On a hot afternoon in July Harold “Junior” Bray walked around his small farmhouse one last time before it was time to leave for the hospital. Everything was in order -- the coffee maker was unplugged, the windows secure and the message on his brand new answering machine informed callers that he would return their call as soon as his health permitted. Every step was deliberate, slow and painful. Whenever he ...

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A new study confirms what previous studies tell us. That a robotic hysterectomy is not a safer or a more efficient way to remove a uterus for non-cancerous (benign) surgery than a traditional laparoscopic approach. This study indicates that there is little difference between the two types of surgery with one glaring exception, a robotic hysterectomy was $2,489 more expensive than a laparoscopic hysterectomy. Several months ago the American Congress of ...

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From MedPage Today:

  1. Budget Deal Muddles SGR Fix. As the dust settled following yesterday's last-minute budget deal to avert a federal government's default, a frightening fact emerged for the nation's doctors.
  2. A Better Way to Rate Bariatric Surgery Quality? A composite measure that includes procedure complications, patient and surgeon volume, and other outcomes provided a more objective scale to rate sites that provide bariatric surgery.

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Medical errors are a real problem. I won't deny that. It was bad enough when the often-quoted Institute of Medicine figure that 98,000 deaths per year in the US are caused by medical errors was in vogue, but now a paper in the Journal of Patient Safety states that adverse medical events result in 210,000 to 400,000 deaths per year and 10 to 20 times those numbers of serious ...

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It was a battle. Looking back I don't think we ever had a chance, but you don't just give up on a young man in the prime of his life. We had to try. He was my patient. He was a foreigner, on a gap year in Africa where he was going to learn all sorts of things about conservation and African wildlife. Up until the accident, all had apparently gone ...

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I have been a loyal patron of the Karma Hair Salon in New Haven, Conn. for at least the past 15 years. Whenever my hair looks good, it is thanks to Karma and owner Cheryl McMahon's expert attention to my unruly head (the thickness of my hair -- a good problem, I know! -- could give a yak envy; and I have more cowlicks than several small countries). If ever my hair doesn't look ...

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The potential to do dramatic good, as is the case with surgery, means that sitting and staring back at you at the other end of the see-saw is a grinning dysmorphic ogre. He keeps his eyes locked on yours, staring with the smug certainty that you can't toss him off, up when you're down; down when you're up. The ugly little sonovabitch never goes away. It's an issue for every healthcare provider. Were it ...

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An anesthesiologist at a California hospital pasted stickers simulating a mustache and teardrops on the face of a hospital employee while she was having surgery on a finger. According to the Los Angeles Times, the doctor said, "I thought she would think this is funny and she would appreciate it." And if that wasn't bad enough, a "nursing attendant" took a photograph. The patient, who said she had to quit her job ...

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The latest salvo in the federal government’s war on physicians comes to us courtesy of the Veterans Health Administration (VHA), which is proposing drastic policy changes to expand nursing scope of practice in all veterans’ hospitals. A new draft VHA Nursing Handbook would eradicate all existing VHA policies concerning physician supervision, and would designate all advanced practice registered nurses (APRNs), including nurse anesthetists, as licensed independent practitioners (LIPs).  This means that ...

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The doctor was adamant. "This is America, not Sweden," he told me. "We operate." How did this happen to me? I wondered, looking at him across the ER exam room. How could I, a healthcare provider, not have insurance? I had woken up that morning with a mildly upset stomach. Nonetheless, I'd gone to my job (begun only six weeks earlier) as a physician assistant at a Beverly Hills HIV clinic. I'd seen patients ...

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