best interests in mind and they would rather forsake their ethical duties as physicians and put their patients at risk unnecessarily than to do what is best for the government. Even if a procedure is medically indicated and will help the patient substantially, Obama wants to have a mechanism of interjecting himself into the decision-making process to prevent what he defines as greed-based medicine. Physicians are evil and do not deserve the right to practice independently.

Private Health Insurance is Dead

2009-07-21T16:45:00.002-05:00

From Section 102 of HR 3200 "America's Affordable Health Choices Act of 2009":

Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.

The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.

It is over. The death-knell of private health insurance has been rung.

Say good-bye to your health insurance.

Say hello to government control of your healthcare decisions and options.

(Image from Eqqman via Flickr)

Lego Visualization of Obama's Healthcare Plan

2009-07-13T16:27:00.001-05:00

Sick in America: 'Free' is good?

2009-07-08T19:05:00.002-05:00

From ABC News online:

Is the "free" Canadian healthcare system good for America?

If you can't take the heat, stay out of the kitchen

2009-06-26T16:12:00.002-05:00

Devinsky asked the president pointedly if he would be willing to promise that he wouldn't seek such extraordinary help for his wife or daughters if they became sick and the public plan he's proposing limited the tests or treatment they can get.

The president refused to make such a pledge, though he allowed that if "it's my family member, if it's my wife, if it's my children, if it's my grandmother, I always want them to get the very best care.

Filed under: Force onto others that which you do not want yourself.

What would you like to say to future physicians?

2009-06-23T19:28:00.004-05:00

Dear Future Physicians of America,

You will soon be recognized by the public as the leading experts in all things medical. Experts in diagnosis and in treatment. Experts within your specialty.

Transformation into a medical expert required you to devote not just a few hours to studying the pathological.

You have lived and breathed it.

You have spent enormous amounts of time in pursuit of a deep understanding of biochemistry, pathology, microbiology, immunology, psychopathology, pharmacology, anatomy, internal medicine, surgery, pediatrics, obstetrics.

What time have you spent studying the pathology or treatment of our healthcare system's ills?

Just as it is a failure of medical education for a physician to be ill-equipped in any of the above areas, it is also a failure for a physician to know nothing of healthcare's greatest faults and its best solutions.

"How do bank lending rates contribute to overuse of diagnostic testing and procedures?"
"How does a billing system cause increasing numbers of Americans to be on Medicare and Medicaid?"

A policy-maker could require and trust your expertise about a disease process, and you are capable of offering it.

Why can he not rely on you to discuss the systemic causes of problems ailing your medical practice?

Are vague references to malpractice insurance premiums and insurance companies your only reply?

There is no better time than now to seek a deeper understanding of the flaws of the American healthcare system.

Become the expert the public expects you to be.

Healthcare Concept Map, Updated

2009-06-22T11:25:00.009-05:00

Step 1 of USMLE is over at last. Thank God. For my contribution in celebration of this momentous occasion before rotations, I have updated the Healthcare Concept Map, the single most popular post I have ever written. Click the image above to see the updated concept map.

Please feel free to add your own observations or recommendations in the comments section or by email.

GM as the Public Option to compete against Toyota

2009-06-16T10:29:00.006-05:00

If Government Motors (GM) ran like the Public Option to "compete" against Toyota...

GM receives taxpayer money to subsidize car cost
Toyota receives no government subsidy

Toyota cars must have same features as GM cars

Mandates require every employee to have a car paid by employer
Mandates require every American to have a car

Employers and individuals compare prices of subsidized GM cars versus non-subsidized Toyota cars in "Online Car Purchase Exchange"

Toyota dealerships must stock and sell GM cars, even if Toyota loses money on each GM car sold

If Toyota has a market advantage over GM, the government will legislate the advantage away from Toyota
If GM needs an unfair advantage over Toyota, the government will legislate the unfair advantage

Toyota must generate revenue in excess of cost of business, or risk failure with no hope of government-provided funds
GM does not need to be profitable, since the government will always bail it out (e.g. Amtrak)

The end result: Toyota goes bankrupt and Government Motors (GM) is the only company left.

Since the government can not afford to subsidize GM at current rates forever, it cuts costs and features, rations who can get what kind of car, and outlaws any competition (e.g. Amtrak).

