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Surgery and surgeons

1,981 articles · Since 2004

Articles, page 32

Physician voices

For medicine to grow, we need to look at our own biases

If you had told me I would be writing someday on women’s issues, I would have grabbed a pulse oximeter and placed it on your finger to check your oxygen levels. As a physician scientist, I have spent the majority…

If you had told me I would be writing someday on women’s issues, I would have grabbed a pulse oximeter and placed it on your finger to check your oxygen levels. As a physician scientist, I have spent the majority of my career reading, studying and writing on clinical medicine. Then, something changed.

For years, I have had the pleasure of working with and for some pretty phenomenal men in medicine. …

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For medicine to grow, we need to look at our own biases

Health policy

This is what to remember in health reform: We are all one patient

As a physician, I am often discouraged when I turn on the news and read about the state of health care in our country. I can see all 397 sides of the debate and some truth in all sides. The…

As a physician, I am often discouraged when I turn on the news and read about the state of health care in our country. I can see all 397 sides of the debate and some truth in all sides. The enormous cost of medicine is overwhelming to comprehend for patients and families and even to those of us in medicine.

I think it is important to know all that goes into …

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This is what to remember in health reform: We are all one patient

Physician voices

New health policies must cover our most vulnerable

7

Cancer treatment delays are sometimes inevitable. Here is a story, though, that haunts me. Years ago, long before the Affordable Care Act, I was asked to evaluate a very pleasant man with hoarseness in a local free clinic. He struggled…

Cancer treatment delays are sometimes inevitable. Here is a story, though, that haunts me.

Years ago, long before the Affordable Care Act, I was asked to evaluate a very pleasant man with hoarseness in a local free clinic. He struggled to make himself heard. “Things have been getting worse and worse,” he said.

“When did you start losing your voice?” I asked.

“About six weeks ago,” he responded. “When it started getting more …

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New health policies must cover our most vulnerable

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Conditions and diseases

Deep extubation is a useful technique for any anesthesiologist to master

2

There are two schools of thought about how to extubate patients at the conclusion of general anesthesia: Allow the patient to wake up with the endotracheal tube in place, gagging on the tube and flailing like a fish on a…

There are two schools of thought about how to extubate patients at the conclusion of general anesthesia:

Allow the patient to wake up with the endotracheal tube in place, gagging on the tube and flailing like a fish on a line, while someone behind the patient’s head bleats, “Open your eyes!  Take a deep breath!”

Or:

Remove the endotracheal tube while the patient is still sleeping peacefully, which results in the smooth emergence …

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Deep extubation is a useful technique for any anesthesiologist to master

Physician voices

Does the public shaming of Carmen Puliafito go too far?

4

Recently, the Los Angeles Times broke a story that Dr. Puliafito, former Dean of the Keck School of Medicine of USC, had been abusing drugs and keeping company with a group of younger individuals who engaged in drug use and…

Recently, the Los Angeles Times broke a story that Dr. Puliafito, former Dean of the Keck School of Medicine of USC, had been abusing drugs and keeping company with a group of younger individuals who engaged in drug use and illicit activity.  Much of this activity occurred while he was dean, and it is a shocking story: A 66 year-old titan of the field of ophthalmology, renowned for inventing …

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Does the public shaming of Carmen Puliafito go too far?

Physician voices

Goodbye to all that paperwork: An orthopedic surgeon leaves practice

14

"For what it's worth: it's never too late or, in my case, too early to be whoever you want to be. There's no time limit, stop whenever you want. You can change or stay the same, there are no rules…

“For what it’s worth: it’s never too late or, in my case, too early to be whoever you want to be. There’s no time limit, stop whenever you want. You can change or stay the same, there are no rules to this thing. We can make the best or the worst of it. I hope you make the best of it. And I hope you see things that startle you. …

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Goodbye to all that paperwork: An orthopedic surgeon leaves practice

Physician voices

Want to go on a surgical humanitarian trip? Here are 12 things to think about.

Travel is one of our passions. Spending time in unique places, trying new foods, and meeting different people is enjoyable and exciting. We are also passionate about our jobs as otolaryngologists. Humanitarian trips allow us to combine both of these…

Travel is one of our passions. Spending time in unique places, trying new foods, and meeting different people is enjoyable and exciting. We are also passionate about our jobs as otolaryngologists.

Humanitarian trips allow us to combine both of these loves.

