The annual meeting of my profession’s national society last fall may have been the last old-school, convention-size, professional meeting I will ever attend. I could be wrong, but it may mark the end of an era. Disruptive change to the convention business model was inevitable, though hastened by COVID-19. This year, the leadership of many medical associations announced that their upcoming annual meetings would be virtual – if ...

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I live and work in Los Angeles, one of the plastic surgery capitals of the world. Quite a few of my patients have “had a little work done” — the blandly euphemistic term you’ll hear for plastic surgery makeovers of all kinds. That’s fine. Plastic surgeons have children to feed too. The problem is this: many of my patients want to convince everyone that their “look” is entirely natural. They don’t ...

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Do you think I went too far in my last blog post, calling out some journalists as “pontificating parasites” who love nothing more than to slam physicians and blame us for the cost of health care? If you do, then you must not have read Elisabeth Rosenthal’s latest salvo in the Feb. 16 New York Times, where she says physicians are in “a three-way competition for ...

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If physicians are “muggers” and co-conspirators in “taking money away from the rest of us,” then journalists and economists are pontificating parasites who produce no goods or services of any real value. I don’t think either is true, but the recent attacks on physicians by economists Anne Case and Angus Deaton, and “media professional” Cynthia Weber Cascio, deserve to be called out. You ...

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Though the news at first stayed local in Philadelphia and the northeast, it’s gaining traction nationwide. ZDoggMD is on it. Bernie Sanders held a rally. What happened? The venerable Hahnemann University Hospital, the main teaching hospital for Drexel University College of Medicine in Philadelphia, is bankrupt and will soon close its doors after more than 170 years as a safety-net hospital serving inner-city patients. Why should we care? After all, there ...

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If you’re a parent who is still on the fence, trying to decide whether or not to vaccinate your children, I’m going to try to be kind and helpful. Here is a link to a video by a physician and father, Dr. Zubin Damania, with facts that may address some of your fears. If you’re firmly pro-disease and anti-vaccine, however, I am baffled at your irrationality and frankly enraged by ...

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For several years now, I’ve been the social media curmudgeon in medicine. In a 2011 New York Times op-ed titled “Don’t Quit This Day Job,” I argued that working part-time or leaving medicine goes against our obligation to patients and to the American taxpayers who subsidize graduate medical education to the tune of $15 billion per year. But today, eight years after the passage of the Affordable Care ...

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We’re very fortunate in anesthesiology. We’re seldom the physicians who have to face families with the terrible news that a patient has died from a gunshot wound. But all too often we’re right there in the operating room for the frantic attempts to repair the bullet hole in the heart before it stops beating, or the blast wound to the shattered liver before the patient bleeds to death. Despite all the skills ...

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A true allergic reaction is one of the most terrifying events in medicine. A child or adult who is highly allergic to bee stings or peanuts, for instance, can die within minutes without a life-saving epinephrine injection. But one of the most commonly reported allergies — to penicillin — often isn’t a true allergy at all. The urgent question that faces physicians every day in emergency rooms and operating rooms is ...

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We’re all human beings, but we’re not all alike. Each person experiences pain differently, from an emotional perspective as well as a physical one, and responds to pain differently. That means that physicians like myself need to evaluate patients on an individual basis and find the best way to treat their pain. Today, however, doctors are under pressure to limit costs and prescribe treatments based on standardized guidelines. A major gap looms ...

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Let me say first that any woman who has ever been harassed or assaulted should never be made to feel that it is her fault. It is always the perpetrator’s fault. Men can be boors, or worse, and testosterone can be toxic. I went to Princeton University at a time when the ratio of men to women was 8:1, graduated from medical school in the 1980s, and raised two daughters. I’ve ...

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When you tell anyone in health care that “sedation” to the point of coma is given in dentists’ and oral surgeons’ offices every day, without a separate anesthesia professional present to give the medications and monitor the patient, the response often is disbelief. “But they can’t do that,” I’ve been told more than once. Yes, they can. Physicians are not allowed to do a procedure and provide sedation or general anesthesia at the ...

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No, I’m not talking about putting fentanyl into my own veins — a remarkably bad idea. I’m questioning the habitual, reflex use of fentanyl, a synthetic opioid, in clinical anesthesiology practice. I’ve been teaching clinical anesthesiology, supervising residents and medical students, in the operating rooms of academic hospitals for the past 18 years. Anesthesiology residents often ask if I “like” fentanyl, wanting to know if we’ll plan to use it in ...

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A commencement address delivered on August 5, 2017, to the 2017 class of anesthesiologist assistants (AAs), Emory University. Distinguished faculty, graduates, honored guests: It is a great pleasure and an honor to be here, and to congratulate all the graduates of the Emory University Class of 2017 on your tremendous accomplishment. Just think about all you have learned in the past two years. You’ve transformed yourselves into real anesthesia professionals, able to ...

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There are two schools of thought about how to extubate patients at the conclusion of general anesthesia: Allow the patient to wake up with the endotracheal tube in place, gagging on the tube and flailing like a fish on a line, while someone behind the patient’s head bleats, “Open your eyes!  Take a deep breath!” Or: Remove the endotracheal tube while the patient is still sleeping peacefully, which results in the smooth emergence ...

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I wish I knew who coined the term “DRexit” so I could send flowers or a bottle of whiskey as a thank you gift. There couldn’t be a more perfect term to describe the growing exodus of physicians from our beloved profession, which is turning into a morass of computer data entry and meaningless regulations thought up by people who never touch a patient. The one bright note on the horizon ...

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My husband and I, both anesthesiologists, enjoy our Sunday mornings together -- coffee, the New York Times, a leisurely breakfast. No rush to arrive in the operating room before many people are even awake. Today, though, seeing reporter Jan Hoffman’s front-page article in the Times -- “Staying Awake for Your Surgery?” -- was enough to take the sparkle out of the sugar. Her article on how much better it ...

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In the interests of full disclosure, I acknowledge with delight that I have a non-time limited board certificate from the American Board of Anesthesiology (ABA), issued before the year 2000. I can just say “no” to recertification. The more I learn about the American Board of Medical Specialties (ABMS) and its highly paid board members, the more disillusioned I’ve become. It’s easy to see why so many physicians today have concluded ...

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Classic rock music lovers who think they don’t like poetry, and literary purists who think they don’t like popular music, may have been equally baffled to hear that Bob Dylan is a winner of the Nobel Prize in Literature. As an unrepentant English major, I’m delighted. I can’t remember a time when Dylan’s music wasn’t a part of my growing up, from the rebelliousness of the anti-Vietnam era to ...

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You may have read about the recent tragic deaths of two healthy children -- Marvelena Rady, age 3, and Caleb Sears, age 6 -- in California dental offices. Unfortunately, they aren’t the first children to die during dental procedures, and unless things change, they probably won’t be the last. State Senator Jerry Hill has asked the Dental Board of California (DBC) to review California’s present laws and regulations ...

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