Surgery and surgeons

1,981 articles · Since 2004

Articles, page 34

Vik or Vikram: The challenge of physician identity

February 9, 2017Feb 9, 2017

"Does he speak English?" As I was busy working at my computer dictating on the last patient, I overheard the question posed to my receptionist. The receptionist, unfazed, responded with a polite, “yes.” My medical assistant ushered the patient into…

“Does he speak English?”

As I was busy working at my computer dictating on the last patient, I overheard the question posed to my receptionist. The receptionist, unfazed, responded with a polite, “yes.”

My medical assistant ushered the patient into one of the exam rooms where Ms. Smith proceeded to expound on how she had experienced some less than ideal interactions with Indian physicians — they had seemed cold and curt; their …

Physician voices

Building a career and a life around the difficult moments

Bruce Campbell, MD

February 6, 2017Feb 6, 2017

“An expert is a person who has made all the mistakes that can be made in a very narrow field.” - Niels Bohr Five experienced, well-published, and widely respected head and neck cancer surgeons are sharing the dais at the…

“An expert is a person who has made all the mistakes that can be made in a very narrow field.”
– Niels Bohr

Five experienced, well-published, and widely respected head and neck cancer surgeons are sharing the dais at the national medical meeting to explore the topic “Can We Be Better?” The panel represents a spectrum of experts from around North America, and they have served as program leaders, department chairs, and …

Physician voices

The real danger of maintenance of certification and what to do about it

Karen S. Sibert, MD

January 27, 2017Jan 27, 201712

In the interests of full disclosure, I acknowledge with delight that I have a non-time limited board certificate from the American Board of Anesthesiology (ABA), issued before the year 2000. I can just say “no” to recertification. The more I…

The more I learn about the American Board of Medical Specialties (ABMS) and its highly paid board members, the more disillusioned I’ve become. It’s easy to see why so many physicians today have concluded …

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How subtle sexism is isolating female residents

Anonymous

January 25, 2017Jan 25, 20173

I was sitting next to two of my co-residents during a break in conference this morning, answering emails on autopilot and half-listening to the buzz of conversations around me, when their muffled laughter caught my attention. “What’s so funny, guys?”…

“What’s so funny, guys?” I asked them, thinking that a good joke or funny story might break up the monotony of hours of lecture. The reply I got stunned me.

“It’s man talk,” one of them …

Physician voices

Do surgery checklists really work?

Skeptical Scalpel, MD

January 12, 2017Jan 12, 20175

A before and after study at the University of Vermont Medical Center found that a 24-item operating room checklist did not significantly reduce the incidence of any of nine postoperative adverse outcomes. More than 12,000 cases were studied, and outcomes…

More than 12,000 cases were studied, and outcomes included: mortality, death among surgical inpatients with serious treatable complications, sepsis, respiratory failure, wound dehiscence, postoperative venous thromboembolic events (VTE), postoperative hemorrhage or hematoma, transfusion reaction and …

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Do surgery checklists really work?

Physician voices

The case against a surgery volume pledge

Vamsi Aribindi, MD

December 30, 2016Dec 30, 20164

Dr. Pronovost is a leading figure in the patient safety movement, and is someone I greatly admire. His work with surgical checklists is touted by Dr. Atul Gawande as having saved more lives than any researcher in the past decade. However, I disagree with his latest initiative: to get hospitals who perform certain procedures at very low rates to stop performing them altogether.

On the surface, it seems like …

Medical education

Are surgical residents really doing the cases they scrub on?

Skeptical Scalpel, MD

December 25, 2016Dec 25, 2016

According to the Residency Review Committee for Surgery, "A resident may be considered the surgeon only when he or she can document a significant role in the following aspects of management: determination or confirmation of the diagnosis, provision of preoperative…

According to the Residency Review Committee for Surgery, “A resident may be considered the surgeon only when he or she can document a significant role in the following aspects of management: determination or confirmation of the diagnosis, provision of preoperative care, selection, and accomplishment of the appropriate operative procedure, and direction of the postoperative care.”

In nearly all instances, resident “determination or confirmation of the diagnosis, provision of …

Physician voices

Surgery volumes should be made public. Here’s why.

Peter Pronovost, MD, PhD

December 16, 2016Dec 16, 20163

Her voice cracked with strain. I could imagine the woman at the other end of the line shaking, overcome with remorse about the hospital where her husband had had esophageal surgery. Might he still be alive, she asked me, if…

The couple had initially planned to have the procedure done at a well-known medical center, but when she went online to do her homework, she …

Conditions and diseases

Anesthetic neurotoxicity in infants and children: Current state-of-the-art

American Society of Anesthesiologists & Caleb H. Ing, MD & Dr. Sean Flack & Randall Flick, MD, MPH

December 13, 2016Dec 13, 2016

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. The possibility of anesthetic neurotoxicity in infants and children -- the supposition that anesthesia may alter normal activity in the nervous system - was first suggested more than…

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

The possibility of anesthetic neurotoxicity in infants and children — the supposition that anesthesia may alter normal activity in the nervous system – was first suggested more than 15 years ago with findings of increased neuronal cell death in the developing brains of rodents after they were exposed to ethanol at an early age. Similar findings …

Physician voices

Please tell me what a “mommy-friendly” medical career is

Heena P. Santry, MD

December 13, 2016Dec 13, 20164

I had a familiar conversation the other day with yet another female medical student. “I really loved surgery!” she said, “but I was concerned about the lifestyle, so I decided on ______.” Lifestyle — it turns out — almost always…

I had a familiar conversation the other day with yet another female medical student.

