Surgery and surgeons

1,981 articles · Since 2004

Articles, page 51

The memories of my first hospital job remain fresh

October 31, 2013Oct 31, 2013

You cannot connect the dots looking forward; you can only connect them looking backwards. -Steve Jobs "Doesn't that window open any wider? Bring in another fan!" the surgeon demands. Beads of sweat gather at the edge of his cloth cap…

You cannot connect the dots looking forward; you can only connect them looking backwards.
-Steve Jobs

“Doesn’t that window open any wider? Bring in another fan!” the surgeon demands.

Beads of sweat gather at the edge of his cloth cap and the circulating nurse steps up periodically to wipe them away. Heat and city noise roll through the open windows and into the operating room. The brief morning rain shower has left the …

Health technology

How video can reduce medical errors and improve patient care

Robert Wachter, MD

October 28, 2013Oct 28, 201315

About eight years ago I was desperate to improve my golf game. I just couldn’t straighten out my drives or hit my irons crisply. (Yes, I’m fully aware that this is a first world problem). I decided to try golf…

My sensei, a crusty ex-touring pro named Artie McNickle, watched me hit several dozen balls on the driving range, video recorder running. “So, …

Physician voices

Tales of two nights before hip surgery

Hans Duvefelt, MD

October 23, 2013Oct 23, 2013

On a hot afternoon in July Harold “Junior” Bray walked around his small farmhouse one last time before it was time to leave for the hospital. Everything was in order -- the coffee maker was unplugged, the windows secure and…

On a hot afternoon in July Harold “Junior” Bray walked around his small farmhouse one last time before it was time to leave for the hospital. Everything was in order — the coffee maker was unplugged, the windows secure and the message on his brand new answering machine informed callers that he would return their call as soon as his health permitted.

Every step was deliberate, slow and painful. Whenever he …

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Tales of two nights before hip surgery

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Insurers should stop paying for robotic hysterectomies

Jennifer Gunter, MD

October 21, 2013Oct 21, 201320

A new study confirms what previous studies tell us. That a robotic hysterectomy is not a safer or a more efficient way to remove a uterus for non-cancerous (benign) surgery than a traditional laparoscopic approach. This study indicates that there is little difference between the two types of surgery with one glaring exception, a robotic hysterectomy was $2,489 more expensive than a laparoscopic hysterectomy.

Several months ago the American Congress of Obstetricians …

Physician voices

Not all adverse events are preventable

Skeptical Scalpel, MD

October 16, 2013Oct 16, 201357

Medical errors are a real problem. I won't deny that. It was bad enough when the often-quoted Institute of Medicine figure that 98,000 deaths per year in the US are caused by medical errors was in vogue, but now a…

Medical errors are a real problem. I won’t deny that.

It was bad enough when the often-quoted Institute of Medicine figure that 98,000 deaths per year in the US are caused by medical errors was in vogue, but now a paper in the Journal of Patient Safety states that adverse medical events result in 210,000 to 400,000 deaths per year and 10 to 20 times those numbers of serious …

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Not all adverse events are preventable

Physician voices

I no longer wanted to be a surgeon

bongi, MD

October 16, 2013Oct 16, 20135

It was a battle. Looking back I don't think we ever had a chance, but you don't just give up on a young man in the prime of his life. We had to try. He was my patient. He was…

It was a battle. Looking back I don’t think we ever had a chance, but you don’t just give up on a young man in the prime of his life. We had to try. He was my patient.

He was a foreigner, on a gap year in Africa where he was going to learn all sorts of things about conservation and African wildlife. Up until the accident, all had apparently gone …

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I no longer wanted to be a surgeon

Physician voices

Medical training is a product of willful preparation

David L. Katz, MD

October 15, 2013Oct 15, 2013

I have been a loyal patron of the Karma Hair Salon in New Haven, Conn. for at least the past 15 years. Whenever my hair looks good, it is thanks to Karma and owner Cheryl McMahon's expert attention to my…