During these trips, I have repaired cleft lips/palates, removed cancers, reconstructed facial disfigurations and improved breathing and swallowing. Few things are more gratifying than being able to provide life-changing operations without …

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Want to go on a surgical humanitarian trip? Here are 12 things to think about.

Physician voices

Go ahead and call me bossy. Bossy saves lives.

Since I was a little girl, I have been called a lot of things. Sensitive. Funny. Strong-willed. Outgoing. Take-charge. Friendly. Bossy. Focused. And my favorite — domineering. I’ve always been a direct person. I’m an extrovert, which means I walk…

Since I was a little girl, I have been called a lot of things. Sensitive. Funny. Strong-willed. Outgoing. Take-charge. Friendly. Bossy. Focused. And my favorite — domineering.

I’ve always been a direct person. I’m an extrovert, which means I walk into a room and I am energized by the people around me. I am also a positive person; I assume you are my friend until you prove otherwise. On most days …

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Go ahead and call me bossy. Bossy saves lives.

Physician voices

The real reason we think plastic surgery is just boob jobs and tummy tucks

Be honest. What’s the first thing you think of when you hear the words "plastic surgery?" Breast implants? Nose jobs? Or maybe you’ll think about one of the numerous television programs out there that have featured the discipline: "Nip/Tuck?" "Botched?"…

Be honest. What’s the first thing you think of when you hear the words “plastic surgery?” Breast implants? Nose jobs? Or maybe you’ll think about one of the numerous television programs out there that have featured the discipline: “Nip/Tuck?” “Botched?” “Grey’s Anatomy?”

If so, you aren’t alone. Plastic surgery as a discipline is poorly understood by many, including primary care physicians, nurses, medical students and the public. Plastic surgeons perform many …

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The real reason we think plastic surgery is just boob jobs and tummy tucks

Health technology

Artificial intelligence in medicine is still a long ways off

"Medicine is a science of uncertainty and an art of probability." - Sir William Osler Two people presented to my clinic on the same day with classic symptoms of head and neck cancer. Each reported several weeks of unilateral throat…

“Medicine is a science of uncertainty and an art of probability.”
– Sir William Osler

Two people presented to my clinic on the same day with classic symptoms of head and neck cancer.

Each reported several weeks of unilateral throat discomfort, ear pain, and a neck mass. Each was having some trouble swallowing and had changed his diet to accommodate the soreness. When they opened their mouths, each had a mass with a …

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Artificial intelligence in medicine is still a long ways off

Physician voices

Think doctors make too much money? Think again.

25

Lots of people write about how “doctors work so hard.” But let's look at it from an economics and value-creation perspective. I’m a neurosurgeon, so you know I do pretty well financially, but how much value am I adding to…

Lots of people write about how “doctors work so hard.” But let’s look at it from an economics and value-creation perspective.

I’m a neurosurgeon, so you know I do pretty well financially, but how much value am I adding to society? Here are a few examples:

1. A mail carrier couldn’t work because of a herniated lumbar disc. We’ll figure he makes $50,000/year. I operated on him; he goes back to work. …

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Think doctors make too much money? Think again.

Physician voices

None of us should have to choose between MOC and DRexit

3

I wish I knew who coined the term “DRexit” so I could send flowers or a bottle of whiskey as a thank you gift. There couldn’t be a more perfect term to describe the growing exodus of physicians from our…

I wish I knew who coined the term “DRexit” so I could send flowers or a bottle of whiskey as a thank you gift. There couldn’t be a more perfect term to describe the growing exodus of physicians from our beloved profession, which is turning into a morass of computer data entry and meaningless regulations thought up by people who never touch a patient.

The one bright note on the horizon …

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None of us should have to choose between MOC and DRexit

Physician voices

These physicians are crying. Here’s why.

I cried this morning. It wasn’t because of the patient who coded with a wide-complex tachycardia and died in front of me, and it wasn’t because of the patient who tried to spit on me for not giving her a…

I cried this morning. It wasn’t because of the patient who coded with a wide-complex tachycardia and died in front of me, and it wasn’t because of the patient who tried to spit on me for not giving her a prescription for narcotics. Nor was it my intoxicated 2 a.m. bar fight patient yelling at my other patients, including one whom I’d recently diagnosed with metastatic cancer. It was because …

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These physicians are crying. Here’s why.

Physician voices

Trauma in the OR. From doctors’ bullying.

