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Rural medics make more, because few doctors want to live in the boondocks.
On average, Ms. Farber pointed out, "LAM patients endure four years without a proper diagnosis, primarily because few doctors are familiar with the disease".
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There are also fears that providing more NHS services at weekends could increase the risk of death facing patients who are in hospital during the week, because fewer doctors will be on duty then.
Richards also claimed that Hunt had ignored a series of studies of mortality rates among patients admitted to hospital when he began claiming in July 2015 that as many as 11,000 patients a year admitted on a Saturday or Sunday die unnecessarily because too few doctors are on duty – the "weekend effect".
Dr. William Schreiber, an internist in Louisville, Ky., at first said in an interview that he did not believe the survey's results, because, he said, few doctors he knows routinely prescribe placebos.
"I saw everybody celebrating, because a few doctors had given up their vacation time," he said.
There is little competition because so few doctors offer it in the United States; a list can be found at http://www.dupuytren-online.info/needle-aponeurotomy.html.html
Keogh is the first senior doctor to articulate in public the warnings that many leaders of the profession have recently given the BMA privately about the danger of patients dying because too few doctors were on duty.
However, he says, better quantifying the risk is important because too few doctors understand the importance of regular skin exams.
But because so few doctors have mastered the operation, "in reality, it is almost certain to give you worse continence and worse potency".
"But neurologists now also accept there's a much larger area known as the ischemic (blood-starved) penumbra that isn't dead, but is physiologically traumatized - and because so few doctors know how to treat this condition, eventually it does die".
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com