August 2019

3 Minutes…

By |2023-11-21T06:49:17-04:00August 7th, 2019|

So, yesterday I was talking to guy who just opened a new plumbing business. His "hook" is that when you call for plumbing services, he can guarantee that he will have a plumber at your house within 90 minutes of that phone call. Wow! That is great, huh? But he did go on to say, there was a price for that time guarantee. He didn't tell me exactly how much that price was but there was a price to be paid for that perk. We at QuikSurg have a time guarantee, too. We "hate the wait" so we are committed to seeing patients within 3 minutes of their arrival. How do we do that? By scheduling patients with enough time between them and by planning (done even before we opened our doors) to have a surgical suite that is designed for fast set up and fast clean up. But more than that, we committed to being known as the clinic that always put the patient first. We figured that scheduling, organizing, planning, executing were all under that simple mission (which does NOT include having patients wait when they are scheduled for a certain time). BTW, there is no charge for [...]

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What To Do With a Lipoma?

By |2023-11-21T06:49:57-04:00August 7th, 2019|

In my last blog, I talked about lipomas and what they are. These "fatty tumors" are usually solitary and usually not dangerous (not cancer). So what should be done about them? If you have what you think is a lipoma, it would be a good idea to see a doctor to confirm your suspicions. As I said last time, sometimes it's difficult to know whether you have a skin cyst ( a walled-in keratin sac made popular by Dr. Pimple Popper) or a lipoma, but neither are particularly emergent unless the cyst has become an abscess. Lipomas are not going to abscess but they do grow over time. I have seen some whoppers in my 30+ years of being a surgeon, many of them you could easily "see" right through their shirt. It's size that usually brings people to my door:  When they get big (we're talking 4-5 inches in diameter or larger) most surgeons want to remove them in the Operating Room where general anesthesia can make the whole process easier and faster... but certainly NOT cheaper! If you go to the OR, the cost to the patient skyrockets! If you have the time and the place to [...]

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By |2023-11-21T06:50:42-04:00August 7th, 2019|

Whenever I'm given the chance to tell people what I do, I invariably get to the part where I list the procedures done at QuikSurg. Most, of course, are easily understood... I remove skin tags, warts, toenails. I repair cuts and ear lobes. I excise skin cancers, moles, epidermal cysts, and lipomas. Most everyone understands everything on that list until I come to the end... "what is a lipoma?" The simplest definition is a "fatty tumor" (lipid=fat, oma=tumor) but it's important to quickly add, "It's a tumor but it's not a cancer. Cancer grows and spreads to other parts of the body, a lipoma grows but rarely ever spreads". So they are fat lumps under the skin but separate from the surrounding fat and typically not dangerous. It's been my experience that the 2 most common lumps under the skin are cysts and lipomas. Most of the time, they "feel" differently to the clinician but there are times when you don't know which is which until you open the skin. Do they need to be removed? It's up to you. That question is answered in the next blog.

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Does Time Really Matter?

By |2023-11-21T06:51:21-04:00August 7th, 2019|

When I have a few additional minutes to kill, I turn on the TV and click through the channels. I will always find something that interests me, a favorite movie, a MASH rerun, or the news of the day. Yesterday I found the last 25 minutes of the movie, "Sully". I think we all know about the "Miracle on the Hudson" but it truly astonished me when I learned at the end of the movie that the time from the landing in the river to the dramatic rescue from the plane's wings took 24 minutes. That is truly incredible! Think about it. Had it been an exercise, a practice rescue on the Hudson, it would never have gone that well. It took cool under pressure from Captain Sullenberger but equal coolness from another Captain who was on the Hudson. Captain Vince Lombardi (no kidding), who was the man in charge of the Thomas Jefferson ferry, saw the plane and immediately headed their way. Upon arriving at the plane, his crew just did what they were trained to do. Said Captain Lombardi, 'they knew what needed to be done." (and they DID it!) As a result, others joined in the rescue [...]

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What Would You Do To Change Healthcare?

By |2023-11-21T06:51:57-04:00August 7th, 2019|

Just the other day, I was asked an interesting question by a patient while I sewed up her arm. "What would you do about the healthcare mess in this country?" Not exactly a question that lends itself to a short answer but here is the essence of what I told her... "I would do exactly what I am doing now! When I "retired" from my hospital surgical practice, I had a choice to make. Either leave the medical field altogether or do something that could possibly be a way to contribute to the solutions rather than the problems of healthcare. To my way of thinking, healthcare has 2 major problems: 1) the patient is no longer the focus of our attention and 2) there are people making decisions about your healthcare who have no business making those decisions, their concern is NOT for the patient. So my challenge was to design a system/clinic that would serve as a model to right those two wrongs. I opened this clinic with the purpose of caring for patients by respecting their time (seeing them within 3 minutes of their arrival if at all possible), respecting their money (we have cash prices that [...]

