A Catholic nun, who was the administrator of a small hospital once summed up for me the role business plays in patient care: “No money, no mission.”
In order for a practice to be successful, it must be run with healthy business principles in place. But the truth is that few physicians have any training in or knowledge about the business aspects of running a practice. A satisfying and successful career …
Once in a while someone asks me if it is hard to be a mother and a surgeon. Certainly, any surgeon-parent can appreciate that juggling a household full of schedules, classes, meals, bedtimes, and activities with a practice full of office visits, pre-operative clearances, post-operative check-ups, and surgeries has its challenges. And to be sure, before I became a mother I had no idea how this would impact my work.
Before any patient can go to the operating room, they need medical clearance from their primary physician. I look at this as a good thing.
Occasionally, a routine chest x-ray reveals lung cancer. Or, blood work shows abnormal values that point toward leukemia.
The bottom line for me is that I never argue when a primary care physician or specialist, such as a cardiologist, says the patient is too sick to have …
When doctors don’t have access to medications that are necessary to successfully perform procedures, patient safety is at risk. Over the past several years, drug shortages have significantly impacted the health care industry, making it not only difficult for physicians to do their jobs, but for …
Pilots never expect to hit a flock of birds on take off, or flame out an engine in mid-flight. No one plans to get disoriented in the air or have an equipment malfunction miles from the nearest airfield. And, it certainly isn’t routine to fly into hostile airspace with a heightened awareness of the known ground threats, the position of each member of your formation, and the safety of the …
One of my Physician’s Weekly posts last month was on the subject of surgeons possibly losing proficiency for doing open cases because of the ever-increasing popularity of laparoscopic and other minimally invasive techniques resulting in declining numbers of open operations for residents during their training.
Although some suggested that knowing how to do open cases would be unnecessary in the future, to me that is wishful thinking.
I don’t have much in the way of eyebrows. They were victims of too much plucking back in the 1960’s and when you do that, sometimes they don’t grow back. There’s a very nice woman in Solana Beach who shapes and darkens what I have left, infrequently, when I bother to think about it which isn’t very often.
I was in there about a year ago when she told me, “I …
An anesthetized patient fell to the floor headfirst from an operating room table during a laparoscopic appendectomy in Scotland. The table had been tilted into an extreme head down position to facilitate the operation. Fortunately, no injury occurred.
The Edinburgh Evening Newsaccount says that there were 10 staff members in the room at the time the case started, but no one had placed a safety restraint on the patient.
His right testicle had jumped into his abdomen after he lost control of his motorcycle on the highway. My 43-year-old patient, whom I’ll call Richard, in otherwise healthy condition, was brought to the ER with severe pain. Fortunately, his testicle was still intact and only needed to be put in the proper place.
I am an attending physician in the emergency department and trauma center at San Francisco General Hospital. I …
Arthroscopic knee surgery is big business in the United States. Arthroscopic partial meniscectomies alone cost $4 billion per year. Yes, billion. But do they work?
I’ve written previously about arthroscopic surgery for a torn meniscus and how it adds nothing above and beyond physical therapy for people with arthritis. We also know that arthroscopic knee surgery for arthritis isn’t effective either. Given the poor performance of these other arthroscopic surgeries, answering the …
When you need anesthesia for surgery or a diagnostic procedure, of course you want to know who’ll be giving you anesthesia. If you live in Texas, Florida, the District of Columbia, or 14 other states, you may be lucky enough to have an anesthesia team taking …
Referring to the idea that, like athletes, surgeons are engaged in demanding physical work, I wrote about having an “off-day.” Another side of the same coin is having a tough day: as distinguished from not being on one’s game, here I mean to describe what it’s like to face an exceedingly difficult and danger-filled situation.
Notwithstanding having one’s faculties and wits gathered and finely honed, as in command of yourself as you …
Recently, after a fairly long day of surgery where everything was going well, I was finishing my fourth case. It was about 2pm on a Friday, and we were running on schedule, which made me happy.
As I walked out to the waiting area in search of the family of the elderly woman on whom I had performed an elective procedure, I noticed her husband sitting in the corner. He stood …
We were startled to learn recently that Sheridan Healthcare Inc., a physician services company based in Florida, has bought one of the largest private anesthesiology group practices in California, the Medical Anesthesia Consultants Medical Group Inc. (MAC) of San Ramon.
The deal, which closed November 14, is Sheridan’s first in California, and “provides a platform that will accelerate our expansion in the California …
Partial liver donation is the only life-saving deed that a non-surgeon can do for another person suffering from end stage liver disease. On the other hand, a major operation on a healthy individual with no indication for surgery has been viewed by society with caution and skepticism.
One could wonder why a young, healthy individual would succumb to an elective high risk procedure. Simple answer: they want to save a life. …
I have generally felt in control of my life and behavior. Although I understand the future is always uncertain, I do as much as I can to plan for it and minimize risk to myself and my family. This includes focusing on avoidance of stress, healthy eating, and daily exercise. Despite this, anything is subject to change at any time for no apparent …
By its very nature, medicine involves close personal contact with others. Communication with patients, families, staff and colleagues is essential to success. All physicians have different ways in which they communicate — some more effective than others. The best communicators are able to inspire, engage, and cultivate trust. Everyone is born with different skill sets and communication styles may vary widely.
Recently, I came across an article in Inc.com that discussed …
Just as elite athletes are born with amazing skill, elite surgeons and doctors in other procedure-based specialties are also equipped with innate abilities that others do not possess. Surgical skill is often difficult to quantify. Certainly, outcomes data can be obtained and reputations are formed over time. Years of training allow the truly gifted surgeons to develop their skills and perfect their craft.
However, all surgeons are not created equal. During …
A Twitter follower wrote me this: “Hospital making me use ‘safety scalpel’ w/retractable sheath. I’ve almost cut myself x 2. Do you know of any data about it?”
That got me interested because I like to question things. Was this going to be yet another rule without evidence?
I thought I would have to do an exhaustive search to see if anyone had ever …
I have written a good amount about automation, the good, the bad and the ugly. I have written about doctors and ancillary providers and physician extenders, also good, bad and ugly. A recent comment on Karen Sibert’s excellent blog A Penned Point caught my eye as an amalgamation of these subjects.
This person wrote, and I hope he doesn’t mind my quoting him:
American anesthesiologists should focus much more …
