“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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Can anxiety be severe enough to cause a physician to leave medicine?  Absolutely.  I know a number of physicians who have left for this reason.  In my coaching practice I am increasingly aware of the toll anxiety takes on many doctors and am making it my mission to bring more attention to this problem and to find solutions.  The physicians I have talked to are just the tip of the ...

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At the end of an otherwise informative article about the nuances of performing a Heimlich maneuver, New York Times science reporter Jane E. Brody recommends that if all else fails, a cricothyrotomy should be attempted. She goes on to briefly explain how the procedure is done. In the right hands, a cricothyrotomy is safer and easier to perform than a formal tracheostomy. However, for a layperson who has never seen either ...

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Most of us would agree that there aren't enough valid and meaningful health care quality measures to guide patients' choices of hospitals and physicians. While the federal government has steadily expanded the number of publicly available measures on its Hospital Compare website, it still falls short of what many patients, payers, and providers would like. This is particularly true in the realm of outcomes such as ...

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If only being in the OR can be as smooth as the singing from Gary Corzine's group, the Laryngospasms.

Resurge In the arms of every parent who waited on the long line outside the clinic in Mexico was a child born with a facial deformity, usually a cleft lip or palate. Many of these mothers and fathers had walked long distances, carrying their child. Some families included grandparents, aunts and uncles, and others, just a mother, and her baby. Most of these ...

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