"Choice of Doctors" = Mandatory Physician Participation in Public Health Option?

2009-06-16T09:29:00.004-05:00

When Obama speaks of the public option having a "free choice of doctors", is this an omen of legislated compulsion of physicians to participate in the public health option, with the consequent "or else" clause?

It makes a lot of sense.

Politically, this is how it could play out: when opponents decry the "mandatory physician-participation" legislation, Obama retorts with "my opponents are against free choice of doctors. They do not want you to have the doctor you want."

Mandatory participation is absolutely necessary for success of the public option; failure to require it will cause the public option to suffer the same fate as Medicare and Medicaid in the decreasing number of physicians participating in the plan: Two-thirds of physicians will not take new Medicare patients, and half of all physicians do not participate in Medicaid.

How would Obama compel physicians?

Threaten physicians with revoking of license if they choose not to participate
Require all physicians who apply to residency in the U.S. to accept the public option
Institute steep tax penalties for physicians who do not participate.

(Image from william.k via Flickr)

Would the public plan have access to taxpayer funds unavailable to private plans?

2009-06-06T16:06:00.001-05:00

If the answer is yes, then the public plan would not offer honest competition to private plans. The taxpayer subsidies would tilt the playing field in favor of the public plan. In this case, the whole idea of a public option seems to be a disingenuous route toward a single-payer system, which many on the left favor but recognize is a political nonstarter.

Greg Mankiw investigates "competition" among healthcare plans of the future.

Quote of the Week

2009-05-31T13:51:00.002-05:00

"Everything's peaches and cream when it's an easy day, with healthy patients, but sometimes it's extremely sick patients on the verge of death, or a complicated surgery where they're losing blood, and you're praying they're going to come through alive."

Filed under: Inadequate Depth of Training.

I would have hoped that the person in charge of the well-being of patients under anesthesia could handle both easy and challenging patients without violating the limits of their formal training.

Language of Medical Socialism: Reimbursement

2009-05-31T11:44:00.001-05:00

Do lawyers receive reimbursement for their services?

Do cab drivers receive reimbursement for their services?

No, these individuals receive payment according to what they bill.

Only in a socialist healthcare system does a physician slavishly beg the government or insurance companies to be reimbursed for the expenses in providing services to patients.

It is the very language of the healthcare debate which frames the stratification of power:

As it is now, the government is in control: it is the one who mercifully decides who shall receive reimbursement and who shall be denied.
The physician is the slave, powerlessly unable to charge for services rendered and to be paid according to that bill. It must accept whatever the government gives: take it or leave it.

It is at this point which physicians must fight to ensure freedom from domination by government bureaucrats.

Step one: fight for the right to balance bill patients who use government-provided insurance.

Guaranteeing the right to "payment" --not reimbursement-- for services rendered is critical in avoiding the perils of socialized, bureaucratic medicine.

Hyperkulturemia

2009-05-23T19:56:00.007-05:00

I am fascinated with Stendhal syndrome. It is defined by the medical journal, Wikipedia, as:

a psychosomatic illness that causes rapid heartbeat, dizziness, confusion and even hallucinations when an individual is exposed to art, usually when the art is particularly 'beautiful' or a large amount of art is in a single place. The term can also be used to describe a similar reaction to a surfeit of choice in other circumstances, e.g. when confronted with immense beauty in the natural world.

Dr. Graziella Magherini, a psychiatrist in Florence, coined the term as she began diagnosing dozens of tourists who were somatically overwhelmed with the artistic gravitas of the city.

There likely exists a spectrum to the "illness" described above, much alike the near-entirety of a psychopathological catalogue.

Most people do not vaso-vagal themselves to the floor while viewing Water Lilies.

Of the rest, who is to say that he has never been awed by natural beauty, even to the point of corporally feeling that amazement?

When viewing the greatness of the Grand Canyon, does not the heart flutter and twitter, saying "at Grand Canyon, AZ. WOW! just skipped a beat"?

Does one off-handedly contemplate the origins of physical reality, and yet arrive at "something does come from nothing"?

Does not one suffer from nocturia while absorbing the cosmic radiance of a trillion-billion astral bodies on a clear summer evening?

To the contrary, is it instead pathological to be bereft of a heart which dares not be stirred up by evidence of immense power outside of human grasp?

