Surgery and surgeons

1,981 articles · Since 2004

Articles, page 61

Patients and families must be tireless in expressing any frustrations

October 4, 2011Oct 4, 20116

I was reading the other day in a magazine the personal account of a woman who had a "perfect example of a mitral valve click" (a type of heart murmur) that was so textbook in sound that she was asked…

I was reading the other day in a magazine the personal account of a woman who had a “perfect example of a mitral valve click” (a type of heart murmur) that was so textbook in sound that she was asked to be a listening post for a class of medical students. She was pleased to help, but was disappointed in how of the 15 examiners no one treated her like …

Physician voices

Is medical tourism a dire threat to American surgeons?

Richard N. Fogoros, MD

September 30, 2011Sep 30, 20119

In an earlier post, DrRich offered several potential strategies for doctors and patients to consider should healthcare reformers ultimately succeed in their efforts to make it illegal for Americans to seek medical care outside the auspices of Obamacare. To those readers who persist in thinking that DrRich is particularly paranoid in worrying about such a thing, he refers you to his prior work carefully documenting the efforts the Central Authority has already made …

Conditions and diseases

Discussing a colostomy in a patient with rectal cancer

Sid Schwab, MD

September 21, 2011Sep 21, 20114

Sturdy and thickly-built, long since widowed, cheery in a sardonic sort of way, tough and opinionated, Flora's European roots ran deep; she'd been an Italian farm girl, and she'd rather be in her garden than anywhere else. The only reason…

Sturdy and thickly-built, long since widowed, cheery in a sardonic sort of way, tough and opinionated, Flora’s European roots ran deep; she’d been an Italian farm girl, and she’d rather be in her garden than anywhere else. The only reason she agreed to come inside and go to the doctor was that her bowel movements had finally gotten too painful, and too bloody to ignore. Which she had been doing, …

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Physician voices

The shortage of general surgeons demands attention

Skeptical Scalpel, MD

September 17, 2011Sep 17, 201119

There is much hand-wringing about the shortage of primary care physicians. But primary care not the only specialty with deficits. In a few years, all surgical specialties will experience significant decreases in availability. Here is what will be happening with…

Demand-side facts

The current population of the United States is about 311 million people. Estimates are that by 2020, it will rise to over 340 million.

As baby boomers age, the increase …

Patient voices

The dual tragedy of suffering catastrophic illness and being uninsured

John Maa, MD

September 9, 2011Sep 9, 201118

An estimated 60% of American bankruptcies result from overwhelming medical costs. My uncle’s tale illuminates the dual tragedy of suffering catastrophic illness and being uninsured. The 2008 recession claimed my uncle’s job, health benefits, and assets, except for a small…

An estimated 60% of American bankruptcies result from overwhelming medical costs. My uncle’s tale illuminates the dual tragedy of suffering catastrophic illness and being uninsured.

The 2008 recession claimed my uncle’s job, health benefits, and assets, except for a small inheritance. By 2009 he found work (but not health coverage) as a consultant.

One day he noticed that his eyes were yellow. He emailed a photograph, and I immediately recognized jaundice. I …

Physician voices

The graveyard hidden in a surgeon’s mind

bongi, MD

September 9, 2011Sep 9, 20114

This is a difficult story to tell but if I am to be true to the complete experience of a surgeon, I do need to tell it. One of my seniors used to say that every surgeon has a graveyard…

This is a difficult story to tell but if I am to be true to the complete experience of a surgeon, I do need to tell it.

One of my seniors used to say that every surgeon has a graveyard hidden away somewhere in the dark recesses of his mind. He went on to say it was unfortunately normal, so long as you remember all the names engraved on the tombstones. …

Physician voices

Don’t always blame anesthesia for problems in the OR

Anesthesioboist T., MD

September 5, 2011Sep 5, 2011

People blame anesthesia personnel for everything. You name it, they blame us for it. They call us by the umbrella name "Anesthesia" and if there's a problem, it's always "Anesthesia's" fault. Got into the room late? Blame Anesthesia. (Even though…

People blame anesthesia personnel for everything. You name it, they blame us for it. They call us by the umbrella name “Anesthesia” and if there’s a problem, it’s always “Anesthesia’s” fault.

Got into the room late? Blame Anesthesia. (Even though the anesthetist’s been sitting at the bedside for twenty minutes waiting for the surgeon or the nurses to be ready.)

Patient craving ice cream when she woke up? Must be Anesthesia’s fault.

No …

Conditions and diseases

Heart valve repair without open surgery

Stephen C. Schimpff, MD

September 2, 2011Sep 2, 2011

A major innovation are the recent reports of success in replacing or repairing diseased or damaged aortic or mitral valves via catheter-based techniques instead of open surgery. Mitral regurgitation is when the valve becomes unable to close tightly. Once the…

A major innovation are the recent reports of success in replacing or repairing diseased or damaged aortic or mitral valves via catheter-based techniques instead of open surgery.

Mitral regurgitation is when the valve becomes unable to close tightly. Once the regurgitation becomes sufficiently severe to cause heart failure, the death rate reaches about 5% per year. Most such individuals are referred for cardiac surgery to either try to repair the valve, …

Read more…

Heart valve repair without open surgery

Health policy

The emotional costs of malpractice mean more to doctors than money

Kevin Pho, MD

August 19, 2011Aug 19, 20117

Every year, according to a recent study from the New England Journal of Medicine, a typical physician has about a 7% chance of being sued for medical malpractice. Surgeons almost certainly will face a malpractice claim sometime during their career.…

Every year, according to a recent study from the New England Journal of Medicine, a typical physician has about a 7% chance of being sued for medical malpractice.

