Surgery and surgeons

1,981 articles · Since 2004

Articles, page 49

Physicians specializing in the patient experience

March 22, 2014Mar 22, 2014

Imagine -- where would elective surgery be today if patients still worried about operating rooms exploding or developing liver and kidney failure from anesthesia? Having major surgery would be a very different experience without anesthesia. Before the advent of safe…

Imagine — where would elective surgery be today if patients still worried about operating rooms exploding or developing liver and kidney failure from anesthesia?

Having major surgery would be a very different experience without anesthesia. Before the advent of safe anesthesia techniques, the world of surgery was basically limited to amputations and other attempts at life-saving maneuvers. Dr. Bigelow’s publication describing the safe administration of ether changed everything, and the New …

Physician voices

The act of doing surgery will always be honorable

Sid Schwab, MD

March 19, 2014Mar 19, 20144

In my core, I always loved doing surgery, and being surgeon to my patients. As I hope I've made clear in my blog, I was always amazed that I was allowed to do it, and awed at the mysterious beauty…

In my core, I always loved doing surgery, and being surgeon to my patients. As I hope I’ve made clear in my blog, I was always amazed that I was allowed to do it, and awed at the mysterious beauty of it all. As much of a responsibility as it is, it’s also an inexplicably wondrous honor and privilege. Those words aren’t lightly written. But in a diabolical …

Physician voices

Aviation and anesthesiology: The importance of training

American Society of Anesthesiologists & James R. Mesrobian, MD

March 8, 2014Mar 8, 20145

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Comparisons between the airline industry and anesthesia care are common. One of the most commonly heard analogies is that the takeoff and landing of a jetliner are similar…

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

Comparisons between the airline industry and anesthesia care are common. One of the most commonly heard analogies is that the takeoff and landing of a jetliner are similar to induction and emergence during a general anesthetic. But there are other equally important analogies between the two professions. Today, payers, health care organizations and medical providers are focused more …

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Medical education

What is the best way to choose residents?

Skeptical Scalpel, MD

March 7, 2014Mar 7, 201410

On Twitter a while ago, a medical student asked me how surgical program directors select new residents. Then a discussion arose among some academic surgeons on the same topic. Someone suggested that medical school grades were the best way to…

The fact is that we aren’t really sure what the best way to choose residents is.

First, here’s what we really do.

A 2011 …

Conditions and diseases

Get rid of the cancer first before considering breast reconstruction

Miranda Fielding, MD

March 2, 2014Mar 2, 20147

When it comes to surgery for cancer, having a “positive margin” is a bad thing. It means that when the surgeon said he “got it all,” even though he meant it with all of his heart, likely he didn’t. For a woman undergoing a lumpectomy for breast cancer, that positive margin means a re-excision of the lumpectomy site or alternatively, a mastectomy. For a woman who has just had a …

Conditions and diseases

8 myths about painful breastfeeding

Bobby Ghaheri, MD

March 2, 2014Mar 2, 20143

In this post, I will do my best to try and address what is commonly said by doctors, dentists and lactation consultants who don't understand the correlation between tongue-tie and lip-tie and poor breastfeeding. I think that we must first…

In this post, I will do my best to try and address what is commonly said by doctors, dentists and lactation consultants who don’t understand the correlation between tongue-tie and lip-tie and poor breastfeeding. I think that we must first disprove what they think they know. I think these myths are born out of a complete lack of education, and with time, hopefully we won’t hear them as frequently.

I’ve compiled a list …

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8 myths about painful breastfeeding

Physician voices

Evidence-based guidelines today, malpractice tomorrow

Karen S. Sibert, MD

February 21, 2014Feb 21, 201411

We hold these truths to be self-evident: A hospital administrator with a clipboard is in search of a physician who isn’t following “evidence-based guidelines.” There are fads in medicine just as there are in fashion -- today’s ”evidence-based guidelines” may…

We hold these truths to be self-evident:

A hospital administrator with a clipboard is in search of a physician who isn’t following “evidence-based guidelines.”

There are fads in medicine just as there are in fashion — today’s ”evidence-based guidelines” may be tomorrow’s malpractice.

Did your hospital, like so many, abruptly switch from povidone-iodine antiseptic solution to ChloraPrep® for cleaning a patient’s skin before surgery? If so, I’m sure the staff was told that ChloraPrep would …

Conditions and diseases

The joy of creating smiles

Bhupesh Vasisht, MD

February 16, 2014Feb 16, 20143

As I finished surgery on a beautiful 10-year-old girl from a local orphanage with a secondary cleft lip deformity, I did not realize how this tiny little Filipino girl was about to humanize me and my entire team involved in her care. When I met her the day before with her caretaker from the orphanage, it was obvious that she had …

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The joy of creating smiles

Conditions and diseases

10 things to know about anesthesia and heart surgery

American Society of Anesthesiologists & Gregory M. Janelle, MD & Kent B. Berg, MD, MBA

February 15, 2014Feb 15, 2014

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. February is American Heart Month. Unfortunately, heart disease is a major problem in the United States that can result in surgery. In addition to discussing your procedure with…

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

February is American Heart Month. Unfortunately, heart disease is a major problem in the United States that can result in surgery. In addition to discussing your procedure with your surgeon, you want to be sure to discuss your anesthesia care with your physician anesthesiologist.