I have been a loyal patron of the Karma Hair Salon in New Haven, Conn. for at least the past 15 years. Whenever my hair looks good, it is thanks to Karma and owner Cheryl McMahon’s expert attention to my unruly head (the thickness of my hair — a good problem, I know! — could give a yak envy; and I have more cowlicks than several small countries). If ever my hair doesn’t look …

Conditions and diseases

A tiny baby on a big table in a huge OR

Sid Schwab, MD

October 13, 2013Oct 13, 20133

The potential to do dramatic good, as is the case with surgery, means that sitting and staring back at you at the other end of the see-saw is a grinning dysmorphic ogre. He keeps his eyes locked on yours, staring with the smug certainty that you can’t toss him off, up when you’re down; down when you’re up. The ugly little sonovabitch never goes away. It’s an issue for every healthcare provider. Were it …

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A tiny baby on a big table in a huge OR

Social media in medicine

The OR is not a good place for a prank

Skeptical Scalpel, MD

October 2, 2013Oct 2, 20136

An anesthesiologist at a California hospital pasted stickers simulating a mustache and teardrops on the face of a hospital employee while she was having surgery on a finger. According to the Los Angeles Times, the doctor said, "I thought she…

An anesthesiologist at a California hospital pasted stickers simulating a mustache and teardrops on the face of a hospital employee while she was having surgery on a finger.

According to the Los Angeles Times, the doctor said, “I thought she would think this is funny and she would appreciate it.”

And if that wasn’t bad enough, a “nursing attendant” took a photograph.

The patient, who said she had to quit her job …

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The OR is not a good place for a prank

Physician voices

The latest salvo in the federal government’s war on physicians

Karen S. Sibert, MD

September 27, 2013Sep 27, 201327

The latest salvo in the federal government’s war on physicians comes to us courtesy of the Veterans Health Administration (VHA), which is proposing drastic policy changes to expand nursing scope of practice in all veterans’ hospitals. A new draft VHA…

A new draft VHA Nursing Handbook would eradicate all existing VHA policies concerning physician supervision, and would designate all advanced practice registered nurses (APRNs), including nurse anesthetists, as licensed independent practitioners (LIPs). This means that …

Patient voices

A 77 percent success rate is good enough for a guy without insurance

Andrew T. Gray, PA-C

September 26, 2013Sep 26, 201320

The doctor was adamant. "This is America, not Sweden," he told me. "We operate." How did this happen to me? I wondered, looking at him across the ER exam room. How could I, a healthcare provider, not have insurance? I…

The doctor was adamant. “This is America, not Sweden,” he told me. “We operate.”

How did this happen to me? I wondered, looking at him across the ER exam room. How could I, a healthcare provider, not have insurance?

I had woken up that morning with a mildly upset stomach. Nonetheless, I’d gone to my job (begun only six weeks earlier) as a physician assistant at a Beverly Hills HIV clinic. I’d seen patients …

Physician voices

3 stories of surgeons that I find disturbing

Skeptical Scalpel, MD

September 23, 2013Sep 23, 201313

An orthopedic surgeon from New York reportedly has 261 malpractice suits against him. He has been accused of performing "phantom" and unnecessary operations. In one case, he supposedly performed a knee reconstruction, and the patient died of a pulmonary embolism…

An orthopedic surgeon from New York reportedly has 261 malpractice suits against him. He has been accused of performing “phantom” and unnecessary operations. In one case, he supposedly performed a knee reconstruction, and the patient died of a pulmonary embolism the same day. A post-mortem examination allegedly showed no evidence of a reconstructed knee.

There is also said to be evidence showing that in one day he was doing as many …

Physician voices

With the patient hemorrhaging, doctors are backed into a corner

Jordan Grumet, MD

September 23, 2013Sep 23, 20133

We were pretty damn lucky that she was young and healthy. The surgery had been technically successful. I watched as the resident finished with the last sutures. Although the attending had already left the room, I looked on with the…

We were pretty damn lucky that she was young and healthy.

The surgery had been technically successful. I watched as the resident finished with the last sutures. Although the attending had already left the room, I looked on with the eagerness of a third year student. Orders were written, and the patient was transferred to recovery.

