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Commentary: Should AVFs be ligated after kidney transplant?
Hemodynamic complications of arteriovenous (AV) access are uncommon but can be potentially life threatening. Fistulas and grafts can cause a decrease in systemic vascular resistance and secondary increase in cardiac output in patients who may already have myocardial dysfunction secondary…
Commentary: Physician burnout: It’s good to complain
Burnout among vascular surgeons and other physicians is a serious national epidemic that needs immediate attention by senior policy makers and health care leaders. Not only is maintaining an appropriate supply of fully qualified surgeons important to the medical demands…
What I learned from Navy SEALs about resilience
In 2017, the National Academy of Medicine recognized the urgent need to address burnout, wellness, and resilience in physicians. A consortium was subsequently put together comprising many cosponsoring organizations, including the Accreditation Council for Graduate Medical Education (ACGME), and the…
Terminating an employee
I’ve written more than once about the private practitioner’s least favorite task. Most physicians find it so objectionable that they will tolerate marginal employees rather than fire them. And that hurts the efficiency and morale of your good employees –…
Some patients leave a scar on you
Every surgeon has experienced the anguish of an adverse outcome. The elective aneurysm that dies on the table, the asymptomatic carotid patient that has a stroke in the recovery room, the cosmetic varicose vein case that has a pulmonary embolus.…
Reflections on women in surgery
As I reflect upon the past year, 2018 has certainly made a mark for addressing burnout among medical professionals, enforcing wellness, and targeting implicit and explicit gender bias in medicine and surgery. Dr. Laura Drudi Looking back, I entered surgery…
Physician value thyself!
The Merriam-Webster dictionary defines value as “the regard that something is held to deserve; the importance, worth, or usefulness of something” and “relative worth, utility, or importance.” We usually assess our professional worth by how we are treated at work.…
Should toe amputation be delayed in diabetic patients with osteomyelitis?
Amputation: Resistance is not futile! What’s in a toe you may ask? Why worry about saving it? Just amputate and move on … Dr. Issam Koleilat Not so! I implore you to resist the desire. We vascular surgeons are accustomed…
Point/Counterpoint: Should FEVAR be used for a short neck?
FEVAR is generally the best option The advent of endovascular aortic aneurysm repair (EVAR) has steadily become the standard of care in the management of infrarenal abdominal aortic aneurysms (AAAs). In fact, it has now surpassed open surgical repair and…
Shinal v. Toms: It’s Now Harder to Get Informed Consent
Question: Which of the following statements regarding Shinal v. Toms, a recent landmark decision on informed consent, is correct?: A. The case was heard in the Pennsylvania Supreme Court and its decision is binding only in that state. B. It…