Winning the Doctor Lottery

By ANISH KOKA, MD A poignant piece recently appeared in the journal Health Affairs and was rapidly devoured on social media by the health policy community. The story is a harrowing first person account of a woman’s multiple interactions with doctors. The doctors in the story are either very good or very bad. One pediatrician turns the author and her sick son away on three consecutive days with colic, only to have a more careful partner sound the alarm and discover pyloric stenosis. The author then recounts the tale of her father’s death at age 42 due to a surgeon who operated for diverticulitis unnecessarily. My family and I haven’t always won The Doctor Lottery. My father’s surgeon, for instance, had pushed him to have the bowel resection to “cure” him of diverticulitis, a disease in which the colon’s lining becomes inflamed. He stitched up my father’s intestines with a suture known to dissolve in patients who’ve been on steroids and hadn’t read my father’s chart to see that his internist had recently had him on cortisone. Nor did he look at the list of medications my father had carefully written down on his patient intake forms. When the sutures dissolved, my father, who had a bleeding disorder, went into shock. His abdomen was distended and hard. My mother asked the nurse to page the surgeon. “My husband is in so much pain!” she said. The surgeon, who was playing golf, told the nurse to tell my ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs

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Postoperative management of hallux valgus varies widely. Setting preoperative expectations is an important aspect of attaining a successful outcome, but this is not routinely reviewed in the literature. This chapter offers suggestions on successfully navigating this area of patient care. Current concepts focus on pain control, immobilization, and return to activities. This chapter also reviews the current literature in these areas and sets out the authors ’ preferred management in the postoperative setting.
Source: Foot and Ankle Clinics - Category: Orthopaedics Authors: Source Type: research
Publication date: Available online 23 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Prathiba M. De Silva, Ayesha Mahmud, Paul P. Smith, T. Justin ClarkAbstractObjectiveTo identify the most effective analgesia for women undergoing office hysteroscopy.Data sourcesMedline, Embase, CINAHL and the Cochrane library were searched from inception until August 2019 investigating the effect of different analgesics on pain control in office hysteroscopy.Methods of study selectionRandomised controlled trials were included that investigated the effect of analgesics on pain experienced by women undergoing diagnos...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Publication date: Available online 23 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Whitney Trotter Ross, Jordan M. Newell, Richard Zaino, Allen R. Kunselman, Gerald J. Harkins, Andrea S. BentonAbstractStudy ObjectiveTo evaluate the diagnosis of appendiceal endometriosis in coincidental appendectomy specimens using a standard versus modified histopathologic analysis.DesignProspective analysis of 300 consecutive patients undergoing coincidental appendectomy at time of a primary gynecologic procedure.SettingAcademic tertiary referral hospital in the Northeastern United States.PatientsWomen ages 22 to...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
High blood pressure: A common diagnosis, that shows hardly any symptoms, but can be deadly. Hardened arteries and blood forced too hard against artery walls can lead to a heart attack or stroke. Fortunately, there are lifestyle improvements that can lower blood pressure and potentially save your life.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Abbott Laboratories has been wildly successful with its FreeStyle Libre continuous glucose monitor (CGM) since winning FDA approval in 2017, but it seems some investors and patients may be getting restless as the U.S. market waits for the second-generation of the blockbuster technology. We first noted some signs of impatience for Libre 2 in our coverage of Abbott's third-quarter earnings call in October. One reader commented on that article that "I don’t particularly care about investors becoming impatient, as a Freestyle Libre user I am growing impatie...
Source: MDDI - Category: Medical Devices Authors: Tags: Business Source Type: news
Authors: Monsalve Alonso S, Miranda García P, Santander Vaquero C Abstract Cap-polyposis is a rare benign condition characterized by inflammatory colorectal polyps covered by a "cap" of fibrinopurulent exudate. Mucous diarrhea and rectal bleeding are frequent symtoms. It can be difficult to diagnose and it is necessary to make a differential diagnosis from other entities. Its pathogenesis is unknown and it has a variable clinical course. The optimal treatment has not been established. PMID: 31960689 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
CONCLUSIONS: acromegaly may be associated with more polyps in SB. PMID: 31960686 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
We present the case of a 74-year-old man, with a history of residual schizophrenia, who underwent abdominal-pelvic CT with intravenous contrast, due to abdominal acute pain, that showed a stenosis at the origin of the celiac trunk and a large aneurysm of the hepatic artery, secondary to a mediam arcuate ligament syndrome, of the diaphragm was observed. PMID: 31960685 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
We report the case of a 60-year-old male with a giant colorectal laterally spreading tumor at the recto-sigmoid junction. A single tunnel-assisted endoscopic submucosal dissection was performed that constructed a submucosal tunnel along the longitude axis of the tumor. An en bloc resection was achieved with no perforation or post-operative bleeding and a comparatively low procedure time. PMID: 31960681 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Authors: Ruiz Rebollo ML, González Obeso E, Burgueño Gómez B, Santos Fernández J Abstract A 75-year-old male was referred due to dysphagia and iron-deficiency anemia. An upper endoscopy was performed which revealed a friable mass at 30 to 37 cm from the incisors, consistent with esophageal malignancy. However, the pathology only demonstrated granulation inflammatory tissue. An endoscopic ultrasound exam showed a 2-3 cm esophageal wall thickening with a 1.5 cm lymph node, which was staged as a T2-3 N1 esophageal tumor. A CT-scan also identified a 7.5 cm esophageal malignancy surrounded by...
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
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