New York City’s Health and Hospitals Corporation (HHC), which runs 11 hospitals in four of the five boroughs of New York, is negotiating a new deal with the union representing some 3,300 salaried physicians. The corporation wants to base MD pay raises on 13 quality indicators. The New York Times article that broke the story does not list all of the indicators but mentioned the following: how well patients ...

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Next in a continuing series. Inside the belly, everything is slippery. The peritoneum is a glistening layer of self-moistening plastic wrap, enveloping the surfaces of all the organs, and the inner aspect of the abdominal wall. Undisturbed, the intestines coil and slither, reptilian. Watching waves of peristalsis makes me smile: there's something always entertaining about those moving contractions, following one upon another, gurgling, surprisingly tight bands of tension moving ...

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As an intellectual female surgeon, I have always resented being pinned down by my gender. Throughout medical school, I refused to join “Women’s Societies”. I felt that these were excuses for disillusioned women to get together and complain that the reason they were not succeeding was their gender. I, on the other hand, did not feel limited by my gender nor did I hide it. Instead, I relished it. I ...

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My son has been accepted into medical school, we learned last week, and I must say I’m about as happy a mother and a physician as you could find anywhere.  For everything that’s wrong with the American healthcare system today, medicine is a wonderful profession and it’s still the greatest honor in the world for a patient to have faith in your skills and care. It will be interesting to see ...

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In 2010, a surgical scrub technician named Kristen Parker was sentenced to thirty years in federal prison after allegedly diverting fentanyl from operating rooms, injecting herself with the powerful intravenous narcotic, refilling the contaminated syringes with saline, and replacing them to be used on patients.  She was infected with hepatitis C, and her drug diversions infected over two dozen patients in the Denver area. In 2012, David Kwiatkowski, also positive for ...

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Today I had the displeasure of sitting in judgment before a modern inquisition at one of the hospitals I attend. Although the grand inquisitor lacked the trappings of a monsignor or bishop, and without a physical executioner in the room, I was subjected to  round after round of questions regarding my apparent disregard for system wide medical and post surgical protocols. Such protocols have been adopted by CMS (which oversees ...

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I did not want to go to the emergency room. I really didn’t.  Resisting the idea, I lay doubled over with the worst abdominal pain of my life for 12 hours, unable to eat or drink or move, and finally vomiting before I considered it. I was well aware that this sequence of symptoms made me a textbook case of appendicitis, but I still consulted an ER doctor to ask: was ...

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I read the recent popular posts from Matthew Moeller (Dear lawmakers: this is what it’s like to be a doctor today) and Nick Rademacher (Lawmakers shouldn’t care about the personal hardships of doctors) with great interest. They reflect perspectives from two interesting turning points for most medical careers- medical student, and established attending physician. I’m a U.K.-based surgeon and though the healthcare systems in the UK ...

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Inappropriate blood transfusions: Surgeons should lead the way Despite the fact that many papers have identified the problem, inappropriate blood transfusions continue in hospitals across the nation. This topic was featured at the recent Patient Safety Science and Technology Summit that was held in Orange County, California. Transfusion of packed red blood cells is very common. Over 2 million patients or 5.8% to 10% of inpatients are transfused every year with some ...

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"I can fix this." The neurosurgeon was nothing if not confident. "The cyst is pushing on your spinal cord. If it continues to expand, it will damage your nerves and you may lose the ability to walk. But I can remove the cyst, and cure you." The patient was a business school professor, a man comfortable with risk-benefit ratios and complex decisions. He probed for more information. The surgeon was happy to provide ...

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