A new study found several senior academic surgeons had published papers in what used to be termed “predatory journals.” The newer, gentler term is “solicited publishing,” but it defines the same pay-to-play, low-quality publications. Surgeons from the University of California, San Diego examined 110 emails sent to the senior author from 29 publishers during a six-week period and early 2017. Nearly all were requesting manuscript submissions. The 29 publishers represented 113 ...

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In a 2012 blog post called “Things that puzzle me about surgical education,” I wrote the following:

There was the emphasis that still exists today on making sure every resident did research. At last, some are questioning the value of this for the average clinical surgeon. Contrary to the prevailing wisdom, there is no evidence that a resident who is dragged kicking and screaming through a clinical research project or ...

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Kang Se-hoon, a surgeon in South Korea, operated on a popular rock singer and song writer in October 2014. According to reports, Shin Hae-chul had abdominal pain, and the surgeon performed laparoscopic lysis of adhesions. Without having obtained consent, he decided to also do a weight reduction procedure. The patient was discharged a few days after surgery but returned a day later with fever and severe abdominal pain. Kang did not ...

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For almost 20 years, the value of the digital rectal exam (DRE), a long time staple of the complete examination of the trauma patient, has been questioned. Performing a rectal examination on all trauma patients is no longer advocated except for a few specific indications. As recently as two months ago, trauma surgeon Michael McGonigal blogging at the Trauma Pro reinforced the message. Because a rectal examination is so uncomfortable ...

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Two recent posts highlight the problems facing many medical students today. The first was by an anonymous rising fourth-year student who has come to the conclusion that going to medical school was “a terrible, terrible decision.” It ended with a comment that medical school “is not fun. It’s jarring, scary, disappointing and absolutely depressing.” The second was by another anonymous student who described how miserable he (or she) has been ...

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A survey of 1,000 volunteer adults found 71% regularly watched medical television dramas, but only 12% said the shows “were a reliable source of health information.” The participants were given some brief vignettes describing scenarios where CPR was administered: a 54-year-old who suffered a heart attack at home and received CPR by paramedics, an 80-year-old with a postoperative cardiac arrest in the hospital after surgery, and a post-traumatic arrest in an ...

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Unnecessary testing wastes money and can lead to further testing. Why does it occur? Almost 60% of medical personnel surveyed at a large academic medical center believed that hospitalized patients should have daily laboratory testing. Of 1,580 attending physicians, fellows, residents, physician assistants, nurse practitioners, and nurses sent surveys, 837 (53%) responded; 393 (47%) were RNs, and 80% of those nurses felt that daily laboratory testing should be done on all patients. Nurses ...

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For several years, Medicare has tied hospital reimbursement to its definition of quality of care. Poorly performing hospitals can be penalized as much as 2% of their Medicare payments. As part of Medicare’s assessment of quality, surveys are used to measure patient experience and satisfaction. One of the components of the Medicare survey is pain management, which Medicare describes as follows: I’m not sure who, if anyone, ...

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The committee that plans and oversees medical care for the county of Hertfordshire, England announced recently that unless obese patients lose a specified amount of weight and smokers quit smoking for at least eight weeks, they will not be allowed to undergo elective surgery. Patients with a body mass index (BMI) greater than 40 must lose 15 percent of their weight within nine months, and patients with a BMI over 30 ...

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Recently, Dr. Ashish K. Jha, a Harvard internist and health policy researcher, published an opinion piece in JAMA, advocating public reporting of individual surgeon outcomes. I have followed Dr. Jha for many years on Twitter and have enjoyed his blog posts and papers. However, I must respectfully disagree with much of what he wrote this time. He tries but fails to refute the arguments that critics of individual surgeon reporting ...

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