Clinical

On Evidence-Based Medicine

A few weeks ago, I read an editorial in the JBJS that made me think of the meaning of the word “evidence” and how it relates to clinical practice in 2016. In their article titled “Level-III and IV Evidence: Still Essential for the Field of Musculoskeletal Medicine and Surgery” Drs. Sangeorzan and Swiontkowski argue that the “wholesale buy-in of statistical…
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Work/Life Balance

There goes a firetruck…

A hobby is defined on Google, since we are in the electronic era, as “an activity done regularly in one’s leisure time for pleasure.”  As part of my residency, fellowship and the beginning of my academic career, I would see instructional course lectures (ICLs) and other lectureships related to the work-life balance.  Visiting professors would even often incorporate topics like…
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Clinical

Who Needs a Thumb Anyway?

In my pediatric practice, I’ve often wondered if the children that we “fixed” as a child have actually been made better or whether they would have adapted and done just fine on their own. These decisions are made by parents and surgeons since the babies certainly don’t have an opportunity to participate in the decision making. Often it seems we…
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Patient Communication

The Opioid Epidemic: What is our role?

“To see what is in front of one’s nose is a constant struggle”.  – George Orwell The United States is grappling with an epidemic of prescription opioid medications, and the statistics are frightening. Opioid prescribing remains higher in the United States compared with anywhere else in the world, and 80% of the world’s opioids are prescribed and consumed in this…
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Patient Communication

Forgive and Remember

Since I was informed of New York State’s investigation of my practice in 2010, when a drug-seeking patient complained that I did not prescribe postoperative narcotics, I have had ample time for introspection and self-evaluation. Indeed, I have asked myself how such a “good physician” and “good man” could be shamed so mercilessly, particularly since I, like Mark Chassin expressed…
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Ethics

Often Wrong, but Never in Doubt

The popular trope of the confident, arrogant and swashbuckling surgeon is usually as far from representing reality as a Norman Rockwell painting is from representing modern urban life. "Often wrong, but never in doubt" is a phrase bandied about medical schools for laughs to describe the attitudes of those who practice surgery. I am often wrong, often in doubt, and…
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Work/Life Balance

Happiness in Hand Surgery

One of the main reasons I chose the field of orthopaedics and later, hand surgery, was that my mentors along the way truly seemed to enjoy their jobs. The hand surgeons I encountered bantered with their patients in the clinic and played country music in the OR. They ran marathons and made time to attend children’s plays and sporting events.…
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