I’m starting to understand why graphic pictures on cigarette packs are so effective. We are studying pathology, which is the human body gone wrong. The photos–taken from autopsies–are gross, meaning their structures can be seen with the naked eye. Cirrhotic livers are littered with bumps and scars, the heart dies and leaves a band of black tissue behind, the lungs are stretched so far that they can’t pull in the air they need.
I was a general surgery residency program director for 24 years. I’ve seen them come and go. Here is some advice for those of you who are beginning residency training.
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.
A colleague who practices pediatrics recently bemoaned the fact that several insurers in his state no longer reimburse him for each medical service he performs. Instead, the insurers give his practice a budget for each patient, and he can earn more by meeting certain quality goals. “I’m all for quality,” he said, sighing.
When a single incision approach is elected over a standard laparoscopic approach, many technical challenges present for the surgeon. Far too often, access devices are coupled with specialized instruments to overcome hurdles such as limited triangulation, restricted visualization, fixed port placement and limited procedural applications.
We are surrounded by technology. No matter where you go, you will find technology rearing its face, whether ugly and ungodly or tempting and beautiful. These advances have brought both good and evil to many professions, especially healthcare. Twenty years ago, you would not have found signs instructing people to turn off their cell phones in physician offices.
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.
Whenever someone is scheduled for an operation, the assigned nurse is required to fill out a "pre-op checklist" to ensure that all safety and quality metrics are being adhered to. Before the patient is allowed to be wheeled into the OR we make sure the surgical site is marked, the consents are signed, all necessary equipment is available, etc.
Make it a rule never to be angry at anything a sick man says or does to you. -Benjamin Rush, MD (1809) Thirty years ago, I heard dozens of stories about a memorable doctor. His daily outbursts in the hospital were legendary. No one wanted to get in his crosshairs, so people scattered when he was spotted coming down the hall.
There are various factors to consider when choosing the proper tools to perform laparoscopic surgery through a single incision. To date, the single-incision approach appears just as safe as traditional laparoscopy 1 . If performed correctly, studies show single-incision procedures have improved cosmetic outcomes compared to traditional laparoscopic approaches and there is a trend towards a reduction in postoperative pain, both of which are very attractive to patients.
FDA Reminder: Thermogram No Substitute For Mammogram Despite widely publicized claims to the contrary, thermography should not be used in place of mammography for breast cancer screening or diagnosis, states the U.S. Food and Drug Administration. A mammography is still the most effective way of detecting breast cancer in its earliest, most treatable stages.
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.
A few years ago during a visit home, my mother interrupted me as I was recounting the details of a transplant operation I’d done a week earlier. For as long as I’ve been a doctor, my mother, who owns a small business, has queried me about my long work hours, usually punctuating her questions with sympathetic clucks and gentle exhortations to eat more of the Taiwanese food she has prepared.