shutterstock_153912641 Recently, Marshall Allan and Olga Pierce, two journalists at ProPublica, published a surgeon report card detailing complication rates of 17,000 individual surgeons from across the nation. A product of many years of work, it benefitted from the input of a large number of experts (as well as folks like me). The report card has received a lot of attention … and a ...

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shutterstock_226271230 If you want to know who the best surgeon in the hospital is, ask the surgical nursing staff. If you want to know who does the best job opening up coronary arteries using catheters, balloons, and stents, ask the cardiac catheterization lab nurses and technicians. Unfortunately, these approaches to comparing physicians’ skills are only available to hospital personnel. They are the only people who are ...

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shutterstock_287266676 When report cards of performance became available, cardiac surgeons in New York and Pennsylvania avoided high risk patients. Could something similar happen, nationally, after the forthcoming revolution in transparency inspired by ProPublica’s data release? Take two fictional orthopedic surgeons, Cherry Picker, MD and Morbidity Hunter, MD. Cherry Picker lives in the Upper East Side of New York. His patients give ...

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shutterstock_153098018 With much hype and fanfare, the independent investigative journalism outfit, ProPublica recently released their Surgeon Scorecard, assessing individual specialist surgeons who perform elective knee and hip replacements, spinal surgery, prostate surgery, and gallbladder removal surgery. I had blogged about the impending release.  My trepidation about the idea of a non-medical, non-scientific organization analyzing complex surgical data concerned issues such as ...

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shutterstock_280962767 The long-awaited Finnish randomized controlled trial of antibiotics vs. surgery for appendicitis was just published in JAMA. Depending on your perspective, 73 percent of patients were successfully treated with antibiotics or 27 percent of patients failed antibiotics and needed surgery. The good news is that it was a large multicenter study involving 273 patients randomized to surgery and 257 to ...

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IMG_0785 Sitting in a rickety jeep rumbling through treacherous mountainous terrain, on winding unpaved roads full of blind curves and teetering on the edge of cliffs recently ravaged by an earthquake, I began to question my decision to go along on this trip.  We were about 3 hours outside Kathmandu, Nepal heading to a small village along the banks of the Melamchi ...

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shutterstock_277040312 american society of anesthesiologists A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Summer is immortalized in popular culture for good reasons -- no other season can match it for the variety of fun and exciting activities it brings. Unfortunately, that variety of activities and the large volume of ...

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Well, decision time was here and it looked as if Bill would choose surgery, and why not, with the doctors liberally throwing around the word "cure.'" The various tests Bill endured, breathing tests, echocardiogram and MRI of the brain, were all within tolerable ranges, we were told.  The oncologist noted some marks in the brain that suggested mini-strokes, but Bill didn't hear this or it didn't register with him, or ...

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shutterstock_280855511 After the last elective case of the day, the neurosurgeon I was shadowing told me that he was on overnight call that evening, and that I could stick around to observe more surgeries if I wanted to. “Yes,” I responded. “Absolutely yes.” My fascination with surgery stems from its ability to provide immediate results to a patient by cutting out, repairing, reshaping, or ...

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shutterstock_116541763 You could hear a pin drop. The awkward silence at a dinner table after my pager went off. Eyes locked on me. For a split second, the laughter ceased, forks held in mid-air, chewed food, half-swallowed. The nervous system of every doctor adapts to the sound of his or her pager during residency. Early in training, widening pupils and hair-raising palpitations fade ...

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