Roger L. Simon: Health Care Thread
Mr. Simon (a for-real author in addition to blogger) has started a thread about health care, with its attendant problems of cost, access, and not just a little about whether medical care is a “basic right” like freedom of speech. As of this posting, the commenters seems to be on a roll, with civilised and reasonable debate. I haven’t seen any answers that are new yet, but that’s not the point.

It makes for good reading to see what a group of intelligent non-medical people think on the issue.

thanks to reader Jim for the tip

A Fisking. Or, a commentary, depends upon your viewpoint. You have been warned.

Yahoo! News – Condom Mishaps Spell Trouble for Men

Silly title. Whenever do men use condoms as a solo act?

FRIDAY, Sept. 17 (HealthDayNews) — A new study of people who visited a Colorado sexually transmitted disease clinic found that about half of those who regularly used condoms reported mishaps ranging from breakage to slippage.

The condom problems spelled trouble, at least for men. The risk of gonorrhea and chlamydia grew by several times among the heterosexual men who reported condom “errors.” For reasons that aren’t entirely clear, condom problems didn’t translate into higher risks for heterosexual women or gay men.

Think about that one for a second, while reading on.
Read the rest of this entry »

One of the reasons I went to the Movable Type 3.11 was to have the MT Blacklist plugin, which works pretty well. The nice thing about the 3.11 version is that it would update automatically, instead of daily cut-and-pasting.

This morning I found that the decision was well worth it: my logs show that I had OVER 400 comment spams blocked automatically overnight (and all from 2 IP addresses, which are now banned at the server).

Anyway, the plugin works very well, and I highly recommend it.

The Cellar Image of the Day
The first is most impressive to me: section on section of overwater bridge upset from its pilings. There’s a truck on the bridge to assist with scale (and to give some truck driver religion, no doubt).

There is going to be one really amazing bill for the reconstruction.

And, If you need a political fix (not my thing on this blog, yet), just scroll down into the comments to see why this is happening.

HoustonChronicle.com – Sept. 21, 2004: Texas’ largest medical liability insurer cuts rates

Drop is second since jury award cap was imposed
Associated Press

AUSTIN – Texas’ largest medical liability insurance provider said Monday it will cut its rates by 5 percent starting in January.
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The drop by the Texas Medical Liability Trust, or TMLT, comes on top of a 12 percent decrease the company implemented last January, after a new law and state constitutional amendment allowed a cap on jury awards and limited insurance companies’ liability.

“If you think about it, that’s a 17 percent reduction in rates in just a year, and I think what’s more important than that, that’s over $34 million of savings to TMLT’s Texas physicians in a single year,” TMLT president and CEO W. Thomas Cotten said during a Capitol news conference.

WooHoo! Great news!

Except…

TMLT had raised its rates by 147.6 percent between 1999 and 2003, according to the Texas Department of Insurance.

Lt. Gov. David Dewhurst also attended the news conference and used the occasion to praise the medical malpractice reform law.

Dewhurst said the medical malpractice insurance market has stabilized and 13 new insurance companies have entered the Texas market.

TMLT, however, is the only major company that has reduced rates since the new law was approved. Dan Lambe, executive director of the consumer advocacy group Texas Watch, said that TDI data showed that doctors statewide have seen less than a 4 percent drop in premiums since the bill was approved. That is not the meaningful relief that doctors were promised, Lambe said.

Beats another 147% increase!

TDI data shows that Texas doctors covered by the top four insurers paid $396 million in total premiums before September 2003 and now pay about $383 million.

TMLT said it represents about 12,000 doctors, serving 48.2 percent of the available physician market in Texas.

They insure me, so I just got a raise.

via MedPundit

PointofLaw.com | PointOfLaw Featured Discussion

We’re excited to have a special Election 2004 featured discussion by hosting two contributors who are very well-versed in the topic of tort reform but come down on the opposite sides of the political fence. Dr. Ron Chusid, founder of Doctors for Kerry, and our own Ted Frank, a Bush supporter, will make the case for their respective candidates.

