In 2009 I posted a blog here on videotaping of surgeries and the issues and challenges this would present. I did not say I am in favor of this as a means of policing medical practice, but for documenting surgeries the technology can be very useful. I do video as many of my surgeries as I can, and I offer to show these recordings when appropriate to my patients. …
Implications when technology catches up with medical practice
Dr. Lewis didn’t sleep last night.
All day he stood, heavy in full surgical scrub with a human heart in his hands, replacing damaged valves and calcified arteries until the heart beat on its own again. After he finished, there were a few hours before the transplant to get some dinner, to call home.
The heart came on a helicopter. A young man, a bad accident, a perfect heart. Dr. Lewis pierced …
Attending physicians who work too many hours need restrictions too
I didn’t know her name until it was over, much too late.
What I knew was she was thirteen and that on this winter day someone in her family had been pulling her behind their car, on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl — probably screaming (fear? delight?) — held onto the sled as …
When you close an abdomen after a failed rescue, the OR is silent
When you think of surgeons, you likely picture heroes deftly using scalpels to pull patients back from the brink. But sometimes, as much as surgeons want to save someone, they simply can’t. A new survey finds that some of the men and women doing amazing feats of medicine in the OR don’t think quite so highly of themselves.
Suicidal thoughts could be the result of depression and job burnout. …
Surgeons with depression and suicidal thoughts don’t get the care they need
As medicine adapts to the 21st century, new specialties arise.
General surgery is seeing two new fields emerge. One is “Acute Care Surgery,” which encompasses three facets of general surgery — emergency surgery, critical care and trauma care. The other is the concept of a surgical hospitalist. That is, a surgeon works only in a hospital and has no office or private practice. The idea is similar to the medical …
New fields in general surgery and the rise of the surgical hospitalist
If nothing else, this post illustrates that surgeons are not that great with the whole bedside manner thing. I would like to think I’m an exception … but I still am a surgeon.
I make a point of communication with my patient. Obviously if he is a child, I use the same measure of effort in communicating with the parents. But few things irritate me more than some …
A surgeon makes it a point to directly communicate with the patient
Every now and then a tonsillectomy patient bleeds after arriving back on the ward after surgery. On this occasion, there was nothing remarkable in the event itself. What was remarkable was the efficiency of the response.
I got the phone call from the ward sister at 11:05 am, and immediately drove the short distance back to our local hospital. I checked on my patient in the ward, confirmed the bleed, …
What big hospitals can learn from smaller ones
by Anar Mikailov
I recently finished my surgery rotation at a Level 1 Trauma Hospital in Philadelphia and amidst the ephemeral eight weeks I quickly realized the immense demands of a surgical residency. So, as an avid technology enthusiast and a team member, I took note of inefficient workflows with potential for technology driven solutions. By discussing the observed inefficiencies and potential solutions I hope …
Hospital inefficiencies observed during a surgery rotation
by Eric Marcotte, MD
Associated Press health writer Marilynn Marchione recently reported on the rapid growth of so-called “fix-me-it is” in orthopedic surgery. Healthier and younger than the typical patients undergoing joint replacement, Baby Boomers are driving the next big wave of joint replacements in medicine.
This is definitely welcome news for Zimmer, Biomet, and our other fine biomedical companies here in Indiana. Whether this …
Baby Boomers are driving the next wave of joint replacements in medicine
A Florida study assessed the rate of needle versus surgical breast biopsies over a period of five years.
What we’re talking about here are non-palpable abnormalities that are identified on screening mammography. A mammogram report will come back that assesses the relative risk of an abnormal collection of calcifications harboring an invasive or pre-invasive cancer (staged on a scale from I-V). With such data, one is obligated, …
Why private practice surgeons perform more open breast biopsies
Surgery is expensive, there are no doubts about that. However, there are a few things a patient without insurance who desires surgery can do to minimize the costs as much as possible. Before going into cost-cutting measures, you first need to understand where the costs come from.
In rank order, the costs of surgery come from (highest to lowest):
How to minimize the costs of surgery
I recently had the opportunity to go to the anatomy lab and help the first years go through the pelvic anatomy. What a blast! There is nothing like dissecting a cadaver to tune up one’s surgical anatomy skills, and helping young eager medical students through it is a great experience.
Prior to going into the lab, I spent many hours going through Netter’s atlas to brush up on the anatomy so …
Going through Netter’s to teach medical students pelvic anatomy
I don’t know what your destiny will be, but one thing I do know: the only ones among you who will be really happy are those who have sought and found how to serve.
– Albert Schweitzer
The middle-aged Tanzanian woman lived many hours away and had traveled to the academic medical center in Moshi. She had now waited all day to see …
6 ENT physicians practicing in Tanzania, a country of 40 million people
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I was in practice about five years and was about to do a radical nephrectomy on a patient.
I met with the patient and his son in my office and the son informed me that he and his father were Jehovah’s Witnesses and that he didn’t want his father to receive any blood or blood products before, during, or after surgery. I asked the father if that was his wish and he …
Transfusing a Jehovah’s Witness during surgery
by Felasfa Wodajo, MD
The iPad has received a significant amount of attention in the health care arena since its introduction last year.
The attraction is fairly obvious; it is a portable, lightweight, powerful computing device with an intui-tive interface and a large library of built-in applications. In fact, major medical schools such as Read more…
How to use an iPad in the OR during surgery
There are few things I enjoy more than talking about the spine and the brain.
Therefore, it stands to reason that I enjoyed our state neurosurgical society meeting recently. I don’t like big national meetings, being an introvert at heart. Our state meeting, however, is small; this makes for a more intimate atmosphere and more outspoken dialogue. Colleagues from across the state can exchange ideas, new techniques, and opinions. We also …
A neurosurgeon considers stepping out of her comfort zone
by Chris Porter, MD
“Treat your patients as you would your own loved ones,” is advice taught throughout training in health care.
Great advice. I use it constantly. Mr. Davis is dying of multiple organ failure in the ICU after exploratory abdominal surgery. His siblings and children trickle in from Florida and Montana.
I’m always sorry for the last to arrive, who visits his dying brother’s bedside minutes before …
How a family conference affects the decision for surgery
Harold was 51 years old and needed his left arm amputated. A year ago he noticed some swelling in his forearm and went to his primary care doctor.
An MRI showed something. It was small and hard to define, hard to categorize, probably a collection of blood, but there was an outside chance it could be a sarcoma, a tumor originating from muscle …
Arm amputation from a rare sarcoma
I am a self-taught bass guitarist in a church band, and, to be honest, it sometimes shows. I know I need to improve my skills, but time commitments make formal lessons difficult. So two days ago I opened up YouTube and entered “bass guitar lessons” into the search box.
19,000 hits registered. I selected a few that looked good on …
Can doctors learn surgical skills on YouTube and Facebook?
She was a Korean woman, spoke passable English. We always exchanged pleasantries, and she called me “doctor” when I picked up my laundry. This time she was notably quiet, distant.
I didn’t figure it out until I got home and hung up my jacket, on the inside of which I noticed she’d pinned an envelope. It contained a photo I’d taken months ago, left and forgotten in one of my pockets. …
Sixteen stab wounds, seriously delivered
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