About Dr David Redd

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So far Dr David Redd has created 29 blog entries.

July 2018

The Freedom of Why

By |2018-07-07T18:40:20+00:00July 7th, 2018|

When people first come to QuikSurg, we typically ask them, "how did you hear about us"? The most common answer is "I Googled _______" (fill in the blank with mole or wart or cyst removal, for example) They found someone to take something off of them that they wanted off. When they get here, they learn that we are a different kind of clinic. They are given a 1/2 page form to fill out and then they are seen almost immediately. They pay a cash fee that is always less than they expect (usually way less!) and they are treated like family. It's a place that kind of surprises people because it's unique in many ways: who ever heard of a minor surgical clinic? how can they see me so quickly? why is the price so much lower than the hospital ER or a dermatologist's office? QuikSurg does have a story behind it and that story is what drives us to do the things we do... I am a surgeon who has spent the last 30 years caring for patients with surgical problems. The "machine" (America's medical system) has continued to change over those 30 years and I have tried to keep pace with [...]

The Urgent Care Center of Restaurants

By |2018-07-07T18:39:33+00:00July 7th, 2018|

I thoroughly enjoyed reading a blog on KevinMD.com by Dr. Linda Girgis entitled "These McDonald's practices should be avoided in health care". I agreed with her premise and her conclusions but I began to wonder if there are now ways that healthcare can learn from the way McDonald's does things and therefore we should advance them rather than avoid them. I am old enough to remember when McDonald's started as a fast food eatery in San Bernardino, California. The original brothers, Mac and Dick McDonald, had the idea of providing an efficient and clean "walk-up" restaurant that ran like an assembly line. Not everyone liked it. Some thought they were too hurried. They wanted to sit down, order, and eat their meal without the rush. But others found the pace to fit them and their situation. I see McDonald's as the "urgent care center" of restaurants. It's not an expensive restaurant, it's not a "hospital". It's a facility where you can go where a sore throat doesn't take 2 hours to figure out, where an earache in a toddler does not require an extended time to diagnose. I am not a frequenter of McDonald's but I occasionally stop in there especially when I'm [...]

A Meeting of Doctors

By |2018-07-07T18:38:24+00:00July 7th, 2018|

I just had one of the more delightful weekends that I have had in a long time. A few months ago, I was invited to speak at the Association of American Physicians and Surgeons Conference called "Thrive, Not Just Survive". The meeting was this past Friday in Atlanta. The AAPS is celebrating it's 75th anniversary this year, supporting doctors since 1943. It is dedicated to the highest ethical standards of the Oath of Hippocrates and to preserving the sanctity of the patient-physician relationship and the practice of private medicine. I had the opportunity to talk for 20 minutes about QuikSurg and to be an encouragement to those who were thinking about starting their own cash-based practice. Both my wife and I were impressed by the attendees at the conference... they were all about returning the joy of practicing medicine to the doctor and the patient! It was refreshing to hear of others who had decided to leave the middleman behind and offer transparency and respect for patient's time and money. Thank you, AAPS for all you do!

Local Anesthesia

By |2018-07-07T18:36:02+00:00July 7th, 2018|

I think it's important to talk about the anesthesia we use at QuikSurg because it's a big part of who we are. We use local anesthesia called lidocaine that is absolutely adequate for all the procedures we do. It is the safest form of anesthesia because it numbs the area... I tell my patients "After this medicine is in, you should have NO pain, not a little pain, but none." As a resident in general surgery, I was interested in ways to eliminate pain so I studied the local anesthetic medications and ways to make the experience better. Turns out, there are 3 things that make a big difference: 1) The speed of injection of the medicine- if you get in a hurry and inject too fast, the injection really hurts. This is probably the most common cause of pain while giving this medication. 2) The pH of the medicine- pH is a measure of acidity or basicity of any fluid. Body fluids having a nearly neutral pH. Most local anesthetics are on the acid side so we buffer the local with normal saline or bicarbonate to bring the pH more towards neutral. This significantly diminishes the pain of injection. 3) The size [...]

Lipomas

By |2018-07-07T18:33:54+00:00July 7th, 2018|

They are true tumors but they are not cancers. That's what I try to remember to tell every patient I see with a lipoma. Because they are lumps just under the skin they are often confused with skin cysts but the key difference is that cysts are fluid filled and lipomas are solid. The name "lipoma" tells you exactly what it is: "lipo"= fat and "oma"= tumor so a lipoma is a fatty tumor but (again) almost never a cancerous tumor. Lipomas will grow but they won't spread to distant parts of the body. They can be multiple or solitary but they eventually become bothersome like the one I saw not long ago on the back of a 32-year-old man. "This thing is bugging me and I want it off. What is it, anyway?" I explained that it was likely a lipoma and therefore not dangerous but it probably will continue to enlarge. I have seen some pretty big lipomas poking out of a t-shirt! I have removed lipomas the size of a pencil eraser and some the size of California grapefruit. They are usually fairly straightforward in their removal but they can have "fingers" of branching off fatty tumors that can [...]