Politics makes strange bedfellows: the pro-Bush/Cheney argument on health care is being made by a lawyer, and the pro-Kerry/Edwards side is being advanced by a physician.

They’re apparently planning a rolling debate on this topic through the week, and it’ll be interesting to read.

CNN.com – Doctor starts ‘Mothers Against Meth’

CHATTANOOGA, Tennessee (AP) — Dr. Mary Holley has witnessed the ravages of methamphetamine.

As an obstetrician in Albertville, Alabama, she estimates about 10 percent of her pregnant patients are addicted.

One was “high as a kite. Comes in dilated 9 centimeters. She is pushing out her baby. I am trying to get the clothes off this woman so I can deliver this baby and a gun falls out of her bra,” Holley said.

But the methamphetamine epidemic in Appalachia has now become a personal crusade for Holley: Four years ago, her brother Jim shot and killed himself after a struggle with meth addiction.

“After he died, I started looking into it as a physician, as a scientist,” Holley wrote on her Web site. “What is this drug that destroyed his life in just two years?”

A photo of her brother appears on the Web site for Mothers Against Methamphetamine, or MAMa, a Christian ministry that Holley founded last year to fight the drug.

For the record, I’m against meth use. I’m more and more a conservative (but real world libertarian) as I age, but meth will always stay on my list of “for your own good” drugs.

As an EM resident I saw a lifetime of methed out patients. Gooned out, hypertensive, unable to focus, injured-but-unable-to-feel gooned out. While living in Fresno I got the crap scared out of me by a passenger in a car who was screaming at me. Because I was there, I guess. After another year I realized he was high on meth, and I was just there.

Second only, in my ER estimation, to heroin is meth in addictive qualities. Meth mouth is diagnostic, and unmistakable, like a half-dozen skin-popping abscesses.

I hope their cause does some good, I really do.

Today was power outage day.

My entire corner of town had an interesting little penomenon: intermittent power outage. Repeatedly.

Starting early in the morning, we’d have 5-15 minutes of electrical power, followed by 20-40 minutes of no power. Then back on. Rinse, repeat.

In my home, with all the computer gear necessary to control the worlds’ satellites keep me entertained, the screeing of uninterrupted power supplies (UPS’s) was enough to wake me from the dead, every time the power went out. They’d just bleat their little sirens out and die of power loss just in time for the power to come back on and recharge them. Then, guess what? Whammo, power’s out and the scree soundtrack resumes. Not a good way to sleep.

I’m trying to sleep because working an evening shift. Evening shift means (ideally) being rested when I go to work. Not today. I went to work, but with the soothing sounds of screeing UPS’s in my ears.

Thanks, TXU. I should bill you for my time.

Last April, during the Iraqi invasion, I was watching MSNBC and saw one of my former corpsmen on TV. He made me proud of him and those like him, and I blogged about him at the time.

Last night, he found me through that entry here! My then HM3 Joe Gallardo is now HM1 Gallardo, and is an Independent Duty Corpsman (think PA school focused on the active duty person). He sent me the picture that accompanies this post, and that’s him in Iraq.

He also bragged on his family, three good looking kids, one on the way, and a spouse strong enough to raise a family and support a Navy man. I hope to hear more about him in the future, as his is as bright as I can imagine.

I said it then, and I’ll keep saying it: I’m glad he, and others like him are out there for us.

Sorry, another test before I use this for an actual post. Getting my cron job syntax down has not been as easy as I would have thought.

For those using MT 3.11, here’s the syntax that worked for me:

cd www/cgi-bin/mt; ./tools/run-periodic-tasks

Kevin, M.D. – Medical Weblog
I’m not very good about linking to new blogs. The ones with the pics over in the sidebar are daily reads (yes, all of them, I have no life). Also, I’ve linked to “new” blogs before that died quick, abandoned deaths, so I’m not in a hurry to link to medical blogs.

