Grand Rounds – Wisconsin Sports Edition

This is a great time to be the Healthcare Economist. Not only am I hosting Grand Rounds for the first time, but Wisconsin sports are enjoying a renaissance. The Milwaukee Brewers are in the NLCS, the Green Bay Packers are Super Bowl Champs and undefeated, and the Wisconsin Badgers also have not lost.

How does this relate to this week’s edition of Grand Rounds? I have no idea. But I know if you’ve made it this far, you might as well take a few more minutes to review the best medical posts on the blog-o-sphere during the past week. Enjoy!

Best of the Best

Best post explaining why doctors are like pyromaniac fireman. Precious Bodily Fluids explains “It’s what makes medicine so difficult, the more you try to help your patients the more you expose them to unintended, adverse reactions”.

Most Controversial. According to the American Psychiatric Association, until 1974 homosexuality was a mental illness. After gay activists protested against the APA convention in San Francisco, the APA removed homosexuality from the list of mental illnesses.  Philip Hickey of Behaviorism and Mental Health uses this example to claim that “There are no mental illnesses.”  Read more to find why an mental illness blog argues that there are no mental illnesses.

Health Insurance

Best post on how the uninsured get screwed over twice. Looking at his own EOB, David Williams of The Health Business Blog shows insured individuals not only get reduced cost sharing compared to the uninsured, but their sticker price of medical services is much lower for insured individuals than for the uninsured.

Best post on insurance that is not really insurance. Mini-med plans are low cost but have limited benefits.  Health reform mandates that annual maximum coverage must be at least $750,000, which is significantly above mini-med plans.  HHS has been offering employers waivers to continue offering these low cost plans.  What happens when an employee uses up the limited mini-med benefit? The Colorado Health Insurance Insider investigates.

Best post describing health insurance premium growth.  Your host, the Healthcare Economist, examines trends in employer-provided health insurance.  Whereas premiums grew by only 6% per year between 2005 and 2010, from 2010 to 2011 premiums grew 7.5 percent for single plans and 9.5 percent for family plans.

Nurses vs. Docs

Best post on the nurse-doctor rivalry. “I am Dr. Patti McCarver and I am your nurse.”  Huh?  Turns out that Dr. McCarver received a doctorate in nursing.  Do nurses like the power and prestige that goes with being called ‘doctor’?  Do medical doctors care if other health professionals use the term doctor?  You can guess the answers, but Robert Vineyard at InsureBlog has some additional thoughts including whether more education causes better health care.

Best post on differences between a nurse’s and patient’s perception of quality medical care.  A nurse believes that his evaluation of the patient’s condition is correct.  Nevertheless, a patient complains about not being able to see his doctor.  The patient has a poor opinion of their doctor.  The doctor’s schedule does not allow him to interact with many of his patients and patients get upset.  The conclusion of the story is at In My Humble Opinion.

Law and Medicine

Best post on health-related legal issues. There is research suggesting that 7% of all abnormal labs are never reported to patients.  Why is this?  One reason is that certain state laws do not require providers to make lab test results available to patients.  Would federal laws allowing all lab results to be made available to patients reduce this number?  The Health Care Law Blog investigates.


Best post on worst hospitals.  Characteristics of the worst hospitals: smaller, for-profit or public, and located in the South. Characteristics of the best hospitals: nonprofit, in the Northeast, major teaching hospitals and in urban areas. The ACP hospitalist review the results in more detail and also notes that the worst hospitals are much more likely to treat minorities and poor patients than the best hospitals (Question to the reader: is this a causal relationship and if so in which direction?)

Best post on the drawback of hospitalists.  Elaine Schattner of Medical Lessons writes, “…when I’ve been in the hos­pital, nothing was more reas­suring than visits by my usual doctors – my internist, my oncol­ogist, my surgeon, my orthopedist…Being cared for by strangers, however com­petent, is not the same, although there may never be a study to prove it.”

Literature and Medicine

Best Book ReviewLaika’s MedLibLog reviews Your Medical Mind by Jerome Groopman and Pamela Hartzband.

Most Poetic Post. “Magnets” – a poem about receiving an MRI from The Charles Prize for Poetry.

Drugs, Technology & More

Best post explaining why your pharmacy is out of the drug you need.  There’s been 213 drug shortages so far this year, or two more than all of the previous year.  Because only one or two companies manufacture many drugs, huge gaps occur when problems such as contamination occur.  ACP Internist says this is nothing new; drug shortages have been happening for over a decade.

Best Technology Post.  iPhone’s are an amazing tool.  They can help change behavior.  They can also consume too much of our lives.  “Our brains react to our iPhones the same way they do to the proximity of someone we love.”  How can one use iPhone apps to best change behavior?   Jessie Gruman explore the topic on the Prepared Patient Forum.

Best post explaining the difference between real and fake patients.  FutureDocs notes that Compared to clinical vignettes, doctors treating real patients must deal with: social problems which often trump their medical problems, issues related to caregiver support, how well medical treatment choices meet the patient’s insurance coverage, and meeting medical necessity requirements.


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