As a third-generation physician, I grew up thinking and dreaming of a being a physician, and 33 years later, I am still living the dream. I dreamt of saving people’s lives. I dreamt of a day like today when I…
As a third-generation physician, I grew up thinking and dreaming of a being a physician, and 33 years later, I am still living the dream. I dreamt of saving people’s lives. I dreamt of a day like today when I received a LinkedIn request from a young lady on whom, 21 years ago, I performed a living donor liver transplant from her mother.
While hundreds of doctors have submitted (mostly unfavorable) comments to CMS on the proposed evaluation and management changes, other issues seem to be receiving much less attention than they deserve. And one of those may hit physicians who perform procedures…
While hundreds of doctors have submitted (mostly unfavorable) comments to CMS on the proposed evaluation and management changes, other issues seem to be receiving much less attention than they deserve. And one of those may hit physicians who perform procedures in the wallet.
In 2015, Congress asked CMS to analyze the global period data to ensure procedure weighting accurately reflected the actual work done by physicians. Of course, when Congress asks …
Fourteen hours into their shift, the intern headed down to the lobby to pick up the delivery. Today it was Indian food. He struggled to push the elevator button while holding the bags but managed to make it up to…
Fourteen hours into their shift, the intern headed down to the lobby to pick up the delivery. Today it was Indian food. He struggled to push the elevator button while holding the bags but managed to make it up to the top floor ICU. The rest of the surgeons gathered around the table cluttered with spent pens, journal articles and unused bottles of lidocaine to eat. Someone offered up their …
Since the beginning of a new academic year is fast approaching, here’s some heartfelt advice. You might need it, I hope you read it and heed it. If you’re just beginning your medical school journey, the first line is written…
Since the beginning of a new academic year is fast approaching, here’s some heartfelt advice. You might need it, I hope you read it and heed it. If you’re just beginning your medical school journey, the first line is written specifically for you, but the rest of the piece is pertinent for any doctor, at any age and any stage of their careers.
Match Day is the culmination of a medical student's education: the day all graduating seniors and non-traditional applicants find out where they will spend the next three to seven years to train in a desired specialty. I fell in love…
Match Day is the culmination of a medical student’s education: the day all graduating seniors and non-traditional applicants find out where they will spend the next three to seven years to train in a desired specialty. I fell in love with obstetrics and gynecology (OB/GYN) as it was the perfect way to combine my passion for women’s health with medicine and surgery. I also liked that the patients were relatively …
The bedrock requirement to obtain informed consent before patients may be enrolled in research has been eroding. I’ve documented the different ways and different reasons for this several times over the years ("Informed Consent for Babies: When Experts Disagree," "Informed…
The bedrock requirement to obtain informed consent before patients may be enrolled in research has been eroding. I’ve documented the different ways and different reasons for this several times over the years (“Informed Consent for Babies: When Experts Disagree,” “Informed Consent in Infant Research: Ethical Problems Remain,” “Informed Consent in Comparative Effectiveness Research,” and “The Erosion of Informed Consent in Medical Research”). The latest example is a clinical trial of …
Recent research from Florida Atlantic University and Cleveland State University have found a direct correlation between preventative health care and the number of paid sick leave days a worker gets. Workers with more than 10 paid sick days annually access…
Recent research from Florida Atlantic University and Cleveland State University have found a direct correlationbetween preventative health care and the number of paid sick leave days a worker gets. Workers with more than 10 paid sick days annually access preventative care more frequently than those without paid sick days.
Preventative care, in turn, leads to better overall mental and physical health. Doctors that are in private practice function …
Both patients and providers realize that an internist is different from a surgeon, but specifically how they differ and how this affects their approaches to patient care is largely under-appreciated. Over the last four years, I have conducted over 250…
Both patients and providers realize that an internist is different from a surgeon, but specifically how they differ and how this affects their approaches to patient care is largely under-appreciated. Over the last four years, I have conducted over 250 interviews with physicians across specialties and institutions about what they do and why they do what they do. With each project, I continue finding remarkably distinct, specialty-specific values, perceptions, and …
In the 1984 rock mockumentary This is Spinal Tap, a fictional band discusses the controversy surrounding one of their album covers. “There’s such a fine line between stupid and ...” the lead singer says, realizing where they’d crossed the line…
In the 1984 rock mockumentary This is Spinal Tap, a fictional band discusses the controversy surrounding one of their album covers. “There’s such a fine line between stupid and …” the lead singer says, realizing where they’d crossed the line of tastefulness.
His guitarist finishes his thought, “… and clever,” he says. In life, in rock and roll and in medicine, there is indeed a fine line between stupid and clever.
