Since the introduction of the robotically assisted laparoscopic radical prostatectomy (RALP) in 2000, the long-term prostate cancer control has been uncertain. We now have the first long-term cancer control study that compared the results of the earliest RALP with historical open radical retropubic prostatectomy (ORP) outcomes. Diaz and associates from a recognized RALP center of excellence concluded that RALP has similar long term cancer control compared to open ...

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“I admire anyone who has the guts to write anything at all.” – E. B. White “All you have to do is write one true sentence. Write the truest sentence that you know.” – Ernest Hemingway “Writing is easy. All you have to do is cross out the wrong words.” – Mark Twain “There is no greater agony than bearing an untold story inside you.” – Maya Angelou “There is nothing to writing. All you do is sit down at ...

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unknown Born to a family of scientists --  my father an engineer and my mother an oral surgeon -- I was given a clear message that I could do anything. Case in point: At age nine when I declared my career goal of being “president of the world” nobody batted an eyelash. Their unwavering confidence followed me through college at UC Berkeley and ...

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american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Physicians who care for surgical patients witness the devastating consequences of cigarette smoking almost every day.  For example, smoking increases the risk of acute complications such as pneumonia and wound infections, and adds to the burden of smoking-related diseases such as heart disease. As ...

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In July the investigative journalists at ProPublica released an analysis of 17,000 surgeons and their complication rates. Known as the Surgeon Scorecard, it set off a firestorm. In the months following, the primary objections to the scorecard have become clearer and were best distilled in a terrific piece by Lisa Rosenbaum. As anyone who follows me on Twitter knows, I am a big fan of Lisa -- ...

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“For some must watch, while some must sleep.” – William Shakespeare, Hamlet I admit, I was taken aback at the headline that ran in the Houston Press today: "Going under:  What can happen if your anesthesiologist leaves the room during an operation." It’s bound to make the curious reader wonder why the anesthesiologist would leave the operating room in the first place. Of course, reporter Dianna Wray explains that in many hospitals, one ...

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Wrong procedure, wrong side/site, wrong implant, retained foreign object: big problem.  No patient should ever have to undergo these types of events, and they are therefore called never events. However, these events do occur and when they do they not only jeopardize patient safety but they also breach the trust between patient and practitioner, have financial implications, and reflect negatively on the entire health care system. The good news is never events ...

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Recently, I was speaking with a less is more advocate. He used his superior knowledge of statistics -- he had an MPH -- to debunk randomized controlled trials. We discussed overdiagnosis, overtreatment, and the shakiness of medical sciences. We spoke about measuring the quality of physicians. I remarked that quality metrics have as much evidence as Garcinia Cambogia -- we had just laughed about Dr. Oz. I expected a chuckle. Instead, ...

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Whether experiencing emotional exhaustion, depersonalization, or a low sense of personal achievement, 4 in 10 U.S. surgeons exhibit signs and symptoms of burnout. Among neurosurgeons that number jumps to nearly 60 percent. Burned out surgeons are more likely to report substance abuse, clinical depression, and suicidal ideation. They are more prone to medical errors. Interestingly, academic practice, trauma sub-specialty, increased nights of call, longer hours worked, younger ...

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A new television series called Code Black debuted on CBS. The show’s name supposedly means the emergency department has too many patients and not enough staff. In my over 40 years in medicine, I’ve seen many busy, understaffed EDs but never heard anyone call it a Code Black. There is the usual array of standard medical characters -- the inexperienced new residents on their first day at work, the savvy nurses, ...

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