More Than MDs: Medicine Is a Team Effort

The other day, I was operating on a little girl with a congenital ear abnormality. Not life and death stuff, but delicate surgery nonetheless. My surgical scrub technician was someone with whom I hadn’t worked before, and I asked him if he was enrolled in the operating room nurse training program, as many of the new folks are.

“No, I’m just a tech.”

I stopped what I was doing and replied: “You may be a tech, but you’re not just a tech.” Read more…

How Good Messaging Can Foster Kindness and Trust in Healthcare

“The best healthcare must involve kindness and instill trust,” reads the title of a recent Huffington Post UK article written by David Haslam, Chair of NICE, the National Institute for Health and Care Excellence.

NICE (an appropriate acronym for the article’s sentiment) is in fact not an institution known for charity or do-goodness, but rather, the organization is charged with assessing the cost-effectiveness and benefit of medical innovations – drugs, devices, procedures, and processes. Read more…

I’m a Plastic Surgeon and a Woman. Here’s What Beauty Standards Mean to Me

When I introduce myself as a plastic surgeon, I am often greeted with surprise. Between the slightly quizzical looks, the concerned head tilts, and the explicit queries, the question is clear: How could a woman of substance find herself in that line of work?

The truth is that real plastic surgery (in my world, at least) is nothing like its media representations. The nipped and tucked patients with outlandish requests, the salacious and provocative doctors, the ostentatious displays of wealth and consumption – these have nothing to do with my life or career. Plastic surgery, at its core, is an academic discipline that requires more than a decade of intense study, anatomic mastery of the entire human body, and precision surgical skills that are fine enough to sew a one millimeter blood vessel and strong enough to put the abdominal muscles back together. My patients are real, relatable human beings who have concerns about their physical appearances. Read more…

Ensuring a Better Death for Our Loved Ones

What if you woke up tomorrow and learned that your grandmother had been kidnapped overnight by a couple of strangers, thrown in a white van, and taken to a distant warehouse where she spent the subsequent forty-five minutes being tortured before finally succumbing to her death?

Where she was repeatedly beaten in the chest, where a tube was shoved down her throat, where she was tasered with high voltage, where a metal drill was bored into her leg, where she was stabbed multiple times in the neck, arms, and groin? Read more…

Why I Won’t Close My Practice to New Patients

Closing a medical practice to new patients is like cutting off the very top of a tree. It’s the beginning of the end.

The top of the tree, the crown, is where the newest leaves are. It’s also the part that continues growing ever upward, at least until it reaches its maximal genetic height, depending on environmental factors like the availability of water and sunlight (both of which also depend on how many other trees are competing for them nearby). Read more…

Dr. Google Is Our Ally

“Please do not confuse your Google search with my medical degree.” The quote’s been making the rounds online lately. The funny thing is that this is something I would have expected in 1997. At the time, we were adjusting to the idea of information as the third party in the exam room. Patients had a heady sense of power; doctors had to adjust to a shifting relationship.

Patients now seem to have a more mature connection with information. In my daily practice most seem to recognize that information can’t be equated with knowledge or wisdom. We all seem to have a good sense of where information fits into our dynamic. Read more…

We Need More Time with Patients, Less with Computers

I was dining at a friend’s house recently after a long day in the hospital. He has just bought a beautiful new home with his rapidly expanding family, and like anyone who has just moved into a new house, his spare time is invariably spent working on getting everything in order and undertaking small upgrades to make the new place as perfect as possible. He’s quite DIY-oriented (unlike myself) and was spending a lot of time doing minor construction work. Read more…

On the Joy of Missing Out

As I type these words, a soft pale light envelopes my toasty curled up kittens and me, and sheets of a very fine but persistent snow dance past the window, lightly obscuring the otherwise peaceful stark beauty outside.

Most of the East Coast has been brought to a standstill by a snowstorm so large it’s clearly visible in photos taken by astronaut Scott Kelly from his perch in the International Space Station. I am taking advantage of the opportunity to settle into my comfiest chair with the collection of inspirational and stimulating online lectures, podcasts, and articles I have been accumulating for quite some time. It has been bliss. Read more…

How Doctors Say Things Matters

Most physicians will be thrust into the role of patient or caregiver at some point during their careers. Unfortunately, it’s not until this occurs that many become fully aware of the finer points of excellent care and communication. Take for example, the simple act of reporting test results to a patient. We do this every day, but may not realize that how we frame the information is as important as the data themselves.

I came to realize this on a recent hospital visit when I was in the role of healthcare proxy for a loved one with heart disease. Not only did various physicians present information with different degrees of optimism, but individual doctors presented things differently on different days, depending on (I guess) how tired/hurried they were. Consider these different messages with the same ejection fraction and angiogram test results. Read more…

Most Doctors Want to Be Uber Drivers

Having spent over a decade working with doctors of all specialties, I’ve watched the profession shift is fundamental ways. How has this changed the mindset of the modern physician? Here’s what I’ve concluded: most doctors just want to be Uber drivers.

Okay, so not exactly. What I mean is that (like many of us) many doctors want to perform the job they signed up for – medicine. They want an overarching system to deal with everything else. Read more…