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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I read the recent article on KevinMD: “I’m sorry: Why I lost my love for medicine” with great sadness. My heart goes out to the author; many of their concerns echoed deeply within me. I am sorry that we, as physicians, haven’t effectively succeeded in solving the myriad of problems facing health care today. And the author is right: Health care as a system, in the ...

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As a fourth-year orthopaedic surgery resident, we had some surgical autonomy.  Always at arm’s length from the attending oversight, this was just enough to push us past our comfort zones. My problem was I loved my comfort zone. The single most influential day in my career happened late one evening as a PGY-4.  I was about to start a complex ankle fracture by myself.  The ankle fracture involved the fibula and the ...

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As a practicing surgeon that has one foot in the world of teaching and the other in corporate health care delivery, I enjoy speaking to students and residents about the future. We often discuss topics like the shift from volume to value, consolidation, insurance models, and specialization. Often this information is new to them, and overwhelmingly they ask some form of the question: "How will this affect my career?" The following ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. There is a global anesthesia crisis: too few people trained to give anesthetics for surgery and obstetrics worldwide. The Lancet launched a commission to look at the needs for global surgery, which identified the issues starkly. While international disease control efforts have ...

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Most physicians recall the rigors of their residency training through a mixed lens. In prior generations, a single-duty shift could stretch to 36 or more consecutive hours, but the exhaustion was buoyed by the camaraderie of sleepless on-call nights in the hospital. Despite the exhaustion, resident well-being received scant attention. Beginning with the 1984 Libby Zion case, and later the Accreditation Council on Graduate Medical Education (ACGME) duty hour restrictions ...

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I went to a bar last night -- and I looked good: red coat, black dress, knee-high suede boots.  I was feeling pretty good. I met my best friend at this bar -- he lives elsewhere now -- but this is his favorite spot in the world.  Like Norm in Cheers, he is also their favorite customer. We ordered dinner, and my best friend stepped away to talk to the bartender.  I ...

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We live in an era where plastic surgery is routine.   Indeed, in many parts of the country, plastic surgery is an expected rite of passage.   Years ago, facelifts and "tummy tucks" were done on those in middle age who were trying to experience a surgical time machine.  Now, folks in their 20s are having all kinds of work done, not to recreate a prior image, but to create a new ...

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I recently had a conversation with a new patient who was referred for surgery. As it happens, she discussed me with people she knew before her appointment. I like patients to look me up, talk to friends, find out who I am, and come with an expectation of what they will get in my clinic. We had a normal new patient visit, and per my typical workflow, I explained the agenda: ...

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The younger you are when you are exposed to opioids, the higher the likelihood of addiction later in life. The prefrontal cortex is not fully formed until the age of 25. This means that alterations in the “feel-good” neurotransmitters, specifically dopamine (released by opioids), can have an effect that predisposes the person towards future opioid use. Because teenagers have an overactive impulse to seek pleasure and less ability to consider the ...

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Just before I induced anesthesia, he said, “Doc, I want to apologize beforehand. I am incontinent due to a previous surgery so I might wet the sheets." I told him not to worry and that we understood and that "these things do happen." His response has stuck with me: "Doc, but there is still some shame." I nodded, told him not to worry since he was going to get a catheter anyway, ...

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One of my favorite scenes in the recent Apollo 11 IMAX film was a dramatic panning shot of mission control moments before lift-off. Row after row of mission specialists, engineers, astronauts, communications technicians — all looking ahead in silent, unbreakable focus. All 100 percent dedicated to the three men about to lift-off into history. It was a truly mesmerizing portrait of teamwork. While astronaut safety is the focus of every individual ...

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Head and neck cancer surgeons know when “the questions” are coming. A casual conversation eventually turns to, “What do you do for a career?” The pleasant exchange is replaced with talk of disfigurement and life-threatening illness. The person’s brow furrows. “How can you deal with that day after day? Isn’t it depressing? Why didn’t you pick something happier for a career?” These are legitimate questions. As a medical student many years ...

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I am a cardiac anesthesiologist. I meet most patients I care for minutes before I take them to the operating room and render them unconscious. I breathe for them, administer pain medicine and drugs to give them amnesia, and I keep their hearts, lungs, kidneys, and brains working. Pretty important stuff. I want to speak on behalf of physicians. I want all patients to know something: We need you to talk to us. We ...

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STAT_Logo Women who become doctors must often choose between motherhood and medicine. I’m a mother and a surgeon. I never thought of choosing between the two, even though my employers often asked me to. Today I work as a trauma surgeon in a busy practice. It’s been a long journey since the day five years ago when I ...

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An excerpt from A Mistake: A Novel. “Hello there,” Elizabeth said, leaning over the girl, smiling. “Hello. Hello Lisa.” The girl looked up at her accusingly. “My name is Elizabeth Taylor. Please call me Liz. I’m the consultant surgeon, and this is my registrar, Richard Whitehead.” Elizabeth smiled wider for her. “How are you ...

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STAT_LogoDuring the 25 years I’ve been a transplant doctor, I’ve cared for hundreds of patients who received lung transplants. I’m now worried about the growing number of people who will need this lifesaving procedure in the future but who won’t have enough transplant physicians to do it. At any given time in the U.S., about 120,000 ...

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She placed the stack neatly aside with all forms diligently signed and dated. The inbox was cleared. Being finally rested, her tasks of staying on top of duties and focusing on executions became briefly easier. A few patient callbacks, an eight-page disability form to fill out, a doctor to connect with, seven notes to complete and two test results to review and relay would round off the already pregnant day. ...

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As a profession, we’ve yet to standardize maternity leave and breastfeeding allowances for women. Given the length of medical training (seven-plus post-graduate years), timing (prime reproductive years) and slow increase in the ratio of female to male surgical residents, females choosing to start families during training are particularly afflicted. We just celebrated my son’s first birthday. I had him during one of the busiest years of my surgical residency, and it’s ...

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I lay on my side while my father probed the space between my buttocks, looking for an opening in the incision. I was in bed in the guest room of my house, which had been converted into my room for the last two weeks while I recovered. My father, a surgeon himself, had assumed his professional role and examined the wound with the gentle but firm movements of someone who ...

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