There are two constants in medicine: change and resistance to change
Higher litigation paradoxically because health outcomes improving so people have higher expectations. But drawback that makes doctors reluctant to try new techniques. In 1980's kidney disease a leading killer, then a US team started doing experimental transplants. First 30 patents all died, until got procedure right, leader of team got Nobel Prize and now it's an everyday op that has saved thousands of lives
In book Blood and Guts - A History of Surgery, Richard Hollingsworth described early heart ops where they hooked a volunteer's blood supply up to that of the patient so could pump blood for both - first known procedure with chance of 200% mortality.
Robert Liston, surgeon in the early half of the 19th C. Could perform a full cut and shut amputation of a leg in 2.5 minutes. During the demonstration of one such procedure he severed the fingers of his assistant, and a spectator is said to have died of shock. The assistant and the amputee also both died of infections. Liston is the only surgeon in recorded history to have suffered a 300% mortality rate from a single operation.
A trauma victim arriving at a hospital emergency room but requiring specialized intensive care would usually be transferred promptly to a qualified "trauma center," whose success rate with such patients is believed to be 25 percent better than that of ordinary hospitals. However, a recent study from Stanford University researchers found that, among 636 hospitals observed, there was a greater reluctance to make the transfer--if the patient was fully insured. (That is, the authors suggest, there is a tendency for hospitals to hang onto insured patients, even though their outcomes might be worse, but not to similarly hang onto the uninsured--who are more likely to properly transferred.)
Doctors in Boston experimenting with group visits - 9 or 10 patients with similar problems (elderly heart patients or young maternity cases for example) - by sharing consultation they get longer time with doctor (90 minutes instead of 10 or 15) and hear others questions so get more info. Dr benefits by not having to repeat same info. patients can wait to ask personal Q's in private but a surprising number happy to share problems of depression or family/work issues.
On average, American doctors interrupt their patients within 14 seconds.
Doctors conducted a routine ultrasound scan on a patient who complained of a lump in his testicle, and found a man’s face staring back at them. Writing in the medical journal Urology, doctors Gregory Roberts and Naji Touma reported: “We were amazed to see the outline of a man’s face staring up out of the image.”The authors, from Queen’s University, Ontario, added: “A brief debate ensued on whether the image could have been a sign from a deity. However, the consensus deemed it a mere coincidental occurrence.”
Professional patients now help train would-be doctors, especially in the most delicate and dreaded of exams (gynecological and prostate), where a becalming technique improves outcomes. One "teaching associate" of Eastern Virginia Medical School told the Washington Post in September that the helpers act as "enthusiastic surgical dummies" to 65 medical colleges, guiding rookie fingers through the trainer's own private parts. The prostate associate might helpfully caution, "No need for speed here," especially since he will be bending over for as many as nine probings a day.
A December Wall Street Journal investigation turned up instances of physical-therapy doctors earning millions of dollars a year in Medicare payments by "treating" nonexistent patients or by overtreating real patients or by providing controversial "treatments" that other therapists say is useless. Describing the work of hard-partying, spike-haired Miami Beach doctor Christopher Wayne, one former physical-therapy association official likened Wayne's expensive "treatment" to "back rubs." (Medicare law requires prompt payment to doctors but prevents the public release of doctors' billing records--even if all patient identification is hidden--thus ensuring that any Medicare abuses can only be uncovered by a small team of federal investigators and not by the press unless, as the Wall Street Journal did, they investigate patient by patient.)
The Swinfens run the Swinfen Charitable Trust, a telemedicine charity that uses e-mail to link sick people in poor, remote, or dangerous parts of the world with hundreds of medical specialists in some of the world's finest hospitals. Doctors in about 140 hospitals and clinics in 39 nations use the organization to seek help for patients requiring specialized care beyond their capabilities. Through the trust, they can be put in e-mail contact - often within hours - with one or more of the 400 specialists who work without pay as part of the trust's network. Doctors in distant areas - including Afghanistan, Antarctica, and the Solomon Islands - e-mail photos (many taken with digital cameras supplied by the Swinfens), X-rays, test results, and case notes. The information is reviewed by specialists, who respond by e-mail to help make diagnoses and recommend treatments.
(LST review of TV series...) "I have a lot of time for Dr Alice Roberts - not least because, in her previous series, Don't Die Young, she performed a self-coloposcopy, and showed us the interior of her vagina. Not even Madonna has done that"
"Doctor where shall I put my clothes?" "Right there on top of mine"
"Kiss me doctor." "No it would be unethical. I shouldn't even be fucking you."
"Doctor doctor give me some pills I've become a kleptomaniac." "Take these but if they don't work get me an iPod."
"You don't have a complex at all - you really are inferior
He's a great doctor - once when I couldn't afford an operation he touched up the xrays
He never operates unless he really ..... Needs the money
Most surgeons today specialize - mine seems to specialize in banking