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 [...]

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 [...]

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: [...]

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 [...]

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 [...]