------------------------
Hollywood often destroys the perception of legitimate medical conditions.

Italy is far worse.

There, the syndrome was even made into a debauched film. I have not seen it and I will not recommend it. However, if your soul is wrestling with the "psychosexual mire the way [the director] does" as one reviewer states, you might be in luck.
------------------------

Perhaps those who suffer the spectrum, that is to being overwhelmed with greatness outside themselves, are indeed pathological.

Or perhaps it is the psychiatrist in Florence at fault, failing to thrive by failing to realize that she lives in an environment littered with tangible evidence of hundreds of years of art, history, natural progression, but most importantly, hundreds of years of her non-existence.

Doctor saves boy's life with power drill

2009-05-20T10:52:00.003-05:00

My favorite quote from this story: "Dr Carson told me all he can remember saying is, 'Get the Black and Decker'."

Nicholas Rossi suffered bleeding to the brain and began drifting in and out of consciousness after falling from his bike near a friend's home in Maryborough, Victoria.

After realising the local hospital did not have the necessary surgical equipment, Dr Rob Carson used a drill from the maintenance room to bore into the boy's skull and relieve the pressure on his brain.

He was given advice on the phone by leading Melbourne neurosurgeon David Wallace.

Michael Rossi says his son would have died if Dr Carson had not acted quickly.

Full story here.

One Step Solutions (Part 4 of many)

2009-05-15T14:56:00.003-05:00

How do you eliminate costs from the healthcare system in One Step™?

Abolish the use of healthcare resources by anyone, punishable by death.

Why?

If users of healthcare resources are executed by the government, hospital re-admissions will decrease, and Medicare will be happy
Everyone who does not receive healthcare is cared for equally, and making sure some people do not receive more healthcare than others is crucial to a just society
Comparative Effectiveness Research proves that not a single intervention exists today which prevents mortality over the life of a patient

Why will it happen?

A top priority of the government is to decrease healthcare costs
The above plan decreases healthcare costs by the maximal amount possible
The president's goal that everyone should suffer equal amounts is achieved, as well as his similar goal that those who suffer less than others must be vilified and punished
Comparativeness Effectiveness Research is an excellent non-personal means to deny healthcare resources to individuals

I am hopeful that this will come to pass. Finally, healthcare costs will be controlled.

Eagerly expecting the FREE=MORE Public Option

2009-05-13T19:20:00.003-05:00

I can hardly wait for the FREE=MORE public option for health insurance.

I admit, I don't spend any money on healthcare right now.

But, once I get a slice of the action courtesy of the taxpayer-funded public option, I'll finally get that fancy CT/MRI imaging test that I deserve. I need to rule out any possible disease that can afflict a healthy individual, followed up with more specific tests. A false positive is still a positive, ain't it? Gotta be sure it's not something serious.

I will finally have the freedom to get stuff I want without worrying about the cost.

This is why I love socialism.

I get lots of stuff, and then I can just take money from other people to pay for it!

Massachusetts is a Disaster

2009-05-07T08:25:00.003-05:00

Times are tough in the Bay State. In today's Boston Globe is an article discussing the consideration for moving to a glorified capitation system in that state to curtail rising healthcare expenditures.

Legislators created the commission last year, directing it to identify ways to slow soaring healthcare costs in Massachusetts, where spending is growing by more than 8 percent annually, driven largely by the high price and heavy use of hospitals. The members began meeting in January and said they quickly reached consensus that the best way to do this is for the state to move toward dismantling the fee-for-service system, which Massachusetts private insurers use to pay more than 80 percent of doctors and nearly all hospitals.

The unintended consequences consistently bury these proposals:

Physicians leaving the state or going to cash-only practices to avoid practicing actuarial science instead of medicine
Physicians leaving the state because they are unable to protect themselves against excessive litigation while remaining within the budgetary goals set by state bureaucrats
Patients being burdened in finding one of the few physicians within the state who will take government insurance
Patients not getting the care they need or deserve because of financial restrictions from the state
Physicians who practice medicine not according to what the patient needs but by the dollars taken from the budget

Capitation and budgeting just do not work. The only happy party from this proposal is the state government, which will be able to do less and pay less than it had earlier promised its citizens. Patients and physicians will suffer under the crushing burden of the state budget.

