Brain surgery is getting smarter. The journal Nature Medicine recently published a study that found a new imaging technique that allows pathologists to diagnose brain tumors faster and more accurately than ever before. The study focused on Invenio Imaging technology’s use of artificial intelligence (AI) in making accurate diagnoses. So, will computers replace doctors? That’s unlikely. Treating the human brain requires a human approach. But AI is ...

Read more...

I am in the operating room working with an attending anesthesiologist I have known for years. "Tell me," I ask, "Do you and your colleagues talk about the difference between Des and Sevo?" He looks at me without responding. "You see," I continue, "There was a story on the radio about a hospital that has gotten rid of Desflurane because of the environmental impact. It is ...

Read more...

Today started like any other day. I woke up, got ready, drove into work. I dropped my bag in my office, changed into scrubs, and wandered down to pre-op. After a few minutes of small talk with the staff, I found the patient I was looking for. He was awaiting a major operation. I spoke with him and his fiancé́ and laughed. They shared a few tears. As I often do, ...

Read more...

If you talk to anyone you know, it’s very likely they will tell you that they are on some form of social media. Whether this is Facebook, Twitter, Instagram, Snapchat, TikTok, or YouTube, most people are on at least 1 to 2 forms of social media these days. Video is one of the most powerful tools in marketing. According to Google, 64 percent of consumers use video to research health care ...

Read more...

Recently, I read this great article from Dr. Chethan Sathya, a male surgeon who commented on how women surgeons in this day and age are still treated as second class surgeons. There has been much good commentary and discussion on the topic, particularly on Twitter. But almost as if on cue, a different male surgeon chimed in with the following comment:

I’m 100% sure u will prefer ...

Read more...

I’ve just discharged a kid with a cough, and there are no patients waiting to be seen. “I’ll be back,” I tell the nurse, as I slip away to the hospital kitchen and unlock the door. I steal two frozen grilled cheese sandwiches from the freezer and throw them into the microwave. Minutes later, I’m in the call room. I take a couple of bites and can already feel acid rising ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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: ...

Read more...

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 ...

Read more...

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, ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

Most Popular

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories