KevinMD.com: Social media’s leading physician voice
The KevinMD newsletterReal physician voices, twice a weekFree, and one click to unsubscribe.
Subscribe free →
NEWExperts by KevinMDPhysicians and health care experts, by specialty.Amy Bourne RozellePhysical therapistJoe PazonaUrologistPatricia De Marco CentenoPsychiatristShiv K. GoelInternistIsabella HowerOccupational therapistDuane PenshornEmergency physicianHarsha MooleInternistBarbara SparacinoPsychiatristNebyou BelayPsychiatristHeather BassettInternistAlan P. FerenRetired surgeonTrey WilliamsPediatricianCourtney Markham-AbediPsychiatristRobert MurryFamily physicianBobby DuboisInternistAnne BaskakovaDigital health leaderCraig HaubenHealth care CEOReed ChiuHealth care writerMike ChandoCapital strategistBrowse experts

Surgery and surgeons

1,981 articles · Since 2004

Articles, page 46

Physician voices

Examining the safety of outpatient surgery centers

2

The unexpected death of Joan Rivers at 81 years of age occurred during a routine outpatient procedure at an accredited doctor-owned surgery center. Although there are few confirmed reports of what actually occurred, what we do know is that media-fed…

The unexpected death of Joan Rivers at 81 years of age occurred during a routine outpatient procedure at an accredited doctor-owned surgery center. Although there are few confirmed reports of what actually occurred, what we do know is that media-fed information can resonate amongst the general public — and our patients. Concerns have been raised about the outpatient setting, patient selection, and types of surgeries that are performed.

As a result, the responsibility …

Read more…

Examining the safety of outpatient surgery centers

Physician voices

The outrageous $117,000 bill from an assistant surgeon

96

Recently, I wondered why Medicare could not control its costs using the investigative power of the federal government instead of releasing physician payment data and relying on journalists to do the work. Two stories that appeared within days of each…

Recently, I wondered why Medicare could not control its costs using the investigative power of the federal government instead of releasing physician payment data and relying on journalists to do the work.

Two stories that appeared within days of each other raise a similar question about the private insurance industry’s methods.

An article in Modern Healthcare described the impending closure of …

Read more…

The outrageous $117,000 bill from an assistant surgeon

Physician voices

Joan Rivers’ death: What went wrong?

18

The ear, nose and throat specialist who treated comedian Joan Rivers on August 28 has been identified as Dr. Gwen Korovin, a prominent New York physician who is known as a voice doctor to many entertainers and Broadway stars including…

The ear, nose and throat specialist who treated comedian Joan Rivers on August 28 has been identified as Dr. Gwen Korovin, a prominent New York physician who is known as a voice doctor to many entertainers and Broadway stars including Hugh Jackman and Julie Andrews.

With a physician who is an expert in airway anatomy at her side, and all the technologic …

Read more…

Joan Rivers’ death: What went wrong?

Real physician voices, twice a week

Free, and one click to unsubscribe.

No spam. We never share your email.

Physician voices

Why must medical malpractice cases be devoid of decency?

20

Part 2 of a series. Read part 1. I realized I was entering into a process the rules of which were entirely separate from normal human interaction when it hit me that news of the lawsuit was in the newspaper…

Part 2 of a series. Read part 1.

I realized I was entering into a process the rules of which were entirely separate from normal human interaction when it hit me that news of the lawsuit was in the newspaper before anyone had had the decency to contact me. What kind of people act like that? Civilized behavior, respectfulness — in short, all the ways in which you’d think nice …

Read more…

Why must medical malpractice cases be devoid of decency?

Physician voices

To reduce health costs, everyone needs to be on the same page

“Mr. Jones’ chest x-ray looks normal,” the intern said to me on morning rounds. Mr. Jones just had a transhiatal esophagectomy (THE). The esophagus is the muscular tube that connects the back of one’s throat to their stomach. It can…

“Mr. Jones’ chest x-ray looks normal,” the intern said to me on morning rounds.

Mr. Jones just had a transhiatal esophagectomy (THE).  The esophagus is the muscular tube that connects the back of one’s throat to their stomach.  It can develop cancer or become completely dysfunctional because of benign processes, and therefore need to be removed.

A THE involves cutting out the patient’s esophagus, in Mr. Jones’ case for cancer, bringing the stomach up …

Read more…

To reduce health costs, everyone needs to be on the same page

Physician voices

Surgery is one of the biggest barriers to space travel

6

The astronauts are halfway to Mars when suddenly one of them develops abdominal pain and requires surgery. What will they do? According to NASA, a miniature robot capable of assisting in surgery has been developed, tested in pigs, and is…

The astronauts are halfway to Mars when suddenly one of them develops abdominal pain and requires surgery. What will they do?

