Surgeons
By Michelle Crouch from Reader’s Digest Magazine | October 2012
“If an airline told you that their pilot is the best but he’s not FAA-certified, would you get on the plane?”
“For the same reason, always check if your surgeon is board-certified in his specialty. Many are not.” [Visit absurgery.org.]—Tomas A. Salerno, MD, chief of cardiothoracic surgery at the University of Miami Miller School of Medicine
“Always ask ‘Who is going to take care of me after surgery?’”
“You want to hear ‘I will see you on a regular basis until you have recovered fully.’ Often it can be residents or physician’s assistants. Sometimes it’s not anybody, especially after you’ve been discharged from the hospital.”—Ezriel “Ed” Kornel, MD, clinical assistant professor of neurological surgery at Cornell University
“It’s better to have an elective surgery early in the week.”
“Lots of doctors go away for the weekend and won’t be around to make sure you’re OK. If you go in on a Friday, and then on Saturday or Sunday something icky is coming out of your incision, you’re going to get someone who’s covering for your surgeon.”—General surgeon who blogs under the name Skeptical Scalpel
“Some doctors hire practice management consultants to help capture more revenue.”
“The consultants may want the practice to sell equipment like knee braces or walkers at a markup. They may want the doctors to buy or build a surgery center to capture facility fees. They usually want orthopedic surgeons to get an in-office MRI. Every time a doctor does this, he becomes more financially conflicted. As soon as you put in an MRI machine, you order more MRIs so you won’t lose money on it.”—James Rickert, MD
“It’s amazing how diligent people can be about searching for the right surgeon but have no idea who their anesthesiologist will be.”
“That’s just as important. Ask ‘Who’s going to be putting me to sleep?’ or ask me who I think the best anesthesiologist is. In some hospitals, you can request that person.”—General surgeon who blogs under the name Skeptical Scalpel
“Years ago, a patient sent his slides to three different pathologists and got three different answers.”
“I got very upset on hearing that. Now I never rely on just one pathology exam. If your doctor finds something, ask him to send your slides to a nationally recognized reference lab—not just one or two slides but the whole lot—and get a second interpretation.”—Bert Vorstman, MD, a prostate cancer specialist in Coral Springs, Florida
“So often the risks on legal consent forms aren’t the things we actually worry about.”
“Or, there may be one complication we’re really concerned about. If you truly want to understand the dangers, ask your surgeon, ‘What is the risk that gives you the most pause?’”—Kevin B. Jones, MD, author of What Doctors Cannot Tell You: Clarity, Confidence and Uncertainty in Medicine
“In medicine, you can get a DUI, go to jail for a couple of hours, and walk out at 7 a.m. the next morning and do a surgery.”
“You can be accused of sexual misconduct and drug and alcohol abuse in one state and pop over to the next one and get a license. Some state medical boards don’t even thoroughly research your background; they argue that the less-than-$10 fee to access national data is too expensive.”—Marty Makary, MD
“Mistakes are probably more common than you would think.”
“But most of them don’t actually hurt people. I work with residents, and I don’t let them do anything that I can’t fix if they screw it up. If there’s an error that I fix that I’m sure won’t affect the patient at all, I’m not going to say anything about it. That would accomplish nothing except to stress out the patient.”—An orthopedic surgeon
“Some problems just don’t fix well with surgery, like many cases of back pain.”
“My advice? Grin and bear it. Some surgeons vehemently disagree. They say, ‘Oh, you have a degenerative disk, and that must be the culprit. Let’s fix it.’ But many people have a degenerative disk with no pain. There isn’t a lot of evidence that we’re helping very many people.”—Kevin B. Jones, MD
“Always ask about nonsurgical options and whether there’s anything wrong with waiting a little while.”
“Surgeons are busy, and they like to operate. A professor from my residency would say, ‘There is nothing more dangerous than a surgeon with an open operating room and a mortgage to pay.’”—Kevin B. Jones, MD
“Talk to your doctor about donating your blood or asking your family members to donate blood before an elective surgery.”
“Banked blood is a foreign substance, like an organ, and your body can potentially react adversely. If you can use your own blood or blood from your family, there’s less chance of those reactions.”—Kathy Magliato, MD, cardiothoracic surgeon at Saint John’s Health Center in Santa Monica, California
“Residents have to learn how to operate, and it’s required that an attending physician be ‘present.’”
But ‘present’ doesn’t mean he has to be in the operating room scrubbed in. At an academic institution, ask whether your surgeon will be actively participating in the surgery or just checking in every hour.”—Ezriel “Ed” Kornel, MD
“It’s always interesting to hear what people say when you’re giving them anesthesia.”