With that big buidlup, the aforementioned Kevin, M.D. is very good, and has been on a roll for a good while. I have a couple of others I need to add (email me if you’re reading and think I’m ignoring you), and eventually I’ll get around to adding Kev’s pic in the sidebar.

Welcome aboard, Kevin!

TheAgitator.com: Underage Drinking. And MADD-Bashing.: Comments

Middlebury College President John M. McCardell, Jr., in yesterday’s New York Times

To lawmakers: the 21-year-old drinking age is bad social policy and terrible law. It is astonishing that college students have thus far acquiesced in so egregious an abridgment of the age of majority. Unfortunately, this acquiescence has taken the form of binge drinking. Campuses have become, depending on the enthusiasm of local law enforcement, either arms of the law or havens from…

This is a very well put together rant, and expresses my feelings fairly closely.

This fits in with another rant that has always bothered me, that of the 21 drinking age with the troops. It makes little sense to me that an 18 year old can drive a tank, fire artillery, kill for his country and possibly lose his own life, but demon rum must not pass his lips until he’s 21. That’s just absurd paternalism. (The one good thing that came about from it, ‘it cuts down on fights in the barracks’, is not a good enough reason to abridge rights).

Do not write and lecture about drunk driving. I’m an ER doc, and I see more drunk drivers than any other group, excepting maybe bartenders. I guarantee I see more injured people after drunk driving accidents that any other group, and drunk drivers really piss me off. However, nanny-statism, taking away rights “for your own good” makes me much more angry, and IMHO adds to the cynicism of youngsters towards the hypocritical elders who passed this law.

This federal 21 y/o temperance act makes absolutely certain that when kids drink (they will) they’ll just have worse outcomes because they’re compelled to hide it. Read the above article for what happens when parents try to keep their kids from driving drunk: the prohibitionists come out of the woodwork and are now trying to figure out how to make it a jailable offense.

MADD started out with the right idea (stop drunk driving), but like most do-gooder organizations has become more and more extremist, with a widening agenda. Always be suspicious of those who take away freedoms for your own good. You, and I, should decide for ourselves what is good for us.

via code:theWebSocket;

Update: Dr. Centor is on the same tear.

…and everything’s OK. But, herein lies a cautionary tale for all of us.

The pharmacy called her about 20 minutes after she picked up her prescription, and said “we think we may have overcharged you” which was, frankly, an untruth. This was followed by a request to check out the meds in the bag.

The stapled prescriptions on the outside were correct, but the meds inside weren’t the ones on the outside. In fact, the bottle had the wrong name and the wrong medications. This was reported, and “we’d be glad to exchange them” was the basic reply. (I will NOT entertain queries about what was supposed to be prescribed, or what was in the bag. That would, actually, be a good way to get yourself banned from my site for life).

So, she took the wrong meds back, got a bottle of the right meds, compliments of the house, and all’s well that ends well.

This did engender a bit of ‘lawsuit lottery’ fever in the house, with questions about ‘what if you’d taken it’, etc., bandied about. Unsurprisingly, I was having none of it, pointing out that mistakes happen everywhere, and ultimately it’s up to the patient to make sure they’re taking the right medication.

Moral? Look in the bag before you leave, and realize that mistakes happen everywhere. Caveat emptor, and all that.

Study Shows Beer Has Same Benefits As Red Wine

Beer drinkers can toast the news that their favourite beverage possesses the same benefits as red wine, the alcohol long celebrated for its antioxidant properties.

Researchers at The University of Western Ontario have found one drink of beer or wine provides equivalent increases in plasma antioxidant activity, which helps prevent the oxidization of blood plasma by toxic free radicals that trigger many aging diseases, such as cancer, diabetes, heart disease and cataracts.

Well, thank God, eh? And Guinness.

APOD: 2004 September 15 – Above the Eye of Hurricane Ivan

Too cool for words. A picture of hurricane Ivan from the International Space Station.

Our technology can put men and machines in orbit, but cannot alter the weather. Magnificent, impotent man.

via the Bleat