Here are 10 key questions and answers to help guide you through anesthesia for …

Conditions and diseases

A 2 question strategy to assess the worth of medical tests

Michael Kirsch, MD

February 13, 2014Feb 13, 20144

In the medical world, when a physician, a scientist, a hospital, a drug company or a panel of experts issues a report, the games begin. If one agrees with the statement or benefits from it, then the report is heralded…

If, however, the report suggests a new medical pathway that diminishes your relevance or reimbursement, then the report and its authors are regarded as misguided. Yes, I am …

Conditions and diseases

Analyzing the Jahi McMath case

Christopher Johnson, MD

February 11, 2014Feb 11, 201455

The recent tragedy of Jahi McMath, the 13-year-old girl who died following complications of tonsillectomy and adenoidectomy, has focused many people on the question of brain death. Although I have no more details about this case than anyone else reading the news, I am quite familiar with the sort of things that happened to this unfortunate child. As many of you know, her family does not believe she …

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Analyzing the Jahi McMath case

Physician voices

Physician burnout: The additive effect of bureaucracy on the psyche

Sid Schwab, MD

February 10, 2014Feb 10, 20145

In trying to understand my own burnout, "control" (or lack thereof) is a dominant theme. This is nothing new. In fact, I doubt I'm unearthing bones not already thoroughly analyzed. But I can give instructive personal examples. For a while…

In trying to understand my own burnout, “control” (or lack thereof) is a dominant theme. This is nothing new. In fact, I doubt I’m unearthing bones not already thoroughly analyzed. But I can give instructive personal examples.

For a while I was on the board of directors of my clinic, which was then and is even more so now one of the most successful doctor-owned and -managed in the US. During …

Physician voices

Why doctors and hospitals shouldn’t advertise

Skeptical Scalpel, MD

February 6, 2014Feb 6, 201425

The decline of medicine as a profession began when it became legal for doctors and hospitals to advertise. Apparently it all started when an Arizona lawyer sued for his first amendment right to advertise his services. In 1977, the US…

The decline of medicine as a profession began when it became legal for doctors and hospitals to advertise.

Apparently it all started when an Arizona lawyer sued for his first amendment right to advertise his services. In 1977, the US Supreme Court ruled that states could not prohibit advertising by lawyers.

This opened the floodgates for all professionals. Soon advertising by doctors and hospitals became common.

I don’t know what it’s like where …

Physician voices

Removing a suture: What the future may bring

Bruce Campbell, MD

February 6, 2014Feb 6, 20145

The future of robotic surgery can be determined only by probing the possibilities. To ignore the potential for extending the boundaries and safety of surgical care with robotic technology seems unwise. -"The Future of Robotics," Bulletin of the American College…

The future of robotic surgery can be determined only by probing the possibilities. To ignore the potential for extending the boundaries and safety of surgical care with robotic technology seems unwise.
-“The Future of Robotics,” Bulletin of the American College of Surgeons (July) 2013; 98:9-15.

It is a spring morning in July 2047. Jenny, a nursing assistant, emerges from an exam room and gently closes the door. She is wearing scrubs tastefully covered with …

Physician voices

The callousness of the two surgeons is what remains

Jordan Grumet, MD

January 29, 2014Jan 29, 201414

When I was seventeen, I developed a medical problem due to no fault of my own. It was painful, it was embarrassing, and when it became uncomfortable enough to disrupt my life, I went to see a well known surgeon…

The specialist, tucked away in the hallow halls of academia, stared down at me past a pair of spectacles perched at the end of his ever-protruding nose. When he examined …

Physician voices

Money is only a microcosm of physician burnout

Sid Schwab, MD

January 27, 2014Jan 27, 201412

The medical director of my clinic once gave me a book on burnout. I never read it. Didn't have the time or energy. Because a young reader considering a career in surgery referred to stories he's heard of depressed and…

The medical director of my clinic once gave me a book on burnout. I never read it. Didn’t have the time or energy.

Because a young reader considering a career in surgery referred to stories he’s heard of depressed and disappointed surgeons and asked for my thoughts, I’ll try to address it. Parenthetically, I’ve heard from more than a few readers that my blog and/or book has inspired them to consider …

Physician voices

Take the time to understand the business of medicine

Sidney Christiansen, MD

January 26, 2014Jan 26, 20144

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…

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 …

Physician voices

Being a mother has made me a better physician

Lara Devgan, MD, MPH

January 24, 2014Jan 24, 20143

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.

What …

Physician voices

How to proceed if patients push back

Starla Fitch, MD

January 22, 2014Jan 22, 20144

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…

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 …

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How to proceed if patients push back

Drugs and prescribing

Drug shortages can jeopardize patient safety

American Society of Anesthesiologists & Jeffrey S. Jacobs, MD

January 18, 2014Jan 18, 2014

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

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

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 patients to receive optimal care. For some reason, though, this issue hasn’t …

Surgery and surgeons

Articles, page 49

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