“I once had a guy who was a horse trainer who started going on about how this one horse was a sure thing to win. One of the nurses collected money from everyone in the operating room and bet on the horse. It came in second place. The smart people bet the horse to place, but some had bet the horse to win, so half the staff was happy, and the other was upset. He woke up and had no idea what kind of ruckus he’d caused.”—Michael Salzhauer, MD, a plastic surgeon in Miami, Florida
“I did an intestinal operation on someone who had been stabbed.”
“As I was running my hand along the bowel, I came upon something and said, ‘What the heck is this?’ It felt like a condom. Then all of a sudden, it wiggled! I dropped it, shocked. The guy had worms.”—Sid Schwab, MD, a retired general surgeon in Everett, Washington
“During my six weeks as a surgical intern in the ER, I inadvertently stuck myself twice with contaminated needles…
… briefly nodded off in the middle of suturing a leg laceration, accidentally punctured a guy’s femoral artery while trying to draw some blood, and broke up a fight between the family members of a guy who’d come in with a stab wound to the abdomen. I was slugged in the head by a delirious patient in an alcoholic rage, spat upon, coughed on, vomited on, farted on, bled on, and mistaken for an orderly.”—Paul Ruggieri, MD, author of Confessions of a Surgeon: The Good, the Bad, and the Complicated … Life Behind the O.R. Doors
“When I get polite in the operating room, when I start saying ‘please’ and ‘thank you’ and talking in a monotone, that’s when nurses know things aren’t going well.”
“It’s this mechanism to maintain calm. When we become unglued, everyone becomes unfocused, and that’s when patients die. How you handle stress is absolutely critical.”—Kathy Magliato, MD
“Obese people have no idea how challenging their care is.”
“Starting an IV is tough because chubby arms don’t have many visible veins. It’s difficult to place a central venous catheter. Post-op, they’re more likely to get infections. Just getting someone who weighs 300 pounds out of bed is hard.”—General surgeon who blogs under the name Skeptical Scalpel
“If you ask too many questions, you can be branded as a pain in the neck.”
“When one extremely hostile relative bombarded me every time I walked in, I developed a tendency not to go in the room. If you have three pages full of questions, show them to the nurse. Say ‘How many of these should I wait to ask the doctor about? How many can you help me with?’”—General surgeon who blogs under the name Skeptical Scalpel
“About 25 percent of operations are unnecessary, but administrators e-mail doctors telling them to do more.”
“This is not an insurance company putting pressure on doctors; this is not a government regulation. This is private hospitals pushing doctors to generate more money by doing more procedures. It goes on at America’s top hospitals. The Cleveland Clinic has said this system of paying doctors is so ethically immoral that it started paying its doctors a flat salary no matter how many operations they do.”—Marty Makary, MD
“Every time a patient dies, I think about the family, the funeral, the kids.”
“I operated on a man who had something very complex and died in the operating room. He had a wife and two children. When I came out to tell them, the children were screaming, ‘Mommy, Mommy, I want my daddy.’ That was very hard. Even though we present ourselves as very strong, we’re vulnerable to depression and other problems. We’re human.”—A surgeon in Florida
“I was about to approach the back of a patient’s knee instead of the front for a biopsy.”
“Because of a checklist, I looked at the imaging again and thought, Yikes! What am I doing? Thankfully, I caught the mistake before I even draped the patient, and no harm was done, but I felt horrible about it. It was more than a year ago, and I still think about it.”—Kevin B. Jones, MD
“Very often, plastic surgery patients don’t admit to a previous surgery, and I don’t find out until I’m in there.”
“I’ll go in on an eyelid or a nose, and it’s just a mess. If you don’t tell us you had lipo, there will be scar tissue, and the fat won’t come out normally. So please be 100 percent honest. There’s no need to be embarrassed. We’ve heard it all, and we don’t judge.”—Andrew Ordon, MD, cohost of the hit television show The Doctors and a board-certified plastic surgeon
“If your doctor wants to give you a stent, always ask: Is this better than medicine?”
“If you’re not having a heart attack or an unstable angina, you will do equally well with a stent or medicine, studies show. Having something permanently implanted in your body is not a risk-free proposition. There is evidence that thousands of people have had stents they likely did not need.”—Marc Gillinov, MD
“If I had any kind of serious medical condition, I’d go to a teaching hospital.”
“You’ll get doctors involved with the latest in medicine. Even for simple cases, if there’s a complication that requires an assist device or a heart transplant, some hospitals may not be able to do it. At a university hospital, you also have the advantage of having a resident or physician bedside 24-7, with a surgeon on call always available.”—Tomas A. Salerno, MD
Read more: http://www.rd.com/slideshows/50-secrets-your-surgeon-wont-tell-you/#ixzz3Z7eEqA2S