A patient with progressive neurologic disorder had a gastrojejunal tube placed for feeding. In a nursing home, the tube fell out and was replaced with a Foley catheter. He was sent to the hospital for placement of a new tube.…
A patient with progressive neurologic disorder had a gastrojejunal tube placed for feeding. In a nursing home, the tube fell out and was replaced with a Foley catheter. He was sent to the hospital for placement of a new tube. When he arrived in the interventional radiology suite, the Foley catheter was not visible. A new gastrojejunal tube was successfully placed, and the patient was sent back to the nursing …
My last operative day was October 15, 2009. My last attempt at getting to understand my group disability policy was on May 10, 2018. I’m a disabled anesthesiologist who lost his career when my left median nerve stopped functioning properly.…
My last operative day was October 15, 2009. My last attempt at getting to understand my group disability policy was on May 10, 2018. I’m a disabled anesthesiologist who lost his career when my left median nerve stopped functioning properly. I had two disability policies, a private and a group. My dealings with these two companies have been day and night.
My group insurance carrier hammered my dignity for years. In …
During my pediatric surgery training, I could easily point out which was the hardest day for the three fellows that were under training on that specific year. It was late evening when I received a call that one of our…
During my pediatric surgery training, I could easily point out which was the hardest day for the three fellows that were under training on that specific year. It was late evening when I received a call that one of our patients had coded. I was at home, and the drive usually took me exactly seven minutes.
Due to social reasons, this patient was in the hospital with us for months (at …
Over the last month, a dermatologist practicing in Georgia known as the “dancing doctor” was suspended by the Georgia Medical Board, which said she posed a “threat to public health, safety, and welfare.” At least ten patients have sued this…
"Some data is better than no data at all." Do you believe that? I heard it frequently when the infamous ProPublica's Surgeon Scorecard first appeared three years ago. Back then I blogged about it saying “To me, bad data is…
“Some data is better than no data at all.” Do you believe that?
I heard it frequently when the infamous ProPublica’s Surgeon Scorecard first appeared three years ago. Back then I blogged about it saying “To me, bad data is worse than no data at all.”
A recent study in BJU International confirmed my thoughts about this type of publicly posted data and identified a previously unreported issue. The paper attempted to …
Why does she work? It’s a question that she must answer, for it begs itself every time she picks him up from daycare. She always finds him happy there. And yet that — selfishly? — is part of what tears…
Why does she work? It’s a question that she must answer, for it begs itself every time she picks him up from daycare.
She always finds him happy there. And yet that — selfishly? — is part of what tears at her. Shouldn’t she be the one making him happy at 11 months?
It’s more important to her than any other role that she plays – she wants to be everything that …
It is a little after 9 a.m. I am about to start the second of a long list of endoscopy cases when my phone rings. I glance briefly at the caller ID to confirm it isn’t my office or the…
It is a little after 9 a.m. I am about to start the second of a long list of endoscopy cases when my phone rings. I glance briefly at the caller ID to confirm it isn’t my office or the hospital calling about another patient, and am quickly overcome with dread as I see the screen reads, “daycare.”
Intuitively, I know why they are calling. My four-month-old must have a fever. …
It was 5:45 in the morning on a Monday after a full weekend of call. Thoroughly exhausted, I shuffled into the elevator and was met by the stench of stale clothing mixed with cigarette smoke. A painfully thin teenager exited,…
It was 5:45 in the morning on a Monday after a full weekend of call. Thoroughly exhausted, I shuffled into the elevator and was met by the stench of stale clothing mixed with cigarette smoke. A painfully thin teenager exited, looking lost. I allowed him to wander out, grateful to be spared his odor. I was apathetic, overtaken by a weariness I vowed as a medical student never to have.
A new study found several senior academic surgeons had published papers in what used to be termed “predatory journals.” The newer, gentler term is “solicited publishing,” but it defines the same pay-to-play, low-quality publications. Surgeons from the University of California,…
A new study found several senior academic surgeons had published papers in what used to be termed “predatory journals.” The newer, gentler term is “solicited publishing,” but it defines the same pay-to-play, low-quality publications.
Surgeons from the University of California, San Diego examined 110 emails sent to the senior author from 29 publishers during a six-week period and early 2017. Nearly all were requesting manuscript submissions. The 29 publishers represented 113 …
Editor's note: Graphic image below. Envision a large, loafy muffin top. Not just a central bulge or even love handles. I’m speaking of an apron of skin and fat that hangs down over many an American’s lower torso and groin.…
Editor’s note: Graphic image below.
Envision a large, loafy muffin top. Not just a central bulge or even love handles. I’m speaking of an apron of skin and fat that hangs down over many an American’s lower torso and groin. Surely you’ve seen it — you may even have one. Its medical name is the pannus.
I had never heard of a pannus in medical school and I still never hear it …
I've thought long and hard about writing this, so here goes: I am a female surgical subspecialist. I trained at a Harvard program back in the 1990s, and was one of a handful of women to have completed residency training…
I’ve thought long and hard about writing this, so here goes: I am a female surgical subspecialist. I trained at a Harvard program back in the 1990s, and was one of a handful of women to have completed residency training at a stodgy 125-year-old program. The eighth, to be exact. During that time, I was treated as an inferior, sexually abused verbally, routinely given the bottom of the barrel when …
