nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Friday, November 21, 2008


Researchers say counties with higher rainfall may also have higher autism rates.

USA Today (11/4, Rubin) reports that, according to a study published in the Archives of Pediatric and Adolescent Medicine, "counties with higher precipitation levels" may "also have higher autism rates." Lead author Michael Waldman, Ph.D., a professor of economics at Cornell University, "says he decided to investigate a possible link between precipitation levels and autism rates because of findings from a 2003 U.S. Department of Education survey that collected state autism rates data. States with the lowest rates were New Mexico, Mississippi, Colorado, Oklahoma, and Tennessee, while those with the highest rates were the more northern states of Minnesota, Oregon, Indiana, Maine, and Massachusetts."


It was speculated that “these children may spend more time indoors, or because rain brings chemicals in the atmosphere to the ground, they might be exposed to environmental triggers that can trigger a genetic predisposition to autism”


Doc D:  People are desperate to come up with an environmental cause for autism.  It’s vaccines, it’s the air….This study may be a case of the Texas Sharpshooter fallacy.  The Texas sharpshooter takes his rifle out to the barn and fires repeatedly into the side of it.  Then he goes up and draws a circle around the bullet holes, and announces that he hit the bullseye with every shot.  In science, what one cannot do is use the same information to construct and test the same hypothesis — the question is, did the researcher see the pattern of rainfall in this limited group of states (as it appears above), and then go gather the data from those states?  I see this all the time in epidemiology:  most of the so-called cancer clusters are a result of this type of fallacy.  For example, a hypothetical cluster of brain cancer on one floor of an office building.  There’s not a “killer” chemical present on that floor of the building:  people have just drawn their bullseye (that floor) after the fact.  Remember, for unrelated events to be truly random they can’t be evenly spaced across the domain:  that’s not random, that’s an orderly arrangement.  In true randomness, there will be clumps here and there… randomly.


Ok, that’s enough on that.  My head’s spinning…



CMS says physicians could earn up to 5.1 percent in 2009 bonuses.

Modern Healthcare (11/1, Lubell) reported, "Physicians who successfully comply with various incentive programs could receive an overall payment boost of up to 5.1 percent in 2009, under a final rule issued by" the Centers for Medicare and Medicaid Services (CMS).

        MedPage Today (10/31, Fiore) added that the CMS also "suggested a physician 'could receive up to a 5.1 percent pay boost for 2009.' But, earning that much will require extra initiative" on the physician's part. This "new rule also adopts changes to quality reporting initiative, including the addition of 52 new quality measures, for a total of 153, in areas including osteoarthritis, rheumatoid arthritis, back pain, coronary artery bypass graft, chronic kidney disease, melanoma, oncology, coronary artery disease, hepatitis, and HIV/AIDS."


Doc D:  Right…free money.  Guess how much time is needed to accomplish the paperwork to submit for the payment. This “boon” probably won’t be enough to hire the person you need to accomplish the workload required.  No…wait…that’s it!  This is a jobs program.



Survey indicates nearly half of primary care physicians would consider leaving medicine soon.

CNN (11/18, Willingham) reports that almost "half the respondents in a survey of U.S. primary care physicians said that they would seriously consider getting out of the medical business within the next three years if they had an alternative." After sending "questionnaires to more than 150,000 doctors nationwide," of which 12,000 responded, the Physicians' Foundation also discovered that "many said they are overwhelmed with their practices, not because they have too many patients, but because there's too much red tape generated from insurance companies and government agencies.”


Doc D; the administrative burden is high now, but you aint seen nothing yet.  If we partially nationalize the healthcare system you can expect to see more administrative workload, and the government will need to hire another 50,000 people to handle it.  Failure to address underlying cost increases and reduced access from a physician shortage will make being covered by insurance of little value.



Medical quote of the Day:


So long as the body is affected through the mind, no audacious device, even of the most manifestly dishonest character, can fail of producing occasional good to those who yield it an implicit or even a partial faith. –Oliver Wendell Holmes [1809-1894]


Doc D

Opinions are entirely my own.  Quotations from Kaiser Daily Health Policy Report ( © Kaiser Family Foundation), PND News Briefs – Texas Edition ( © 2008, Physician's News Digest, Inc.), AMA Morning Rounds (© U S News Custom Briefings), and other sources in the public domain.  As always, you may share this column, with appropriate attribution (here and in the text) included:  I just ask that you not forward my email address.  I don't care to argue with wacky strangers.





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