A patient with progressive neurologic disorder had a gastrojejunal tube placed for feeding. In a nursing home, the tube fell out and was replaced with a Foley catheter. He was sent to the hospital for placement of a new tube. When he arrived in the interventional radiology suite, the Foley catheter was not visible. A new gastrojejunal tube was successfully placed, and the patient was sent back to the nursing ...

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An 8-month-old baby fell 3 feet and hit his head on a carpeted floor in a San Francisco hotel room. He was crying and the parents, who were from South Korea, called an ambulance. By the time the child arrived at the hospital he was obviously fine. After a bottle, a nap, and a few hours in the hospital, he was discharged. The hospital sent a bill two years later, which ...

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"Some data is better than no data at all." Do you believe that? I heard it frequently when the infamous ProPublica's Surgeon Scorecard first appeared three years ago. Back then I blogged about it saying “To me, bad data is worse than no data at all.” A recent study in BJU International confirmed my thoughts about this type of publicly posted data and identified a previously unreported issue. The paper attempted to ...

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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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