Monthly Archives: March 2010

Why you should check out your doctors

It’s easy to sensationalize something as strange as butt implants. Today’s Star-Ledger has a story about six women who are now hospitalized after getting injections to increase the size of their rear ends.  These women unfortunately went to an allegedly unlicensed practitioner. Instead of receiving medical-grade silicone, they got a diluted version that you’d use to caulk a bathtub. There’s an image I’d like to forget.

When I worked as a medical malpractice claims investigator, one of my (frequent) clients was a cosmetic surgeon (his specialty was otolaryngology). Not a plastic surgeon – there’s a difference (you’ll get an earful if you ever mix them up in front of a plastic surgeon). My client got in trouble after a calf implant procedure didn’t take. He also had claims filed against him from a man who received pec implants, and a woman receiving a chin implant. Had he done many of these procedures before? No. Was it beyond the scope of what an otolaryngologist should be doing? Well, that was up for debate. The doctor wasn’t criticized for going beyond his scope of expertise with the chin implant, but the pec and the calf implants were harder to defend. He received medical training in those areas, but the expert plastic surgeons we (and the plaintiffs) hired, had a field day.

What was the lesson learned? As a patient, make sure your physician has performed MANY of these procedures before, so you’re not in the guinea pig group. And make sure you’re going to the right specialist for the procedure. The other lessons learned? Check out your doctor before you agree to a procedure. A few places to look:

-State Licensing Boards. The American Medical Association has a list of state medical boards on its website. You can look up whether the doctor is licensed, and often whether there’s been any actions against that physician. I looked up the otolaryngologist, and found that he completed his probation, there was a malpractice award against him, and he had a citation resolved. Is this helpful to a potential patient? You bet.

Health Grades – you can look up 750,000 doctors across the country. While the patient reports can be helpful, take them with a large grain of salt. I again looked up the otolaryngologist, and there were 8 positive patient ratings. Based on the ratings, I would go to this physician. But the background check (which I didn’t run) should show his disciplinary actions, confirm whether he’s board-certified, and more. There’s a fee for the background check ($12.95), plus you may get charged more for their ‘watchdog service’ if you don’t cancel in 14 days.

-Ask for references. Of course the ones the physician gives you will probably be glowing. Ask around. Speak to others who have had the same procedure, so you’ll know what to expect in terms of healing and complications. Ask whether the doctor was easily accessible after the procedure, if you had questions or concerns.

-Make sure you know the risks involved with the procedure. Ask about the worst possible things that could happen. The doctor will give you an informed consent form to sign – it’s often generic, and will list complications like death and unforseen consequences. Ask the doctor for specifics. Granted, bad results can always happen, even to the best of physicians. But if you’re aware of the potential complications, and you’re still game for the elective procedure, then it’s buyer beware.

Developments in Medicine – Dr. William Halsted

Years ago, I worked for the publisher who produced The Face of Mercy: A Photographic History of Medicine at War. It was fascinating to read about the medical advances made during wartime.

These days, we tend to take for granted the use of sterilized equipment, anesthesia and life-saving surgical techniques. Sure, the problem of hospital-aquired infections is still a big one. The epidural during labor isn’t always 100% effective. And the surgery that’s supposed to irradicate a disease sometimes misses some of the diseased cells. We do have have advantages, though, that weren’t available 140 years ago, when physician William Stewart Halsted was practicing.

Last month, the NPR program Fresh Air featured a fascinating interview with author Gerald Imber. He wrote the book Genius on the Edge: the Bizarre Double Life of Dr. William Stewart Halsted.  Halsted was quite the medical pioneer, starting the first residency program and developing the radical mastectomy (lowering the cancer recurrence rate from 100% to 50%). Halsted was the first medical practitioner to implement rubber glove use – after a nurse developed dermatitis issues from Halsted’s mandate that staff clean their hands with mercuric bichloride. He was the first documented physician to do a blood transfusion, using several syringes of his own blood, to revive his sister who hemorrhaged after childbirth.

Halsted performed the first gall bladder surgery – on his mother, no less. He saved her life – especially since he steralized his tools with carbonic acid, lowering the risk of infection from the operation. He realized the value in steralization and tried to convince New York City’s Bellevue Hospital, where he practiced, to build him a sterile operating room. They laughed at him, so he raised the money himself, building a antiseptic operating tent outside on hospital grounds.

Of course not all his discoveries were healthful ones. Cocaine was known to be a numbing agent, and he experimented with it, trying it first on himself and then on his students and patients. Halsted became addicted, as did his students. However, he realized that anesthesia could be used to numb a larger area of the body, resulting in general anesthesia. His research into anesthesia won him awards from the American Dental Association.

I’d recommend listening to Terry Gross’ interview with author Imber. You can listen on your computer or download it to your MP3 player. Then get the book. It’s now on my reading list.