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What You Need to Know About Your Surgical Procedure Part 1

By |2023-11-21T06:52:49-04:00August 7th, 2019|

If you are considering having a surgical procedure in a doctor's office or minor surgery center or are scheduled to have a procedure in the near future, there are a few things to consider before a scalpel ever touches your skin. It makes sense when you consider that NO ONE would consent to any surgical procedure if the surgeon said, "I am going to put in some pain medicine before we get started but it will relieve half the pain." No, local anesthesia must make the area you are operating on COMPLETELY numb so zero pain is felt during the procedure. That's surgical common sense rule #1. But I have had patients tell me that the injection of the lidocaine (the most common local anesthesia) was the worse thing about the whole minor surgical procedure. So here's rule #2: The person who administers the local anesthesia must be experienced with lidocaine infiltration and must have felt the sting of inappropriate administration of lidocaine themselves. Local anesthesia infiltration requires knowledge of a few simple rules about needles, speed of injection, and neutralizing the lidocaine but empathy may be the most important rule to practice. And finally, common sense surgery rule #3: [...]

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Healthcare is Still Tedious and Boring in it’s Ability to Change

By |2023-11-21T06:54:03-04:00August 7th, 2019|

I was thinking the other day that I have worked as a surgeon for over 30 years, I have work in the healthcare industry for over 35 years and I am amazed at the stubbornness of the status quo in the medical world. Have we made much progress with technology? Absolutely. But has that changed much in the world of patient-centeredness? Judging from the comments I hear in my clinic, I would say "definitely not!" What other industries can "claim" that? Who would want to? We have managed to digitalize medical records (although still perfecting that one!) and Xrays. We have one-day labs and robotic operations but we still can't set up appointments and see people in a timely manner. We still can't solve the issue of over-the-top ER bills and charges. We still overemphasize hospital care and underemphasize outpatient care. We gripe and moan about things that should have been solved long ago because they involve the patient's time and money. What does it take to solve these problems? I think it takes clinicians (doctors, PA's, NP's) who start with questions like these: How can we get patients in on time and out on time and still give [...]

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May 2019

Everybody’s Got a Different Stories, But…

By |2023-11-21T06:54:39-04:00May 22nd, 2019|

One thing I can safely say when I talk to my patients about their past experiences with healthcare providers, there's always a story. Typically it's not a happy story of time well spent but usually more like these: * "After I checked in at the ER, I spent 4 hours waiting for them to call me back" * "I had 4 cysts on my head and they made me come back for each one of them" * "My appointment was at 1 pm, the doctor saw me at 3:30 and no explanation was given" * "They sewed up my hand at the hospital, the bill was over $2,500" Virtually every patient has a personal story or a relative's story but most of them are problems, frustrations, issues and not good experiences. How has healthcare gotten away with this stuff? But it's been going on a long time. I can still remember sitting at the dinner table (I was probably about 9 or 10) and hearing my dad telling my mom about his "2-hour wait in the clinic". That was almost 60 years ago! For a while, the problem was partially solved with things like Retail Clinics and Urgent Care [...]

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ER or QuikSurg?

By |2023-11-21T06:55:13-04:00May 22nd, 2019|

Suppose you are using the hedge clippers and you cut your arm.  It's a very good bet that you will need stitches so you contemplate your next move. You could find the nearest hospital ER or you could call QuikSurg. It's also a good bet that your experiences will be as follows: *The ER: You will not be stitched up by a surgeon or a doctor of any kind.                You will not be the first person called to be treated from the waiting room.                You will be uncomfortable in that waiting room chair.                You will have to find a place to remove the stitches.                You will *QuikSurg: You will be assessed and treated, start to finish, by a surgeon with 30+ years of experience.                    You will finish the paperwork in 5 minutes and it is unlikely you will ever even sit in the waiting room.                    You will come back for the surgeon to [...]

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The Emergency Department: A Great Place for Real Emergencies

By |2023-11-21T06:55:57-04:00May 22nd, 2019|

I think just about 100% of patients who come to QuikCare/QuikSurg have an "ER story". As in, "I cut myself and figured I needed stitches" or "I was miserable after a day of nausea, vomiting, and diarrhea. I couldn't get anything to stay down". In both those situations, you are typically heading for the ER for help but the story that's often told after the visit is one of frustration at the time spent waiting or the bill received for the services received. It's a tale that's told while receiving care (sewing up the cut or receiving a bag of IV fluid with some nausea medication) at our clinic, a clinic that's designed to take care of those very situations without the wasted time or big bills. Just last week we saw a man who cut his finger on a handsaw and was in and out of here in 25 minutes with his bill paid before he left ($250) and the next day we treated a dehydrated man who had spent the day previously "going at both ends" with 1,000 cc of fluid, some vitamins, and a med to relieve the nausea. He was a "new man" heading out [...]

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