According to NASA, a miniature robot capable of assisting in surgery has been developed, tested in pigs, and is soon to be trialed in a weightless environment. The robot, which weighs less than 1 pound, can be inserted into the abdomen via the umbilicus and controlled remotely.

The press release from …

Read more…

Surgery is one of the biggest barriers to space travel

Physician voices

Chance: The difference between an unlucky surgeon and a killer

4

Risk-adjusted 30- to 90-day outcome data for selected types of operations done by specific surgeons and hospitals are now being publicly posted online by England's National Health Service. According to the site, "Any hospital or consultant identified as an outlier…

Risk-adjusted 30- to 90-day outcome data for selected types of operations done by specific surgeons and hospitals are now being publicly posted online by England’s National Health Service.

According to the site, “Any hospital or consultant [attending surgeon in the UK] identified as an outlier will be investigated and action taken to improve data quality and/or patient care.”

After cardiac surgery outcomes data were made public in New York, some interesting unexpected consequences were …

Read more…

Chance: The difference between an unlucky surgeon and a killer

Physician voices

Joan Rivers: Pushing the limits of outpatient care

23

There are minor operations and procedures, but there are no minor anesthetics. This could turn out to be the one lesson learned from the ongoing investigation into the death of comedian Joan Rivers. Ms. Rivers’ funeral was held on September…

There are minor operations and procedures, but there are no minor anesthetics.  This could turn out to be the one lesson learned from the ongoing investigation into the death of comedian Joan Rivers.

Ms. Rivers’ funeral was held on September 7.  Like so many of her fans, I appreciated her quick wit as she entertained us for decades, poking fun at herself and …

Read more…

Joan Rivers: Pushing the limits of outpatient care

Physician voices

Taking lawsuits personally: A surgeon’s first malpractice case

26

In all my years of practice, my dad called me at the office only twice. The second was to inform me of a horrible family tragedy. The first -- well, I guess in a small way you could say it…

Part 1 of a series.

In all my years of practice, my dad called me at the office only twice. The second was to inform me of a horrible family tragedy. The first — well, I guess in a small way you could say it was the same.

“I hear you joined the club,” he said.

“What?”

I had no idea what he was talking about. I’d …

Read more…

Taking lawsuits personally: A surgeon’s first malpractice case

Patient voices

Miscommunication added to the cost of neurosurgery

2

A few years ago, as I prepared for neurosurgery, a nurse who worked there told me, “Spend as little time in the hospital as possible, because the longer you stay, the more likely you are to get sick.” In a…

A few years ago, as I prepared for neurosurgery, a nurse who worked there told me, “Spend as little time in the hospital as possible, because the longer you stay, the more likely you are to get sick.”

In a way, that statement seemed quite telling of what was to come for me and an indicator cost of care — the added cost of additional care, additional hospitalizations, and the additional …

Read more…

Miscommunication added to the cost of neurosurgery

Physician voices

Anesthesia outside the operating room: A growing trend

11

I opened my obligatory late-afternoon email to find my work schedule for the next morning: three general anesthetics for MRIs. My heart sank. A week before, I had been assigned to the new neurosciences MRI suite for a 6-hour interventional…

I opened my obligatory late-afternoon email to find my work schedule for the next morning: three general anesthetics for MRIs. My heart sank. A week before, I had been assigned to the new neurosciences MRI suite for a 6-hour interventional radiology procedure, followed by another intervention in the CT scanner. My first thought: Who is trying to punish me?

It’s well known in the anesthesiology field that these types of cases …

Read more…

Anesthesia outside the operating room: A growing trend

Social media in medicine

Medical journals have to become more like blogs

3

An orthopedist asked me if I could explain why a couple of papers of his did not generate any feedback. He wasn't even sure that anyone had read them. He enclosed PDFs for me. Not being an orthopedist, I cannot…

An orthopedist asked me if I could explain why a couple of papers of his did not generate any feedback. He wasn’t even sure that anyone had read them. He enclosed PDFs for me.

Not being an orthopedist, I cannot comment on their validity.

But I think I can explain why the papers have not created much interest.

Are you familiar with the term, “impact factor“?

A journal’s impact factor is an

…

Read more…

Medical journals have to become more like blogs

Physician voices

A bystander to the evolution of plastic surgery

11

I have a new favorite doctor show, “The Knick” on Cinemax, airing on Friday nights. The show stars Clive Owen as the charismatic cocaine-addicted chief of surgery Dr. John Thackery at a fictitious New York City hospital called The Kickerbocker…

I have a new favorite doctor show, “The Knick” on Cinemax, airing on Friday nights.   The show stars Clive Owen as the charismatic cocaine-addicted chief of surgery Dr. John Thackery at a fictitious New York City hospital called The Kickerbocker at a time when surgery was one foot out of the barbershop.  The tagline is as they say, priceless: “Modern medicine had to start somewhere.”

