Doctors Cannot Withhold Care From Gays

The [California Supreme Court has just handed down a ruling][1]. Discrimination is bad, I get it and it shouldn’t happen. I’m not going to argue the merits of the case but I’m curious to know if anyone else thinks that this decision might be interpreted to mean that physicians no longer can say no to … Read more

Saving Medicare?

I’ve been getting to the point lately that the system needs to undergo some catastrophic collapse before it will get better. As the [Happy Hospitalist][1] says: > Here’s my position. It’s time to let the cuts stand. Congress should not reverse the 10.6% cuts that began in July 1st 2008. And here’s why: The financial … Read more


In comes someone with a penetrating injury to the chest, CPR in progress. This is always a bad sign. Into the trauma bay, no pulse, no pressure, no tracing. A quick ED thoracotomy later and I find a pericardium that hissed at me when I opened it. Along with a large pericardial clot was a … Read more


Boy I’d really like to try some of this [QuickClot][1] stuff in the OR. I think it would be great to use for a planned second look. [1]:

Ambulance Chaser

_Yes Virginia, they really do exist._ So here’s the story. The family of a trauma victim, a motor vehicle collision, is met outside the ICU by a lawyer saying that the particular vehicle in which they were traveling has a defect and he and his firm would be happy to represent them. The family never … Read more

Never Events

In October, 2007 CMS (Medicare) proposed a list of eight _preventable_ conditions that result in a prolongation and increase in cost of care to the hospitalized patient. These are what CMS terms **_never events_**. CMS is trying to couch this in terms of _patient safety_ but if you look at the list, there are only … Read more