“I really loved surgery!” she said, “but I was concerned about the lifestyle, so I decided on ______.”

Lifestyle — it turns out — almost always seems to be code for having a family.

Maybe it’s just the kind of students who seek me out. I have yet to encounter someone concerned that a surgical career will hamper their …

Medical education

This resident works 100+ hours per week, but is still a poorly trained surgeon

Anonymous

December 11, 2016Dec 11, 201627

I am forced to write anonymously because of gross neglect by my residency program regarding standard ACGME duty-hour rules. If my name were published, it would identify my program. As a PGY-2, I worked 100+ hours per week on average…

I am forced to write anonymously because of gross neglect by my residency program regarding standard ACGME duty-hour rules. If my name were published, it would identify my program.

As a PGY-2, I worked 100+ hours per week on average last year while taking primary call for my urology department. (Admittedly, the PGY-2 is the historic “worst year” for any urology resident.) On a quarterly basis (depending on manpower), we take …

Physician voices

When you place your faith in another surgeon

Nariman Heshmati, MD

December 3, 2016Dec 3, 2016

It was Thanksgiving morning. My wife was standing in the living room when she received a text message from her father. Her face went pale, and her expression turned to one of anger and disbelief. She cursed. She cried. Her mother had complained of chest pain and stroke-like symptoms and was being rushed to the hospital by ambulance.

Many hours went by with few answers and endless speculation. We had moved …

Conditions and diseases

Does the increased frequency of repair of AAA in the United States reap benefits?

Dr. Saurabh Jha

December 2, 2016Dec 2, 2016

A popular meme is that the U.S. spends more on health care than other developed nations but has nothing to show for that spending. This is different from saying that the U.S. spends more, but achieves something, but the something it achieves is so little that it isn’t worth the public purse. The latter is difficult to assert because the asserter must then say how little is too little in …

Physician voices

Identifying patients by more than their names

Skeptical Scalpel, MD

December 1, 2016Dec 1, 20164

The wrong body was cremated by the county coroner’s office in Los Angeles. Jorge Hernandez died of an overdose, and the body of another Jorge Hernandez, an indigent patient, scheduled for cremation, was also present in the morgue. The distraught…

The distraught family of overdose victim Jorge Hernandez had planned a funeral with a viewing and were shocked when they were told his body had been cremated by mistake because a morgue attendant …

Physician voices

The decision a family can’t make

Shawn C. Jones, MD

November 28, 2016Nov 28, 20167

Just a minute before, I had been in surgery checking on the status of a patient who was undergoing an exploratory laparotomy. She had been doing OK, but deteriorated relatively quickly that afternoon while still in the hospital recuperating from an unrelated operation. The anesthesiologist popped out of the room to tell me what the initial findings looked like. It was not good. That’s when I went to speak to …

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The decision a family can’t make

Medical education

Doctors should take care of teddy bears too

Natasha Abadilla

November 25, 2016Nov 25, 2016

I’m a first-year medical student who recently discovered the magnetic pull of surgery. As one might assume, on my first day scrubbing into the OR under a pediatric surgeon, I was beyond excited. The surgeon’s precision and expertise fascinated me,…

I’m a first-year medical student who recently discovered the magnetic pull of surgery.

As one might assume, on my first day scrubbing into the OR under a pediatric surgeon, I was beyond excited. The surgeon’s precision and expertise fascinated me, and the constant activity in the surgical suite was something I could definitely get used to. Adrenaline was as pervasive as anesthesia in the OR, and I knew I’d thrive there.

However, …

Physician voices

What a life in medicine means to me: What this resident is thankful for

#LifeofaMedStudent

November 22, 2016Nov 22, 2016

Thanksgiving is this week, and I have a lot to be thankful for, both inside and out of medicine. Life isn't always easy as a resident, and to quote the lyrics of Journey, "And lovin' a man, ain't always what…

Thanksgiving is this week, and I have a lot to be thankful for, both inside and out of medicine. Life isn’t always easy as a resident, and to quote the lyrics of Journey, “And lovin’ a [medicine] man, ain’t always what it’s supposed to be.”

What’s a life in medicine mean to me? It’s certainly not the glamorous. I’m on the back half of 30 years old. I’ve been a doctor for little over …

Physician voices

Boo! Being a physician can be downright scary

Physician on FIRE, MD

October 31, 2016Oct 31, 2016

You won’t find me at any haunted houses this weekend. I don’t need any costumed creeps jumping out at me when I least (or most) expect it. I’ve never been a huge fan of strobe lights, fog machines, bad makeup,…

My day job is scary enough.

Some like to say that anesthesia is 99 percent boredom and 1 percent terror. They’re half right. The 99 percent is rarely boring. …

Physician voices

The most skilled surgeons are confident and humble

Sara Scarlet, MD

October 27, 2016Oct 27, 20163

I have a mentor who is quite gifted at getting me to break a sweat in the OR. No matter how well an operation is going, she’ll have me set my instruments down. “If this doesn’t work, what’s your plan B?” We discuss how variations in anatomy, damage to critical structures, or unanticipated pathology could change our operative plan. She challenges me to not only consider plan B, but plans …

Physician voices

The unacceptable cost of silence

Cedrek L. McFadden, MD

October 27, 2016Oct 27, 20165

Nearly a month before our national presidential election, a video surfaced online capturing a conversation between Presidential candidate Donald Trump and reporter Billy Bush. During this 2005 “private” conversation between the two, Trump lewdly brags to Bush about kissing and groping women without their consent. He is even heard boasting he can “get away” with this behavior because of his celebrity status. Trump has been heavily criticized for his words …

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The unacceptable cost of silence

Surgery and surgeons

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