Archive for July 7th, 2009

An essay column in the New York Times discusses a personal reflection on money aspect of practicing medicine by Dr Sandeep Jalhar:

To meet the expenses of my growing family, I recently started moonlighting at a private medical practice in Queens. On Saturday mornings, I drive past Chinese takeout places and storefronts advertising cheap divorces to a white-shingled office building in a middle-class neighborhood.

I often reflect on how different this job is from my regular one, at an academic medical center on Long Island. For it forces me, again and again, to think about how much money my practice is generating.

via Essay – A Doctor by Choice, a Businessman by Necessity – NYTimes.com.

I sympathize with the feeling that one may have entered medicine hoping to not worry about money. Unfortunately, those days are gone… the age where doctor’s are paid enough so that they can just practice and not worry about money have been gone for a couple decades now.

I do think that the current fee-for-service system is sick, and really needs to be fixed.  I know HMO’s got a bad name in the late 80s, early 90s, but I do feel that they are a much better financial structure than the system we have now.  Obviously, I’m a little biased.

I’m pretty sure doctors in general will be happier that way.  I know that there was a survey of Canadian doctors which showed surprisingly high satisfaction scores when compared to their salary.  I’ll need to dig up to reference, I’ll update this post when I find it.

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An article trying to interpret behavior while speed dating and making evolutionary interpretations.  The epidemiologist part of me just cringes at the statement below.  The method (randomization) is meaningless unless you have some grasp of the inclusion criteria and the potential biases introduced there.  Specifically, are the type of men and women who speed-date different from the general population?

I think it is fair to say that most people have never speed-dated in their lives.  If I could hazard a guess, I would also say that men who go speed-dating tend to be more shy, and women who speed-date tend to me more extroverted than average.  (I know someone is going to hate me for making generalizations).   I don’t know if these assumptions are true, but any report on science should at least acknowledge that the study has very little to do with “evolution” and is more something that is limited to speed-dating behavioral dynamics.

In recent years, the emergence of speed dating has given psychologists, economists and political scientists new ways to test this and other hypotheses about mating. Because participants can be randomly assigned to groups and have no prior information about other participants, three-minute speed-dating sessions are about as close to a controlled experiment as researchers are likely to get.

via Testing Evolution’s Role in Finding a Mate – NYTimes.com.

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Some well reasoned advise regarding the recent federal advisory committee report on acetaminophen published in the New York Times health blog.  I think the key points include the very low level of incidence, and the comparitively high level of side effects (although still low compared to how much it is used) of NSAIDs and Aspirin.

Few drugs are more ubiquitous than acetaminophen, the pain reliever found in numerous over-the-counter cold remedies and the headache drug Tylenol.

But last week, a federal advisory committee raised concerns about liver damage that can occur with overuse of acetaminophen, and the panel even recommended that the Food and Drug Administration ban two popular prescription drugs, Vicodin and Percocet, because they contain it.

The news left many consumers confused and alarmed. Could regular use of acetaminophen for pain relief put them at risk for long-term liver damage?

via Well – Reasons Not to Panic Over a Painkiller – NYTimes.com.

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