Do safety scalpels reduce the risk of injury? A Twitter follower wrote me this: "Hospital making me use 'safety scalpel' w/retractable sheath. I've almost cut myself x 2. Do you know of any data about it?" That got me interested because I like to question things. Was this going to be yet another rule without evidence? I thought I would have to do an exhaustive search to see if anyone had ever ...

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I have written a good amount about automation, the good, the bad and the ugly.  I have written about doctors and ancillary providers and physician extenders, also good, bad and ugly.  A recent comment on Karen Sibert’s excellent blog A Penned Point caught my eye as an amalgamation of these subjects. This person wrote, and I hope he doesn’t mind my quoting him:

American anesthesiologists should focus much more on ...

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Last month, a superb study by the Michigan Bariatric Surgery Collaborative showed that the more skilled surgeons were, the better were their outcomes. Surgeons submitted a video of their choice depicting their performance of a laparoscopic gastric bypass. Since it was self-selected, it was presumably their best work. At least 10 of their peers, blinded as to the name of the surgeon, rated skills on the video which had been edited ...

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When I started my surgical internship, my chief resident told me some magic words: Whenever something bad happens , stay calm and say "I assume full responsibility. It won't happen again." As a young surgeon at the bottom of the totem pole, those words were my mantra for the times when someone's head was go ing to roll. In those nascent days of my surgical career, I was just trying to ...

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Kerry was only 28-years-old. He showed up in the ER one night complaining of upper abdominal pain which started suddenly that day. The emergency physician did the usual workup and found two things which led to an urgent call: a large intrabdominal mass and free intraperitoneal air. The large mass was not necessarily an emergency, but free air, that is, air outside its usual place inside the bowel, almost always represents ...

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Halsted once described plastic surgeons as “the surgeon’s surgeons.” Yet in today’s era of media hype about cosmetic surgery, this turn of phrase feels long-forgotten. Despite what reality television may have you believe, the specialty remains at its core about reconstructive surgery, and collaboration is still a key element. Here, a few points that show those words are as true now as they ever were: We manage a patient’s expectations. Patients may have ...

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You cannot connect the dots looking forward; you can only connect them looking backwards. -Steve Jobs "Doesn't that window open any wider? Bring in another fan!" the surgeon demands. Beads of sweat gather at the edge of his cloth cap and the circulating nurse steps up periodically to wipe them away. Heat and city noise roll through the open windows and into the operating room. The brief morning rain shower has left the ...

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About eight years ago I was desperate to improve my golf game. I just couldn’t straighten out my drives or hit my irons crisply. (Yes, I’m fully aware that this is a first world problem). I decided to try golf camp in Palm Springs for a few days. My sensei, a crusty ex-touring pro named Artie McNickle, watched me hit several dozen balls on the driving range, video recorder running. “So, ...

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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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