Surgery and surgeons

1,981 articles · Since 2004

Articles, page 36

The perioperative surgical home: What’s in a name?

American Society of Anesthesiologists & Ronald L. Harter, MD

July 7, 2016Jul 7, 20167

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Our institution, like countless others across the country, has been working to institute processes to achieve the “triple aim” of improving the quality of health care, increasing patient…

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

Our institution, like countless others across the country, has been working to institute processes to achieve the “triple aim” of improving the quality of health care, increasing patient satisfaction, and reducing the cost of providing that care.

As chair of my anesthesiology department, a number of our faculty were intrigued by the perioperative surgical home (PSH) concept …

Physician voices

Physician-led anesthesia is safe anesthesia

Edward R. Mariano, MD

July 5, 2016Jul 5, 20168

Many people, even those who work in the operating room every day, take safe anesthesia care for granted. There has been growing pressure recently to abandon the team model and remove physician anesthesiologists’ supervision of nurse anesthetists with the latest threat coming from within Veterans Affairs (VA) health care. For our veterans, our heroes and arguably some of the most medically complex patients, having both …

Physician voices

Tips to improve your communication with patients

Michael Ho, MD

July 3, 2016Jul 3, 2016

"We experienced an iatrogenic event that produced an untoward sequela, and while it is now quiescent, it may still recrudesce." No one likes to be given bad news, especially of disease. But first, you have to understand what it means.…

“We experienced an iatrogenic event that produced an untoward sequela, and while it is now quiescent, it may still recrudesce.”

No one likes to be given bad news, especially of disease. But first, you have to understand what it means. When it comes to communication of medical information, the way the message is delivered is often just as important as the information itself. Indeed, good communication is the backbone of every patient-provider relationship.

The …

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A patient dies during live video surgery. Who’s to blame?

Skeptical Scalpel, MD

June 23, 2016Jun 23, 201612

"Was the delay in deciding to open influenced by the presence of an audience of 100 surgeons expecting to see a laparoscopic liver resection?" “In addition to his tumor, the patient had hepatitis and cirrhosis. Was he a good candidate?…

“Was the delay in deciding to open influenced by the presence of an audience of 100 surgeons expecting to see a laparoscopic liver resection?”

“In addition to his tumor, the patient had hepatitis and cirrhosis. Was he a good candidate? A major complication was inevitably to occur during a live broadcast.”

As I predicted last year, it had to happen sooner or later.

In that post, I wrote, “A major complication will inevitably …

Physician voices

We need to stop sugarcoating our cancer prognoses

James Wu, MD

June 21, 2016Jun 21, 20166

Mrs. Liu, who was only 58 years old, had metastatic ovarian cancer. Despite radical surgery and chemotherapy, her disease persisted. Worse yet, her PET scan from a few months ago revealed that she had carcinomatosis — numerous deposits of cancer showered throughout her abdomen. This particular night, she starting having more nausea and couldn’t eat or drink anything without vomiting. So, she came to the ED. I was called into …

Physician voices

How our patients make us better

Robert Pearl, MD

June 19, 2016Jun 19, 2016

My last column told the stories of two patients from whom I learned important lessons about gratitude and compassion. In this column, I share stories about patients who taught me critically important lessons about truly listening and the power of…

Samantha — or Sam, as she preferred to be called — was a young surfer recovering from a serious car accident, and Paul a young father with cancer. …

Read more…

How our patients make us better

Physician voices

I’m in the wrong era of medicine to be a doctor. Here’s why.

Cesar Padilla, MD

June 18, 2016Jun 18, 20162

As a doctor ready to finish my residency in anesthesiology, most people would assume I am thrilled to be at the finish line of this long, challenging and grueling process. While I am happy to move on and begin practicing…

Physician finance

When this doctor retires early, here are 4 things he’ll miss

Physician on FIRE, MD

June 10, 2016Jun 10, 201611

As a physician who is planning an early retirement, and is writing about the topic often, I find that retirement is frequently on my mind. It’s not difficult to articulate my desire for an early retirement. I crave the freedom and time with my family. I look forward to restful nights free from the threat of the loathsome pager. Another round of MOC is not for me, and I’m ready …

Physician voices

The hospital’s homeless at night

Ahmed Zaafran, MD

June 9, 2016Jun 9, 2016

Sometimes when I’m working at the hospital overnight, I go for walks. Every now and then, things calm down in the operating room, and you can get some time to relax. Life moves at such a break-neck pace, especially within…

Walking around a hospital at night is very different than during the day. During the day, it feels like …

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The hospital’s homeless at night

Medical education

A surgeon is humbled by unexpected feedback

Heena P. Santry, MD

June 8, 2016Jun 8, 20164

“Hey, Doc!” I heard the patient say as I blazed by bed A. Bed A is the "door" bed. My patient was in bed B, the "window" bed. I had just met him; it was a new inpatient consult. For…

“Hey, Doc!” I heard the patient say as I blazed by bed A.

