The decline of medicine as a profession began when it became legal for doctors and hospitals to advertise. Apparently it all started when an Arizona lawyer sued for his first amendment right to advertise his services. In 1977, the US Supreme Court ruled that states could not prohibit advertising by lawyers. This opened the floodgates for all professionals. Soon advertising by doctors and hospitals became common. I don't know what it's like where ...

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The future of robotic surgery can be determined only by probing the possibilities. To ignore the potential for extending the boundaries and safety of surgical care with robotic technology seems unwise. -"The Future of Robotics," Bulletin of the American College of Surgeons (July) 2013; 98:9-15. It is a spring morning in July 2047. Jenny, a nursing assistant, emerges from an exam room and gently closes the door. She is wearing scrubs tastefully covered with ...

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When I was seventeen, I developed a medical problem due to no fault of my own. It was painful, it was embarrassing, and when it became uncomfortable enough to disrupt my life, I went to see a well known surgeon downtown. The specialist, tucked away in the hallow halls of academia, stared down at me past a pair of spectacles perched at the end of his ever-protruding nose. When he examined ...

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The medical director of my clinic once gave me a book on burnout. I never read it. Didn't have the time or energy. Because a young reader considering a career in surgery referred to stories he's heard of depressed and disappointed surgeons and asked for my thoughts, I'll try to address it. Parenthetically, I've heard from more than a few readers that my blog and/or book has inspired them to consider ...

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A Catholic nun, who was the administrator of a small hospital once summed up for me the role business plays in patient care: “No money, no mission.” In order for a practice to be successful, it must be run with healthy business principles in place. But the truth is that few physicians have any training in or knowledge about the business aspects of running a practice. A satisfying and successful career ...

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Once in a while someone asks me if it is hard to be a mother and a surgeon. Certainly, any surgeon-parent can appreciate that juggling a household full of schedules, classes, meals, bedtimes, and activities with a practice full of office visits, pre-operative clearances, post-operative check-ups, and surgeries has its challenges. And to be sure, before I became a mother I had no idea how this would impact my work. What ...

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Before any patient can go to the operating room, they need medical clearance from their primary physician. I look at this as a good thing. Occasionally, a routine chest x-ray reveals lung cancer. Or, blood work shows abnormal values that point toward leukemia. The bottom line for me is that I never argue when a primary care physician or specialist, such as a cardiologist, says the patient is too sick to have ...

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Drug shortages can jeopardize patient safety A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. When doctors don’t have access to medications that are necessary to successfully perform procedures, patient safety is at risk. Over the past several years, drug shortages have significantly impacted the health care industry, making it not only difficult for physicians to do their jobs, but for ...

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Pilots never expect to hit a flock of birds on take off, or flame out an engine in mid-flight.  No one plans to get disoriented in the air or have an equipment malfunction miles from the nearest airfield.  And, it certainly isn’t routine to fly into hostile airspace with a heightened awareness of the known ground threats, the position of each member of your formation, and the safety of the ...

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One of my Physician's Weekly posts last month was on the subject of surgeons possibly losing proficiency for doing open cases because of the ever-increasing popularity of laparoscopic and other minimally invasive techniques resulting in declining numbers of open operations for residents during their training. Although some suggested that knowing how to do open cases would be unnecessary in the future, to me that is wishful thinking. Another commenter said, "We are ...

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