The Problems of Doctors Opting Out

2009-05-07T07:52:00.003-05:00

This opinion piece by Marc Siegel points to the problem of the government not forcing physicians to take government insurance.

Bottom line: None of the current plans, government or private, provide my patients with the care they need. And the care that is provided is increasingly expensive and requires a big battle for approvals. Of course, we're promised by the Obama administration that universal health insurance will avoid all these problems. But how is that possible when you consider that the medical turnstiles will be the same as they are now, only they will be clogged with more and more patients? The doctors that remain in this expanded system will be even more overwhelmed than we are now.

It is indeed possible, if only the government uses financial, legal, or political punishment on those who refuse to acquiesce.

Hypothetical Situation #2: Obama Administration Threatens Physicians with Retribution if Demands Are Not Accepted

2009-05-06T15:52:00.008-05:00

Earlier this week, it came to light that the Obama Administration allegedly used mafioso-style tactics (audio interview) in order to get its way in negotiations with creditors of Chrysler.

The following confirmed statement was made by Thomas Lauria, an attorney representing several firms in the bankruptcy negotiations and also a fervent financial supporter of the Democrat Party:

Lauria: One of my clients was directly threatened by the White House, and in essence compelled to withdraw its opposition to the deal under threat that the full force of the White House press corps would destroy its reputation if it continued to fight. That's how hard it is to stand on this side of the fence.

Beckmann: Was that Perella Weinberg?

Lauria: That was Perella Weinberg.

An alleged and unconfirmed statement made by Steven Rattner, an Obama Administration official, was relayed to a blog:

Who the [expletive deleted] do you think you're dealing with? We'll have the IRS audit your fund. Every one of your employees. Your investors. Then we will have the Securities and Exchange Commission rip through your books looking for anything and everything and nothing we find to destroy you with.

With the negotiation tactics of this White House Administration slowly being revealed, how does this help us to understand how future negotiations between healthcare reformers and physicians will turn out?

There are several options that the Obama Administration has at its fingertips to effect real change in healthcare. If similar strong-handed tactics will be used when dealing with physicians, the following are decent possibilities:

Institute "All-or-None" negotiations. Either physicians and medical societies accept the White House's healthcare reform proposal at face value, or retribution will ensue.
Sic the IRS to audit any physician who refuses to take government insurance.
Prevent any physician from getting a medical license if he or she refuses to take government insurance.
Prevent any physician from getting a DEA number if he or she refuses to take government insurance.
Mount a public campaign, through use of the White House Press Corps, to smear any medical professional society which refuses to acquiesce to the Obama Administration's demands for its desired change in healthcare policy.

The following are offered up for further discussion:

Is the use of these kinds of tactics by the White House improbable outside of bankruptcy negotiations involving an American company?
Will the Obama Administration not use similar tactics in negotiations with physicians when it comes time to allocate $2.4 trillion in healthcare resources?
How does the case with Chrysler's creditors change the American people's perception of the ethical ways of governments dealing with private individuals in negotiations?
How does the Obama Administrations actions diminish the "right to contract" and the "right to private property"?

(Image from william.k via Flickr)

The Doctor is OUT

2009-05-01T07:23:00.002-05:00

Cartoon by Eric Allie.

Swine Flu in 1976

2009-04-29T15:28:00.001-05:00

It's All About Perspective

2009-04-28T18:07:00.002-05:00

[from: Heritage Foundation and JT]

Drinking from a Urine Specimen Container

2009-04-24T12:30:00.002-05:00

Sounds delicious.

Primetime Drama: Transported transplant heart eaten by dog

2009-04-24T08:29:00.002-05:00

American television writers have officially run out of ideas.

FDA Approves Depressant Drug For The Annoyingly Cheerful

2009-04-13T08:19:00.001-05:00

Anonymous Hero Donates Hospital 200 Human Kidneys

2009-03-31T16:23:00.001-05:00

The Obama Healthcare Plan

2009-03-31T07:48:00.003-05:00

The Wall Street Journal analyzed Obama's plan through the lens of his model: Massachusetts. The result is hardly encouraging:

What really whipped along RomneyCare were claims that health care would be less expensive if everyone were covered. But reducing costs while increasing access are irreconcilable issues. Mr. Romney should have known better before signing on to this not-so-grand experiment, especially since the state's "free market" reforms that he boasts about have proven to be irrelevant when not fictional. Only 21,000 people have used the "connector" that was supposed to link individuals to private insurers.