Surgeons almost certainly will face a malpractice claim sometime during their career. Neurosurgeons, for instance, have a 19.1% chance of being sued in a given year, while that number is 18.9% for …

Conditions and diseases

What do tonsils do and why would we take them out?

Christopher Johnson, MD

August 19, 2011Aug 19, 20115

There are some important new recommendations about tonsillectomy — taking out the tonsils — as a treatment for recurrent strep throats. Some of us can recall a time when getting your tonsils out was one of the rites of passage…

There are some important new recommendations about tonsillectomy — taking out the tonsils — as a treatment for recurrent strep throats.

Some of us can recall a time when getting your tonsils out was one of the rites of passage of childhood. Usually a related procedure is added — an adenoidectomy, removing the adenoids as well. It’s called a T&A in the medical world, and it’s one of the …

Patient voices

Demystifying anesthesia to put patients at ease

American Society of Anesthesiologists & Kenneth Elmassian, DO

August 15, 2011Aug 15, 2011

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. As patient safety advocates responsible for monitoring vital signs, managing pain and safeguarding a patient’s overall health through the surgical process, anesthesiologists are committed to informing patients about…

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

As patient safety advocates responsible for monitoring vital signs, managing pain and safeguarding a patient’s overall health through the surgical process, anesthesiologists are committed to informing patients about the anesthesia experience. The American Society of Anesthesiologists (ASA) and the Michigan Society of Anesthesiologists (MSA) have launched a new public education campaign to help patients better prepare and …

Patient voices

The different types of frail to consider before surgery

Bruce Campbell, MD

August 6, 2011Aug 6, 2011

"If I’d known I was going to live this long, I would have taken better care of myself." -Eubie Blake He leaned forward, energetically listening to my conversation with his daughter. There was more than one cancer treatment option. We…

“If I’d known I was going to live this long, I would have taken better care of myself.”
-Eubie Blake

He leaned forward, energetically listening to my conversation with his daughter. There was more than one cancer treatment option. We reviewed everything and she asked what he could expect with either a major surgery or seven weeks of daily radiation treatments. Soon, both the father and daughter were peppering me with questions about …

Conditions and diseases

The different ways hysterectomy can be performed

Suzanne Hall, MD

August 3, 2011Aug 3, 2011

When you and your gynecologist have decided on hysterectomy as the treatment of choice for your gynecologic diagnosis, there are several routes by which a hysterectomy may be accomplished. A total hysterectomy is the surgical removal of the uterus, and when indicated, the additional removal of the fallopian tubes and ovaries (termed salpingoophorectomy) may be recommended.

There are several routes by which a hysterectomy can be performed. You and your gynecologist …

Physician voices

Why physicians are clueless about malpractice implications of DVTs

Angry Orthopod, MD

July 29, 2011Jul 29, 2011

A medical malpractice attorney and an orthopaedic surgeon are on a golf trip. This sounds like the worst joke of all time, but it’s actually the story of my brother and I 20 years ago. Amidst the rough, he laid…

A medical malpractice attorney and an orthopaedic surgeon are on a golf trip. This sounds like the worst joke of all time, but it’s actually the story of my brother and I 20 years ago.

Amidst the rough, he laid some serious philosophy on me. In most families, that might be about life and love and whatnot. Not in our family. We were engaged about deep venous thrombosis (DVT) and …

Physician voices

Perfect is the enemy of good when it comes to work-life balance

gcs15, MD

July 26, 2011Jul 26, 2011

Over the years, I have come to the painful realization that I am not perfect. Ok, all you other surgeons, close your eyes and ears, because to admit to being less than perfect is a sign of weakness (like asking…

Over the years, I have come to the painful realization that I am not perfect.

Ok, all you other surgeons, close your eyes and ears, because to admit to being less than perfect is a sign of weakness (like asking for help). Don’t read this, patients, because you wish even more than I do that I were perfect (especially when I’m operating on you). But it’s true.

Long ago, I remember feeling …

Physician voices

If I could pick patients, they would be Native American Guatemalans

Chris Porter, MD

July 25, 2011Jul 25, 201110

Spent a sweaty week operating in a hilltop Hospital Nacional in Guatemala a while back. A patient gave me a hat in thanks for her surgery. It’s a full-brimmed canvas safari number – I’m sure Hemingway shot a rhino in…

Spent a sweaty week operating in a hilltop Hospital Nacional in Guatemala a while back.

A patient gave me a hat in thanks for her surgery. It’s a full-brimmed canvas safari number – I’m sure Hemingway shot a rhino in one. I’m just mature enough now to value sun protection and always grateful, sometimes to the point of pain, for gifts from those who have almost nothing. I was also …

Physician voices

Implications when technology catches up with medical practice

Dr. Martin Young

July 20, 2011Jul 20, 20114

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. …

Physician voices

Attending physicians who work too many hours need restrictions too

Felicity Billings, MD

July 8, 2011Jul 8, 201115

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…

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 …

Physician voices

When you close an abdomen after a failed rescue, the OR is silent

Sid Schwab, MD

June 30, 2011Jun 30, 201115

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…

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 …

Physician voices

Surgeons with depression and suicidal thoughts don’t get the care they need

Brian Goldman, MD

June 28, 2011Jun 28, 201112

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. …

Surgery and surgeons

Articles, page 61

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