The American Journal of Surgery had a nice little (38 patient cohort) study from the VA database that tried to determine the process by which patients make informed decisions on elective surgery.  The results were rather surprising, at first glance.

Sixty-nine percent of patients decided to have surgery before meeting their surgeon, and 47% stated that the surgeon did not influence their decision. Although the surgeon was an important source of information ...

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shutterstock_108854663 Sometimes, I feel like I belong in law enforcement. There was a time in my life that I seriously considered a career where I would haul in the bad guys and make society a better place. Of course, every American male youngster fantasized that he would one day drive the Aston Martin, get the girl, defuse the bomb, and sip on a ...

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For most people, anesthesia is one of the more mysterious branches of medicine.  What we do for patients is done, generally, when they are asleep.  You the patient don’t exactly know what we are going to do, or how it’s done, but you put yourselves in our hands willingly.  It’s sort of a weird relationship we have with other humans.  We have done our job right if our patients don’t ...

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I was recently speaking to the clinical leaders of a mid-sized hospital, and a senior administrator posed the question, “should we require our doctors and nurses to get flu shots?” The answer, I said, is yes, and it isn’t just to prevent the flu. It’s to get into the habit of making our folks do the right thing when it comes to patient safety. Preventing the flu is very important. In ...

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One of the first posts I wrote was a about how pharmaceutical reps provide lunch for physicians while presenting information about a medication that they are promoting.  The post, and others like it, have generated visceral reactions on the part of the public. A similar article to the one that I wrote prompted comments like “Get over yourself and buy your own lunch” and “I’m certainly glad that ...

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It's Friday afternoon and I check the day's schedule. A name jumps out at me and I groan a little and worry -- what am I going to say to someone I've treated for twenty years, who's my age and just been admitted to hospice care? If this is goodbye, how do I as a physician, who is more than an acquaintance but not quite a friend, handle this appointment? All ...

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LanceArmstrongOprahinterview “Lance Armstrong is a bad guy who has done some very good things.” These are the words of a sports radio personality I listened to yesterday.  He was obviously commenting on the confession (to my pal Oprah) by Armstrong about his use of performance enhancing drugs.  The sportscaster, along with many I heard talk on the subject, were not as upset by the ...

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The health care scene is evolving. Rapidly. We all know that. Thanks to legislation, changing patient expectations and physician shortages, we are all in for a roller coaster of changes over the next few years. But what does this mean for physicians? Plenty. Most importantly, it means physician’s roles in the health care system will change. Drastically. And that means the traits and skills you’ll need to be successful will change, too. Some traits ...

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shutterstock_68491828 The patient – blue-eyed, red-haired, and healthy but worried looking – guided the doctor’s hand to just below the angle of her jaw, where a small lump was barely palpable.  She had first noticed the swollen lymph node after a cold and thought nothing of it at the time.  But five months later, it was still there.  She knew it was nothing, ...

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For the past month I’ve been trying to formulate a blog that could capture my thoughts about mental illness and the prevention of violence. At this point my ideas are still not crystallized, but perhaps writing this will help. A few days before Christmas I received a phone call from a former patient’s mother.  She called while I was at the mall with my family doing some last minute shopping—I ...

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