Bed A is the “door” bed. My patient was in bed B, the “window” bed. I had just met him; it was a new inpatient consult. For all the rules and regulations surrounding patient confidentiality, the curtains between beds do little to protect privacy since inevitably there will be audible conversations about symptoms, diagnosis, and management between patients and …

Physician voices

As physicians, we learn much from our patients

Robert Pearl, MD

June 7, 2016Jun 7, 20165

When I first met Mary, already in her forties, she had suffered throughout her life from an arteriovenous malformation of the face. As a result, from early childhood, she had endured the discomfort and humiliation that accompanies the stares of…

The abnormal connection between the arterial and venous halves of her circulatory system caused her cheek, jaw, and neck to …

Physician voices

Here are the lessons I learned from caring for my ailing father

Michael Goldberg, MD

May 26, 2016May 26, 2016

I very distinctly remember March 16, 2015. I was the chief surgical resident on call for trauma at my busy urban training program. Like any other springtime trauma call I was steadily busy, running back and forth from penetrating and blunt trauma victims in the trauma bay to inpatients, OR cases, and attending rounds. The characteristically hectic flow of the day was interrupted when I got a call from my …

Physician voices

Plastic surgery is more than Botox. Hopefully doctors can remember that.

Miranda Fielding, MD

May 21, 2016May 21, 2016

My friend Dawn and I recently attended an evening meeting of the Houston Society of Plastic Surgeons. Since we were invited guests, and not plastic surgeons, we didn’t stop on the way into the lovely formal dining room to pick up our name badges because the organizers had not made them for us. On the way out, however, we both noticed clear plastic perfectly formed oval objects sitting on the …

Medical education

A paralyzed surgery resident is told not to come back. She needs your help.

Pamela Wible, MD

May 16, 2016May 16, 201643

Meet Dr. Svetlana Kleyman, a powerhouse chief surgery resident with a heart of gold, who works 16-hour days and runs marathons in her free time. Just 18 months before she was to graduate from SUNY Downstate, she developed a spinal infection that left her paralyzed from the waist down. After months of rehab, she was cleared by her doctors to resume work …

Physician finance

How this doctor achieved financial independence at age 39

Physician on FIRE, MD

May 16, 2016May 16, 20163

I would like to discuss how I achieved financial independence at age 39, and how it allows me the freedom to practice medicine in a way that keeps me happy. Financial independence is defined as having enough money saved and…

I would like to discuss how I achieved financial independence at age 39, and how it allows me the freedom to practice medicine in a way that keeps me happy.

Financial independence is defined as having enough money saved and invested in a way that would allow you to quit gainful employment and continue your present standard of living. The math, based on a 4 percent withdrawal rate, requires you to have …

Physician finance

When looking for a new physician job, location matters most

Cory Fawcett, MD

May 5, 2016May 5, 201612

If it’s time to establish your first practice or change to a new one, don’t make the mistake of thinking it’s no big deal where you go. The decision you’re about to make will positively or negatively impact the rest of your life. If you don’t choose right, the correction can be very expensive and take a high emotional toll. The cost attributed to one of my friend’s moves to …

Physician voices

Why I’m doing one of the riskiest surgeries in medicine

Robin Kim, MD

May 4, 2016May 4, 20162

If the act of organ donation is among humanity’s greatest gifts, what can be said of living donors who undergo surgery to extend and improve the life of another? It’s truly a courageous and inspiring sacrifice. I was honored recently…

I was honored recently to be able to perform my first living-donor liver transplant. Jason Clark, 28, donated about 60 percent of his liver to his father, Lynn, 57, who had been sick for many …

Physician voices

The family member in the corner may be paying more attention than you think

Karen S. Sibert, MD

May 3, 2016May 3, 20164

Nothing brings out the mama lioness in me more than seeing one of my cubs not being treated as well as I think it should be. Recently I had the unusual experience of accompanying my oldest daughter into an unfamiliar…

Nothing brings out the mama lioness in me more than seeing one of my cubs not being treated as well as I think it should be.

Recently I had the unusual experience of accompanying my oldest daughter into an unfamiliar hospital for a minor surgical procedure. Now, this daughter isn’t exactly a cub; she’s a full-fledged adult, with a master’s degree in health care administration, a husband, and two small boys of …

Physician voices

Conquering guilt as a trauma surgeon mother

Jamie Coleman, MD

April 30, 2016Apr 30, 2016

Guilt was not a huge part of my vocabulary until I became a mom. I never felt much guilt about how I spent my time. Didn’t feel guilty about sleeping in, or working out, or having a girls’ night out.…

And then I became a mom. You know, that moment when you get shoved into the most beautiful world; a place more beautiful than you could …

Physician voices

Surgical residency hurt the people that mean the most to me

Anonymous

April 27, 2016Apr 27, 2016

Three weekday call shifts left and two more weekends. The light at the end of the tunnel is shining bright, and I am relieved to be walking towards it. The only question that remains is what will I have left…

I started residency with a husband who I loved more than life itself. I was codependent to a fault, never wanted to …

Surgery and surgeons

Articles, page 36

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