31

It’s Friday morning in any operating room, USA. Nurses and techs are scrambling to get everything in place before the surgeon arrives because if not, there will be hell to pay. The first patient arrives late, the second patient needs…

It’s Friday morning in any operating room, USA. Nurses and techs are scrambling to get everything in place before the surgeon arrives because if not, there will be hell to pay. The first patient arrives late, the second patient needs to use the bathroom, the third patient needs blankets before the IV is started … and here he comes … and we’re not ready. The fear is palpable.

Down the street, …

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Trauma in the OR. From doctors’ bullying.

Physician voices

I’m your anesthesiologist. Let me explain what that means.

8

It’s still dark out when I walk into the busy and bustling preoperative area where patients and their family members crowd into small bays. They hand over their personal belongings to the RNs and their trust to me. As I…

It’s still dark out when I walk into the busy and bustling preoperative area where patients and their family members crowd into small bays. They hand over their personal belongings to the RNs and their trust to me. As I walk in, I grab my patient’s hand, smile and say, “Hello. My name is Dr. Shillcutt. I am a cardiac anesthesiologist, and I am going to take care of you …

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I’m your anesthesiologist. Let me explain what that means.

Physician voices

Overpowering the glass ceiling will take more than outnumbering men in the field

19

I was recently on an off-service rotation and one morning as I entered a patient’s room that had been admitted to our service, I overheard the patient quickly tell the person they were talking to on the phone, “Hey, can…

I was recently on an off-service rotation and one morning as I entered a patient’s room that had been admitted to our service, I overheard the patient quickly tell the person they were talking to on the phone, “Hey, can I call you back? My nurse just walked in to talk with me.”

For a moment I was confused and actually turned around to look for his nurse behind me. Alas, …

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Overpowering the glass ceiling will take more than outnumbering men in the field

Physician voices

Residents performing surgery: Why can’t we reach a middle ground?

2

A comparison of appendectomy outcomes for senior general surgeons and general surgery residents revealed no significant differences in early and late complication rates, use of diagnostic imaging, time from emergency department to operating room, incidence of complicated appendicitis, postop length…

A comparison of appendectomy outcomes for senior general surgeons and general surgery residents revealed no significant differences in early and late complication rates, use of diagnostic imaging, time from emergency department to operating room, incidence of complicated appendicitis, postop length of stay, and duration of post-op antibiotic treatment.

The only parameter in which a significant difference was seen was that attending surgeons completed the procedure significantly faster by 9 minutes — …

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Residents performing surgery: Why can’t we reach a middle ground?

Physician voices

There’s no place for locker room talk in the OR

8

I am nearing the end of my training at one of the top surgical fellowships in the country. I chose this fellowship not just for the name, but also because the surgeons all seemed like genuine and altruistically motivated individuals.…

I am nearing the end of my training at one of the top surgical fellowships in the country. I chose this fellowship not just for the name, but also because the surgeons all seemed like genuine and altruistically motivated individuals. It was two-thirds of the way through fellowship when I found myself in conversation with two male trainees. We were discussing the younger trainee and his girlfriend; he would be …

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There’s no place for locker room talk in the OR

Physician voices

What does your husband think about you being a surgeon?

3

Not once during my eight years of medical school and residency training was I ever asked the converse of the titular question, what was my wife’s opinion of my career choice. Not while scrubbed into a case on my surgery…

Not once during my eight years of medical school and residency training was I ever asked the converse of the titular question, what was my wife’s opinion of my career choice. Not while scrubbed into a case on my surgery rotations, not in the middle of an overnight call in the neonatal intensive care unit and never once by an attending, fellow or co-resident. Even those who knew me best and …

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What does your husband think about you being a surgeon?

Physician voices

A medical student fails USMLE Step 1. Can he ever be a surgeon?

2

I received these emails recently. The writer gave me permission to publish them. They have been edited for length, and some details have been changed to protect his anonymity. I'm a third-year medical student at an allopathic state medical school.…

I received these emails recently. The writer gave me permission to publish them. They have been edited for length, and some details have been changed to protect his anonymity.

I’m a third-year medical student at an allopathic state medical school. I’ve always wanted to do surgery. My problem is I failed USMLE Step 1 the first time and got a 207 on my second attempt. I hadn’t failed anything else throughout first

…

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A medical student fails USMLE Step 1. Can he ever be a surgeon?

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