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Plastic surgery is about more than cosmetic procedures

Physician

October 31, 2013

Halsted once described plastic surgeons as “the surgeon’s surgeons.” Yet in today’s era of media hype about cosmetic surgery, this turn of phrase feels long-forgotten. Despite what reality television may have you believe, the specialty remains at its core about reconstructive surgery, and collaboration is still a key element.

Here, a few points that show those words are as true now as they ever were:

We manage a patient’s expectations. Patients may have …

The memories of my first hospital job remain fresh

Bruce Campbell, MD

Physician

October 31, 2013

You cannot connect the dots looking forward; you can only connect them looking backwards.
-Steve Jobs

“Doesn’t that window open any wider? Bring in another fan!” the surgeon demands.

Beads of sweat gather at the edge of his cloth cap and the circulating nurse steps up periodically to wipe them away. Heat and city noise roll through the open windows and into the operating room. The brief morning rain shower has left the …

What we can learn about weight loss from Al Sharpton

John Mandrola, MD

Conditions and Diseases

October 30, 2013

rev-sharpton

However you see the Reverend Al Sharpton, one thing is certain: you see less of him now. His Twitter pic tells you he is proud of his 167-pound weight loss. Good for him, he should be.

If you care about health, the disappearance of the Sharpton-of-old is worth mention. His story teaches us a lot, and, if one dares to look a little …

How choice can drive patient engagement

Jessie Gruman, PhD

Patient

October 30, 2013

One of my doctors always asks if he can examine me before he starts. He identifies each body part he is going to touch as a question. I feel like I can always say, “No ear exam today, thank you.” Or alternately, “I’ve been having a little pain in my left ear. Can you check it?”

Tiny point. Subtle. But by merely asking me, my doctor signals that I am not …

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How choice can drive patient engagement

What to say when your child asks for an allowance

Claire McCarthy, MD

Physician

October 30, 2013

The other day, my 8-year-old son asked if he could have an allowance. I told him no.

I don’t think Liam needs one, and I don’t really want him to have one yet. But there are plenty of parents who do give their 8-year-olds an allowance. When I Googled “allowance in kids,” I found various sites advocating starting in kindergarten. They argued that it helps them learn about money, and starts …

You have no idea how important your arm is until you can’t use it

Skeptical Scalpel, MD

Physician

October 30, 2013

Recently, I underwent surgery for what proved to be an extensive tear of my right rotator cuff.

I have never had a major operation before. Here is how it went down.

Back in July, I felt a sharp pain in my right shoulder while playing tennis. Of course, I continued to play that day and for two more weeks. When the pain finally prevented me from playing, I saw an orthopedist who …

A more rational concern about the Affordable Care Act

Arnold Birenbaum, PhD

Health Policy

October 30, 2013

Some of the criticisms of the Affordable Care Act (ACA), or “Obamacare,” suggest that the federal government will dictate who will get care and how that care will be delivered.

In fact, recent ads funded by a group supported by the Koch brothers show our dear Uncle Sam preparing to administer exams himself. One depicts him with a speculum in hand …

Changing how doctors, patients and the media perceive prevention

Robert Pearl, MD

Physician

October 29, 2013

Imagine two men in their early 60s. A year from now, both men will be dead.

Changing how doctors, patients and the media perceive prevention could save lives and billions of health care dollars.

Today, each is scheduled for an initial consultation with an orthopedic surgeon and will undergo hip replacement surgery. Patient A will die on the operating table from a surgical complication. Patient B will undergo the procedure without incident. …

The $1000 Pap smear: A pathologist responds

Anonymous

Physician

October 29, 2013

Dr. Cheryl Bettigole, a New Jersey-based family practitioner and a National Physician’s Alliance board member, has written an interesting editorial in the New England Journal of Medicine in which she states she is no longer surprised when laboratories charge her patients $1000 or more for a Pap smear.

According to Dr. Bettigole, the reason for the exorbitant charges are not the actual Pap smear itself (although she does mention the fact liquid-based preps …

How to realize the promise of personalized medicine

J. Leonard Lichtenfeld, MD

Physician

October 29, 2013

I attended a meeting recently that got me to thinking about the fact that as we revolutionize cancer research and treatment, we are also going to have to revolutionize cancer care. And that may prove to be an even more daunting task than finding new treatments for the disease itself.

The meeting was sponsored by a collaboration called “Read more…

How to realize the promise of personalized medicine

Should the health exchanges be shut down?