Which brings us to Washington, where Mr. Obama and Congressional Democrats are about to try their own Bay State bait and switch: First create vast new entitlements that can never be repealed, then later take the less popular step of rationing care when it's their last hope to save the federal fisc.

The idea that spending more (Obama calls this "investment") for medical care will result in less money spent later is utter foolishness. When will America wake up to the fact that Obama is thrusting an immense burden onto the languishing backs of generations upon generations of future Americans?

The Colorectal Surgeon Song

2009-03-20T18:20:00.001-05:00

What is wrong with Congress?

2009-03-20T14:35:00.001-05:00

It is shocking that these are the kinds of people who will "reform" healthcare in America.

Obama set to charge wounded war veterans for VA care

2009-03-16T19:18:00.004-05:00

"It became apparent during our discussion today that the President intends to move forward with this unreasonable plan," said Commander David K. Rehbein of The American Legion. "He says he is looking to generate $540-million by this method, but refused to hear arguments about the moral and government-avowed obligations that would be compromised by it."

At the price of sacrificing a system which many injured war veterans rely on for medical care, Obama is set on covertly moving to single-payor by shifting costs away from an established government structure, which is the Veterans Administration, to private insurance. As the VA healthcare model is phased out, there will be one fewer choice for provision of government-provided healthcare. When private insurance is out-priced by the government-provided plan according to Obama's vision, government healthcare will be whittled down to a single bureaucracy which will be the sole provider of healthcare in this country.

Which structure will it be? Only time will tell.

As it is now, the VA will not be the viable government healthcare program.

Too cute

2009-03-15T21:13:00.003-05:00

Pro-choice: Against slavery? Don't buy one.

2009-03-14T18:31:00.004-05:00

"If you don't want a slave, don't buy one. But don't you dare tell me how to live my life. If I want a slave, I have every right to get one."

Obama on Stem Cells: Morally Unserious in the Extreme

2009-03-13T20:04:00.001-05:00

Insight from Charles Krauthammer:

Obama's address was morally unserious in the extreme. It was populated, as his didactic discourses always are, with a forest of straw men. Such as his admonition that we must resist the "false choice between sound science and moral values." Yet, exactly 2 minutes and 12 seconds later he went on to declare that he would never open the door to the "use of cloning for human reproduction."

Does he not think that a cloned human would be of extraordinary scientific interest? And yet he banned it.

Is he so obtuse not to see that he had just made a choice of ethics over science? Yet, unlike President Bush, who painstakingly explained the balance of ethical and scientific goods he was trying to achieve, Obama did not even pretend to make the case why some practices are morally permissible and others not.

This is not just intellectual laziness. It is the moral arrogance of a man who continuously dismisses his critics as ideological while he is guided exclusively by pragmatism (in economics, social policy, foreign policy) and science in medical ethics.

Anti-Choice

2009-03-09T12:27:00.003-05:00

Is it any longer possible for Obama to call himself "pro-choice" if he has declared himself to be anti-choice, that is, to prevent physicians from choosing not to participate in abortion?

Sensational Health Reporting

2009-03-02T17:48:00.005-06:00

BREAKING NEWS:
Two hospital patients with bacterial infections die.

Found here.

I'm Not One Of Those Fancy College-Educated Doctors

2009-02-23T13:45:00.002-06:00

I'm a doctor, and I'm damn good at it. Why? Because I learned to be a doctor the old-fashioned way: gumption, elbow grease, and trial and error. I'm not one of these blowhards in a white coat who'll wear your ears out with 10 hours of mumbo-jumbo technical jargon about "diagnosis" this and "prognosis" that, just because he loves the sound of his own voice. No sir. I just get the job done.

Those fancy-pants college-boy doctors are always making a big deal about their "credentials." But I'm no show-off phony with a lot of framed pieces of paper on the wall—I'm the real deal. I got my M.D. on the street. These people think they're suddenly a "doctor" because they memorized a lot of big words and took a bunch of formal tests. But there's plenty of things about being a doctor they'll never learn in their ivory-tower medical school.

For example, did you know that human intestines, if they spill out of the abdomen during surgery, can spool out all over the floor if you're not careful? You won't find that in a book, my friend.

Read the rest here.