A few months ago, I got the dreaded 2 a.m. consult from the emergency department. I met Mr. Smith, a man with a very strange looking and inflamed gallbladder. The abnormal appearance on ultrasound meant we had to discuss the possibility of malignancy. Instead of the usual 15-minute spiel about removing the gallbladder, I spoke to the patient and his wife for nearly an hour. I drew the anatomy. I discussed ...

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"Beautiful girl, you can do hard things." I saw that quote on my favorite Facebook group recently, called Physician Moms Group (or PMG). This is a group of women who, like all of us, are just trying to “do” life every day. Because of our integrity and intellect, we are trying to do it better than anyone else. I think that’s from a Type A personality, combined with leadership and wanting ...

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Advice to doctors: Beware of what you say during a procedure! Before, we had a patient secretly record an anesthesiologist during a colonoscopy. Now, a patient hid a microphone in her hair, and secretly recorded the medical staff during hernia surgery. It's now national news.

There has been a significant amount of outrage over the past few months of the maintenance of certification process. The anger has not only been targeted towards the ABIM, but also towards the other specialty boards. Pediatrics, for example, now requires ABP approved quality improvement (QI) projects that have been widely criticized. While these MOC requirements are a major nuisance for most, the implications may actually run much deeper. A number ...

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My heart tells me I lost them.  My brain tells me I never had them to lose. One of my mentors has said that all trauma surgeons have their own personal graveyard, filled with patients we couldn’t save, and families’ hearts left broken.  A truer statement has never been said, and this weekend, this trauma surgeon’s graveyard has increased yet again. The feelings that accompany this increase are always varying and deep. There ...

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It’s Tuesday around 9 a.m., and I, a pediatric ear, nose, and throat surgeon on my third or fourth patient at a satellite clinic an hour away from home when the abdominal pain started. It feels as if someone is repeatedly stabbing a knife, and twisting it around, right below my breastbone. I barely got through that encounter, then moved to the next patient. It will stop, it has to. There were 14 ...

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american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. With the recent expansion of ambulatory surgical centers, the number of outpatient surgical procedures has increased at an exponential rate. Coupled with the rise in volume has been the increasing complexity of procedures and underlying diseases of patients. The convergence of these factors ...

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A surgical resident writes:

I’m sure you have read several recent studies suggesting that current general surgery residents are poorly trained and unprepared for independent practice at the completion of residency. My questions for you: 1. In general, do you agree that current general surgery residents are poorly trained and unable to operate independently at the completion of residency? 2. What should we do differently? I personally don’t feel that “more simulation activities,” which ...

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Even as a child, I noticed that many people, especially my Depression-era grandmother, feared aging and the imminence of death. Death was no stranger to me growing up; I lost my then best friend, my Nano, and my uncle as a child, both traumatically. Yet, death was sad, but natural. Because of this, I never understood our society’s stigma against dying, something that I've struggled with even in medical school. In ...

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Mamas don’t let your babies grow up to be surgeons. Really. Don’t. As the mother of a soon-to-be fellowship-trained surgeon, I know what I’m talking about. Listen to me. Ignore Willie Nelson. You don’t want your babies to be doctors; you want them to be cowboys. Really. Yeah, yeah, I know, your daughter is a whiz at all things mathematical and/or spatial. And your son is a science prodigy. Their eye-hand coordination is legendary ...

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