Robert Laszewski

Health Policy

October 29, 2013

My sense is that the biggest reason Obamacare is now in trouble is because of the top-secret way in which the administration has handled the rollout. If they had developed the computer system in a transparent way, the marketplace would have told them long ago this would not work.

No one outside the inner circle at the Department of Health and Human Services has any idea what’s really going on behind …

The danger of buying breast milk over the Internet

Wendy Sue Swanson, MD

Physician

October 29, 2013

Recent research confirms that buying breast milk on the Internet via milk-sharing sites may not be safe. Although breast milk purchased from online sites may be free or as cheap as $1-$2 an ounce, it may carry significant risk for babies. Clearly the benefits of breast milk are vast; pediatricians and health experts recommend exclusive breast feeding until 6 months of age.

However, simply put, breast milk obtained from unknown (or …

A love affair between big healthcare and big insurance companies

Cindy Fox

Patient

October 29, 2013

My right eye had a blackout in September 2010 when I stepped onto our deck. I didn’t pay much attention to this episode as my vision zoomed back into focus within seconds. But several months later, my eye was playing tricks with me when the only way I could read was with my right eye closed.

Back in 1981, I had lupus though I didn’t know it at the time. My …

How video can reduce medical errors and improve patient care

Robert Wachter, MD

Health Technology

October 28, 2013

About eight years ago I was desperate to improve my golf game. I just couldn’t straighten out my drives or hit my irons crisply. (Yes, I’m fully aware that this is a first world problem). I decided to try golf camp in Palm Springs for a few days.

My sensei, a crusty ex-touring pro named Artie McNickle, watched me hit several dozen balls on the driving range, video recorder running. “So, …

Focus on the thigh gap and the concern for eating disorders

Natasha Burgert, MD

Conditions and Diseases

October 28, 2013

The teenage girl was in my office for a routine physical. As we were talking about healthy dietary habits and routine exercise, she blurted it out: “I make good choices, Dr. Natasha, I’m not like those girls who just want a bigger thigh gap.”

“So, you guys are talking about thigh gaps now?” I asked with horrified curiosity.

“Yeah, mainly the girls in volleyball or cheer. I mean, they have to show their gaps. But, …

Why care must conform to patient values and cultural preferences

Margalit Gur-Arie

Health Policy

October 28, 2013

On his campaign trails, Harry Truman used to call on citizens to go out and vote for themselves, in their own selfish interests. It may sound shallow and divisive, but Harry Truman believed that the individual interests of the people should trump the special interests of the powerful few, and that’s how Democracy should work. Those were simpler times, but the logic still applies today, although it’s becoming increasingly difficult …

Bringing emotions back into medicine

Elizabeth Dzeng, MD, MPH

Physician

October 28, 2013

I had always thought I could never be a great doctor because I felt too emotionally bound to my patients. It was impossible for me to hold back tears when feeling that gut wrenching empathy for families mourning the passing of their loved ones. Because it always seemed as if I were the only resident moved by these scenes, I reasoned that this was an unprofessional impulse that prevented me …

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Bringing emotions back into medicine

When a patient teaches you to tango

Roni Zeiger, MD

Patient

October 28, 2013

Patients continue to teach me new things about medicine and a woman named Bonnie has been one of my best teachers yet. I met Bonnie last month in an online community where she was sharing with other ovarian cancer patients her decision to transition to home hospice.

While explaining that this is of course an intensely personal decision, she wanted her community to understand this option, which we physicians are often …

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When a patient teaches you to tango

A gift to bear witness to the changes in my patients’ lives

Will Harper, MD

Physician

October 27, 2013

As physicians, we bear witness to the health and life events that unfold for our patients. We diagnose and treat diseases. We watch as our patients find partners and celebrate as they bring new life to their families. Yet when the challenge becomes great for our patients, our role must change. We must do more than bear witness. We must shepherd.

When I first began seeing John as a patient, he …

Food deserts are incredibly complex problems

Birju Rao

Health Policy

October 27, 2013

Recently, food has become the center of a revival of interest in cultures that make up Chicago.

The smells, tastes, sounds, and even atmospheres created by cuisine allow both tourists and native Chicagoans to sample our city’s diverse cultural heritage. As such, food has become an increasingly popular and a relatively inexpensive way to enjoy what Chicago has to offer. In fact, one …

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