A Finnish group randomized patients with acute appendicitis to surgery and antibiotics and found that antibiotics were successful in 73 percent of patients. Depending on how this is framed, you can celebrate a 70  percent success or lament a 30 percent failure. Much of the debate in health care is a battle of framing.  The study has limitations. Finland is not just a land of the
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“A good surgeon has the eye of an eagle, the heart of a lion, and the hand of a woman …” – 15th century English proverb #ILookLikeASurgeon, a hashtag on Twitter and the movement it has inspired, has resonated deeply with me. I look like a surgeon. There is so much more behind this seemingly simple statement of fact. I am not just stating that I have excelled and I have achieved and ...

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The vast majority of physicians enter medicine with an inborn sense of compassion. Junior residents, however, are the logistical workhorses of teaching hospitals — their north star is efficiency and they are measured largely on their capacity to “get things done.” The consequence is often a slide towards unwitting apathy. I, like all residents, have witnessed this reality first-hand. By reflecting on my experiences, I hope to discover insights we ...

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A few months ago, I was wrapping up a lengthy consultation, when my patient pulled out three pages of an "ask your plastic surgeon" questions she’d found on Google. I had other patients waiting, so I was about to direct her to my staff, when she posed this question: “Would you do surgery on a member of your family?” What a strange must-ask question, I thought. “No,” I said aloud. “Not major ...

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shutterstock_175398194 american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. I often hear patients say, “I am not afraid of the surgery, just the anesthesia.” But should patients worry?   Physician anesthesiologists suffered a crisis in confidence in 1982 when the ABC television program 20/20 aired, “The Deep Sleep:  6,000 ...

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"To be trusted is a greater compliment than to be loved." - George MacDonald As we adjust her position on the surgical table, I spot some short, vertical scars on the front of her neck. The parallel slashes sit directly over her enlarged thyroid -- a goiter -- and appear to have been deliberately placed. There are two sets of scratches, one set on either side of the neck, nearly identical in length and evenly ...

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“There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.” - Albert Einstein “Miracles happen every day; change your perception of what a miracle is, and you’ll see them all around you.” — Jon Bon Jovi “The miracle is this: The more we share, the more we have.” — Leonard Nimoy It is amazing when things in medicine work just the way ...

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shutterstock_125105294 As a plastic surgeon, I am interested in how people look. Whether I am piecing together a fractured face or reconstructing a cancer-scarred breast, I am focused on appearance, symmetry, contour, and lines. I am always thinking about how our bodies are the physical manifestations of who we are. What I am never thinking about is how that sentiment applies to me. An intern ...

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test9 copy It's time to celebrate diversity in surgery with the #ILookLikeASurgeon hashtag. Inspired by surgery resident Heather Logghe, who says it best: "As women surgeons, whether we are in our first year of training or an emeritus professor, it's most important that we ourselves believe we 'look' like surgeons. Because we do." And it's taken off. Below is a continuously-updated Storify of this movement. Spread ...

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shutterstock_273641858 Like many practicing general surgeons I read with interest the recent Finnish paper published in JAMA that attempted to challenge the long held surgical dogma that the best treatment of acute appendicitis is cold hard steel.  The paper itself, in terms of design, was beautiful.  This was no retrospective review of a series of case studies.  This was a ...

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