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After the ER visit, the financial nightmare begins

Christopher Chang, MD
Physician
September 5, 2012

Imagine this scenario. A young child is playing in the yard when her pet dog bites her face. Bleeding, the child is rushed to the ER and the doctor offers to suture up the child’s face.

A parent will probably ask for a plastic surgeon to suture the face instead of the emergency room doctor.

As such, the plastic surgeon is called in and sutures up the face beautifully.

The child and family …

Read more…

After the ER visit, the financial nightmare begins

Paperwork causes unintended distractions for physicians and nurses

Christopher Chang, MD
Physician
January 21, 2012

I admittedly snorted out loud when I read a New York Times article recently regarding increased physician distraction due to electronic devices, especially with the advent of the smartphone with its emails, text messages, calls, and other alerts that ping intermittently throughout a typical work day.

There is no question that electronic devices distract physicians as the article pointed out. But that’s like complaining about a leaky faucet when there’s a flooded basement …

Read more…

Paperwork causes unintended distractions for physicians and nurses

Treating Adele’s vocal cord hemorrhage

Christopher Chang, MD
Conditions and Diseases
November 6, 2011

Before going any further, the title to a Los Angeles Times story was “Adele to have surgery to treat vocal cord hemorrhage. What is it?”

I sincerely hope that whomever her surgeon is knows not to perform surgery when the vocal cord is in the middle of a hemorrhage. You do the surgery when the hemorrhage is gone and the culprit blood vessel is left behind which likely is the reason …

Read more…

Treating Adele’s vocal cord hemorrhage

Treating fungal laryngitis in patients with asthma

Christopher Chang, MD
Conditions and Diseases
August 31, 2011

It is a big bummer to be an asthmatic. Not only is breathing a problem, but even the treatment for asthma can cause problems.

Take for example steroid inhalers like Advair, Symbicort, fluticasone, etc.

All asthma patients know to rinse their mouth out after inhaler use due to risk of oral thrush, but what about from the back of the mouth down to the vocal cords? This nether region can’t be …

Read more…

Treating fungal laryngitis in patients with asthma

How to minimize the costs of surgery

Christopher Chang, MD
Health Policy
June 5, 2011

Surgery is expensive, there are no doubts about that. However, there are a few things a patient without insurance who desires surgery can do to minimize the costs as much as possible. Before going into cost-cutting measures, you first need to understand where the costs come from.

In rank order, the costs of surgery come from (highest to lowest):

  • Hospital Charges …

    Read more…

How to minimize the costs of surgery

What makes a great surgeon or doctor?

Christopher Chang, MD
Physician
March 21, 2011

What makes a great surgeon or doctor? Or for that matter, a great violinist? As many psychologists suggest (regardless of whether one is talking about sports, music, painting, astronomy, physics, etc), it entails:

  • Focused practice (at least 10,000 hours according to many)
  • Good coaching
  • Great role model to provide motivation

Does this apply to surgeons or doctors? I believe it absolutely does.

Any person who puts in enough …

Read more…

What makes a great surgeon or doctor?

How cocaine can be used in sinus surgery

Christopher Chang, MD
Medications
January 16, 2011

Many people are already aware that marijuana is now legal in some states in the US with a medical prescription.

What many people may not realize is that cocaine is also used in medical care, especially in the ENT world.

Cocaine is one of the most potent anesthetic and vasoconstrictor. These two characteristics make it an ideal medication for use during sinus surgery as well as any nasal procedure where bleeding and …

Read more…

How cocaine can be used in sinus surgery

Teaching Dr. Oz about nosebleeds

Christopher Chang, MD
Conditions and Diseases
November 18, 2010

A reader informed me that Dr. Oz did a TV show recently on nosebleeds.

I took a look at the video clip and it is my opinion that some information Dr. Oz conveyed is not entirely correct. Again, I should stress that this is just my opinion and I’m sure there will be many who may feel differently.

Error #1:
Contrary to what was said on the show, ice packs do …

Read more…

Teaching Dr. Oz about nosebleeds

Chronic cough from laryngeal sensory neuropathy (LSN)

Christopher Chang, MD
Conditions and Diseases
September 30, 2010

Laryngeal sensory neuropathy (LSN) is a recently described condition felt to cause a chronic cough in patients when treatment for everything else (allergies, asthma, reflux, etc) has been evaluated and managed.

Treatment for this condition is with neuropathic medications including Neurontin, Elavil, Lyrica, nortriptyline, etc.

In the past few months, I have seen a few patients referred to me with chronic cough treated with these medications with minimal or no improvement. All …

Read more…

Chronic cough from laryngeal sensory neuropathy (LSN)

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  • Most Popular

  • Past Week

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      The Podcast by KevinMD | Podcast
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      Martha Rosenberg | Medications
    • Doctors’ kids miss them, and the family builds its own fixes [PODCAST]

      The Podcast by KevinMD | Podcast
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      The Podcast by KevinMD | Podcast
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      Diane W. Shannon, MD, MPH | Physician
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      The Podcast by KevinMD | Podcast
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      Josette Pelatan, PhD | Conditions and Diseases
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      Manisha Kaliaperumal | Health Policy
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      Vaishali Popat, MD, MPH | Physician
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