On the third episode, last Friday …

Read more…

A bystander to the evolution of plastic surgery

Physician voices

Deciphering hospital bills is not for the faint of heart

9

An excerpt from The Cost of Cutting: A Surgeon Reveals the Truth Behind a Multibillion-Dollar Industry. Deciphering the hieroglyphics of hospital bills, especially when it involves surgery, is not a job for the faint of heart. As Mr. Wilkes discovered…

An excerpt from The Cost of Cutting: A Surgeon Reveals the Truth Behind a Multibillion-Dollar Industry.

Deciphering the hieroglyphics of hospital bills, especially when it involves surgery, is not a job for the faint of heart. As Mr. Wilkes discovered when comparing notes with a friend, there’s another puzzle: the huge variation in charges between hospitals and surgi‐centers for the same operation. For surgeons, too, trying to figure …

Read more…

Deciphering hospital bills is not for the faint of heart

Physician voices

Surgeons can’t be responsible for every mistake

9

Several months ago, a post called, "Everything's my fault: How a surgeon says I'm sorry," appeared here on KevinMD.com. It was written by a plastic surgeon who feels that no matter goes wrong with a patient, surgeons should never blame…

Several months ago, a post called, “Everything’s my fault: How a surgeon says I’m sorry,” appeared here on KevinMD.com. It was written by a plastic surgeon who feels that no matter goes wrong with a patient, surgeons should never blame anyone else.

She gave some examples such as the lab losing a specimen, a chest x-ray that was ordered and not done, a patient eating something when he was not to …

Read more…

Surgeons can’t be responsible for every mistake

Physician voices

Robots and health costs: Can either be tamed?

15

There are many reasons why the costs of delivering simple, uncomplicated health care in this country keep increasing while quality lags and value fails to keep pace with that of most major industrialized countries. But as a surgeon, I have…

There are many reasons why the costs of delivering simple, uncomplicated health care in this country keep increasing while quality lags and value fails to keep pace with that of most major industrialized countries. But as a surgeon, I have a one-word answer for all that is wrong with health care: “robots.”

Surgical robots, costing an estimated 1.2 to 2.5 million dollars each with matching maintenance fees of $125,000 per year, …

Read more…

Robots and health costs: Can either be tamed?

Medical education

Selecting grittier surgeons is harder than you think

2

In case you haven't noticed, a hot new topic in education is "grit." In order to reduce the long-standing 20% attrition rate of surgical residents, some say we should select applicants who have more grit or conscientiousness. A recent paper…

In case you haven’t noticed, a hot new topic in education is “grit.” In order to reduce the long-standing 20% attrition rate of surgical residents, some say we should select applicants who have more grit or conscientiousness.

A recent paper in Surgery reported residents who dropped out of programs had decreased levels of grit as measured by a short-form survey. But due to unexpectedly low attrition rates in the surgical programs …

Read more…

Selecting grittier surgeons is harder than you think

Physician voices

A relationship between a surgeon and an intensivist

Not too long after setting up shop in this town, I shared a tough case with one of my favorite intensivists. (By way of diversion, I'll add there were only two of them at the time, and they were both…

Not too long after setting up shop in this town, I shared a tough case with one of my favorite intensivists.

(By way of diversion, I’ll add there were only two of them at the time, and they were both my favorites. Practical and canny, surgical-patient-wise, they were a pleasure to work with. Over the years we developed great mutual respect and affection; to the extent that caring for critically ill and deeply …

Read more…

A relationship between a surgeon and an intensivist

Physician voices

A primer on the anesthesia care team model

4

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Daily, and often several times a day, I am asked by patients about my role as a physician anesthesiologist. Occasionally the answer involves reiterating to patients that an…

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

Daily, and often several times a day, I am asked by patients about my role as a physician anesthesiologist.  Occasionally the answer involves reiterating to patients that an anesthesiologist is a physician.  Once we get into the discussion, patients are also surprised to learn that as part of an anesthesia care team (ACT), although I am frequently in …

Read more…

A primer on the anesthesia care team model

Physician voices

Rethinking the fix-it model in medicine

She seemed awfully angry and at the very least dubious that I couldn’t do more for her father. After 7 hours of surgery trying to salvage her father’s leg, I tried patiently to explain that this new (third) bypass we…

She seemed awfully angry and at the very least dubious that I couldn’t do more for her father. After 7 hours of surgery trying to salvage her father’s leg, I tried patiently to explain that this new (third) bypass we had just successfully completed was unlikely to provide her dad with a long-term solution. Ultimately, he would lose the leg, if we were lucky he’d have it for another year …

Read more…

Rethinking the fix-it model in medicine

66
pages