Don’t Go To The ER Unless You Have To!

By |2018-07-07T18:28:46+00:00July 7th, 2018|

Kristin Prentiss Ott has written a very informative blog called "10 Things You Might Not Know About The Emergency Department" and the very first one is: "Wait times in most emergency departments are ridiculous. But, if you have a real emergency, you won't have to wait." I couldn't agree more. I think the ED is clearly one of the most valuable places in any hospital IF you have an emergency. Many ED docs will tell you that many people abuse the ED. Case in point: The man who has chronic back pain for 2 months and then suddenly decides he has an "emergency" and heads to the ED to be seen by a doctor. That man will likely have to wait a long time to be seen especially if there are real emergencies going on around him. Which is why Urgent Care Centers were invented. They don't see people with heart attacks, gunshot wounds or stroke victims (which are true emergencies!), they see people who have had the "stomach flu" and need some nausea meds and a liter of IV fluid or people who have an angry "boil" on their back and need it drained or that back pain guy who [...]

Moles

By |2018-07-07T18:22:40+00:00July 7th, 2018|

When a patient calls in and says, "I have 5 or so moles, I want you to look them over" I am happy to do it but chances are good that one out of the 5 is actually a mole and the others are (probably) benign skin lesions that most people just call "moles". A mole (the medical term is nevus) is a collection of pigmented cells called melanocytes. They can be in odd places on the body, they can be acceptable to the patient in a cosmetic kind of way or they can be not at all acceptable. They can be "suspicious" in that they can force you to wonder about a skin cancer. So when people come in and say, "can you take his off?", I do it if at all possible. Sometimes I recommend it be sent to a pathologist for identification but sometimes I can tell just by looking that it's not a dangerous "mole". You should know that most moles are not cancers. In general, cancer is ugly... not symmetrical, not having regular borders but irregular(jagged), not one color but sometimes more than one, and cancer tends to change and not stay the same. Benign things are [...]

Foreign Bodies

By |2018-07-07T18:15:22+00:00July 7th, 2018|

"I know there's a wire right here in my arm. I saw it go in but I couldn't stop it and I couldn't get a hold of it, but I know it's in there" And he was right. There was an inch long small gauge wire in his left forearm. Although it was difficult to feel, I could feel something that felt like a wire so I knew I could probably get it. I injected a small amount of local anesthesia and made a small incision right over that area. Sure enough, there it was. It was removed and given to the patient in a small container. "Foreign bodies can be anything that doesn't belong... from splinters to fishhooks to bullets to glass pieces to well... wires. The general rule for the surgeon is, if you can feel it, you can go after it. If a patient says "there's something there" but you can't feel it, it's a hunting expedition and they are seldom rewarding. If the FB is in a finger, a splinter, for example, a finger block is done (with plain lidocaine) so that the entire finger is made numb. That allows the surgeon to dissect out the splinter without having [...]

It’s The System

By |2018-07-07T18:14:35+00:00July 7th, 2018|

"I just got sick and tired of being an "assembly line" doctor"! I knew immediately what she meant by that statement, she was on the medical treadmill and going nowhere. Her previous places of employment as a doctor were like production lines, impersonal and cold and neither the patients nor the doctors were happy. But the concept of an assembly line can actually be a good thing in health care, it's not the assembly line that's the problem as much as the people responsible for running it. An assembly line is just a system, a system that allows for maximum efficiency. Take the world's most famous assembly line, the one designed by Henry Ford. In the autumn of 1908, Henry Ford's first Model T rolled out. It cost $825. While much less expensive than the other cars of that time, for Ford it was still too expensive. Ford was convinced that ordinary hard-working people needed cars and his cars were still not affordable for the masses. In 1913, he visited a meat packing plant in Chicago and saw how the large slabs of meat were on an overhead trolley system and butchers would slice off their piece of meat as it [...]

Skin Tags

By |2018-07-07T18:13:36+00:00July 7th, 2018|

They are a bother. They are not dangerous, just a bother and nobody likes the way they look. Skin tags have another name (Acrochordon) but whatever you call them, they are unwelcome. So the patient was thrilled when he found a place that could and would get rid of them. "I was so glad to finally find a place that will take these things off!" I have had patients with just a few and I have had patients with literally hundreds and they all get treated essentially the same way, by simple excision with scissors (after a small amount of local anesthesia) and then cauterizing the base of the skin tag. They are as they are described, small "tags" of skin made up of collagen, tiny blood vessels and nerves (which explains why they need anesthesia and they need cauterization) and a thin layer of skin. They form in places where skin can rub on skin: armpits, groin, neck, eyelids. They are typically small and numerous in these areas. I can't say that I enjoy removing skin tags, it is incredibly tedious. But the appreciation from the patient is off the charts. I have just one recommendation for everyone with [...]