It was a routine hysterectomy. None of the pizazz and flare of a gynecology-oncology surgery, but …

Physician voices

The horror and beauty of performing an amputation

Sid Schwab, MD

September 22, 2013Sep 22, 2013

There's something irresistibly horrifying about doing an amputation. I did several during training, and a few in practice, before eventually turning such cases over to people who did it more. In a way, it's a microcosm of the perversity and…

There’s something irresistibly horrifying about doing an amputation. I did several during training, and a few in practice, before eventually turning such cases over to people who did it more. In a way, it’s a microcosm of the perversity and beauty of surgery; of the screaming contradiction that one must somehow accept to be a surgeon. Removing a limb is so many things: failure, tragedy, cataclysm, life-saver, life-ruiner. Gratifying.

Stark and …

Physician voices

Painting in the OR: The evolution of surgical preparation

David Gelber, MD

September 16, 2013Sep 16, 2013

One would never guess that a frequent activity in the OR is painting. I’m not referring to the application of paint to the walls of a room or house. The painting I’ve seen is limited to the patient and his…

I suppose the first application of “paint” would be the initial scribble placed by the surgeon, marking the surgical site. This is a relatively new requirement and …

Health technology

Google Glass for medicine: 4 reasons why it could be disastrous

Matthew Katz, MD

September 14, 2013Sep 14, 201374

The buzz is that Google Glass will transform medicine. But unless it’s carefully vetted it could be a disaster for patients, clinicians and hospitals. Until the FDA or research confirms its safety, Google Glass is banned from my clinic as…

Here are four reasons why:

1. Privacy violations. Google Glass make it extremely easy to take pictures or …

Physician voices

Lawyers are a big impediment to disciplining bad doctors

Skeptical Scalpel, MD

September 12, 2013Sep 12, 2013198

If you are interested in patient safety and medical errors and haven't read the story in the Texas Observer about a spectacularly incompetent neurosurgeon, you should. It is long but worth it. It will make you cringe. The story includes…

If you are interested in patient safety and medical errors and haven’t read the story in the Texas Observer about a spectacularly incompetent neurosurgeon, you should. It is long but worth it. It will make you cringe.

The story includes many details about operations done poorly and patients suffering paralysis and death at the hands of Dr. Christopher D. Duntsch.

The Texas Medical Board is over-worked, slow to act and …

Conditions and diseases

When should insurance cover body contouring?

Stephanie Van, MD

September 7, 2013Sep 7, 201325

Today in clinic, I interviewed a formerly morbidly obese woman. She has lost almost 300 pounds since undergoing gastric bypass surgery a few years ago, a presentation that has become increasingly common. She was here to see the plastic surgeon…

See, after losing a ton of weight, loose skin remains, especially in places like the arms and abdomen. …

Physician voices

10 questions to ask before anesthesia

American Society of Anesthesiologists & Karen S. Sibert, MD

September 4, 2013Sep 4, 2013

A guest column by the American Society of Anesthesiologists. Not so many years ago, surgeons wouldn't operate on patients they considered too old to tolerate the stress of anesthesia and surgery. Today, however, patients of every age — from Baby…

A guest column by the American Society of Anesthesiologists.

Not so many years ago, surgeons wouldn’t operate on patients they considered too old to tolerate the stress of anesthesia and surgery. Today, however, patients of every age — from Baby Boomers to the Greatest Generation — undergo anesthesia safely for surgery and diagnostic procedures.

Realistically, even if you believe that 60 is the new 40, concerns about having anesthesia are different …

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10 questions to ask before anesthesia

Physician voices

After an adverse event: What should doctors disclose to patients?

Marjorie Stiegler, MD

August 30, 2013Aug 30, 20134

What should doctors disclose to patients in the aftermath of adverse events? Does it matter if the adverse event was related to an error? Does it matter if it was preventable or not, anticipated or unexpected? Recently, I was at…

Recently, I was at the Carolina Refresher Course facilitating a session on adverse events in anesthesiology. We touched on a variety of issues, but spent the most time discussing the importance of disclosure conversations, as …

Surgery and surgeons

Articles, page 51

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