One of the greatest risks I faced from surgery to repair a macular hole in my eye was from a hospital acquired infection. But when I tried to find data on the performance of various hospitals in New York City, there were no ratings for Manhattan Eye, Ear & Throat where I would have my surgery. My doctor had moved from a prestigious New York City hospital to Manhattan Eye, ...

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As predictable as the leaves falling this time of year, another paper on the subject of unnecessary preoperative laboratory testing has appeared. A group from the University of Texas Medical Branch looked at more than 73,000 elective hernia repairs in the National Surgical Quality Improvement Project (NSQIP) database. Almost 2/3 of the patients had preoperative laboratory tests. Of that group, 58.6% had a CBC, 53.5% had electrolytes, 23.7% had ...

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She had only been in the hospital twice in her life: once when she was nine and now, 60 years later.  She had gotten tonsils out then.  She was getting tumors out now. Her abdomen hurt when she was awake.  Her abdomen would also hurt during exploratory surgery, although she wouldn’t be able to feel it under general anesthesia.  Her body would feel it, though, and could respond by dangerously spiking ...

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Recently, a medical student confided in me a thought that few in our profession would dare say aloud: “We may have come to medical school to help people, but we choose our specialty careers based on potential salaries.” This in part explains why the most-prized residencies are in fields such as dermatology and radiology, whose procedures generate high fees. According to a physician survey by the Medical Group Management ...

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In my hospital’s preoperative area, upright on her bed, sat an unhappy middle-aged lady who needed an operation to treat complications from her previous bariatric surgery.  She hadn't lost weight and clearly was feeling discouraged about practically everything.  She was physically uncomfortable, couldn't even keep down her own saliva because her lower esophagus was obstructed, and was in tears. As her anesthesiologist, ...

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Sports fans have heard a lot about football players with Lisfranc injuries recently. Maurice Drew-Jones, running back for the Jacksonville Jaguars and Santonio Holmes, receiver for the New York Jets, have been in the news.  Matt Schuab, QB for the Houston Texans missed last  season from a Lisfranc injury. Many of you may know that a Lisfranc injury is a type of foot injury and that it can sometimes be very serious ...

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Did you know that urine pregnancy tests are routinely performed on all females before every surgery? No exceptions. The Children’s Hospital in Buffalo tests 9 years and above. Don’t know if a parent or a patient has a right to refuse the test, but I do know that the anesthesiologist will refuse to give anesthesia, except for a life-threatening emergency. I have never paid much attention to these tests. The nurses ...

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On a recent Saturday morning, I took my problems to a bar.  The bar was on Boston’s Boylston Street at the end of a row of pubs.  Years ago, during orientation week of medical school, my classmates and I had worked our way methodically down that row. The bar I headed to on this particular day was the Apple Store Genius Bar.  The “bouncer,” a man with skinny arms and a ...

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I have watched more offices over the past few years close their phones and front desk during the lunch hour. If you close your office for an hour at lunchtime, what message are you sending your patients?  You are declaring that serving your patients takes a back seat to serving yourself and your employees.  Closing your phone lines at lunchtime means that you are creating missed opportunities for a vital ...

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It is nearly impossible to ignore the need for clear thinking, confident and “in control” leaders. And whether in Congress or in a physician’s office, medical school department or hospital administrative suite, women leaders are notably absent. And while recent research tells us that women aspire to be leaders, the barriers to achieving this nebulous goal are enormous. So whose fault is it anyway?   I say both the women and the ...

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