Portable Surgical Mentor (eBook)

The Author 6
Acknowledgments 7
Foreword 8
Preface 13
Table of contents 
14 
1 The Transition - Part 1 18
1. Younow LIVE INA GLASS HOUSE 19
2. BE HUMBLE 19
3. BE RESPECTFUL and courteous to everyone that you encounter 
20 
4. Be aware that MORALITY and ETHICS have a strong interplay when it comes to the practice of medicine 
21 
2 Attire 
22 
3 The Little Black Book 
26 
PDA 27
Little Black Book 28
4 Communications 
30 
Overhead Page-Very Unreliable 31
Digital or Numeric Pager-Very Reliable 31
Cell Phone-Very Reliable 31
Home Telephone 32
E-Mail 33
5 Surgery Suite Etiquette 
35 
Scheduling 35
Start Time 36
Equipment and Supplies 36
Personnel 37
Working Relationships 37
Drawbacks 37
Preoperative Activities 38
Assume Responsibility 38
Notes and Orders 38
Reports 39
Wounds 39
Communicate 39
Consent 39
Document 39
Prepare 40
Operating Room Conduct 40
Prepare 41
Reports 41
Time 41
Be Helpful 42
Music in the Operating Room 42
Stay Put 42
Skin Prep 43
Assume Responsibility 43
Scrubbing 43
Assisting or Starting 44
Be Assertive 44
Idiosyncrasies 45
Finishing Up 45
Thank You 45
Postoperative Activities 46
6 The Clinics 
47 
Institutional Clinics 47
1. Entering the Examining Room: 48
2. Communicating with Patients: 49
3. Examining Referred Patients: 49
4. Observing the Patient: 50
5. Follow Up with the Patient: 50
6. Exiting the Examining Room: 50
7. Writing in the Patient's Chart: 50
8. Ending Each Clinic: 51
The Private Office 51
7 Rounds 
53 
Rounds by Yourself 55
Rounds with Residents and/or Students 55
Rounds with Attendings 56
Rounds with the Chief 57
Weekly Rounds 57
If You Are the Presenter of Weekly Rounds 58
If You Are a Helper at Weekly Rounds 59
If You Are a Listener at Weekly Rounds 59
Grand Rounds 59
Teaching and Teachers 60
Note 61
8 Difficult People 
62 
The Difficult Patient 62
Was It You? 63
Was It Them? 63
The Difficult Family Member 64
The Difficult Co-Resident 65
The Difficult Attending 66
The Difficult Consultant 67
Difficult Hospital Personnel 67
9 Documentation 
69 
Patient Charts 71
History and Physical Examination 71
Progress Notes 72
Consultations 72
1. YouRequest the Consultation. 72
2. You are the Consultant 73
Orders 74
Operation Reports 74
1. Preoperative Note. 74
2. Operative Report. 75
3. Postoperative Note. 77
Discharge Summary 77
Face Sheet 78
Informed Consent 78
DNR 79
Living Will 80
Prescriptions 81
Letters, Authorizations, Status Reports 81
10 Presentations 
83 
Preparation of Slides 83
Presentation 84
11 The Mortality and Morbidity Conference 
86 
Preparation 86
Presentation 87
12 The 80-Hour Week 
91 
13 The Boards 
94 
The Operative Record 94
The In-Service Exam 95
Tips for Remembering and Studying for Tests 96
14 The Interview 
98 
The Preparation 99
The Application 100
The Interview 100
The Match 102
15 Medical - Legal 
103 
Malpractice 103
Legal Documents 104
Responding to a Subpoena or Requests from Attorneys 
105 
Testifying 105
Conflict of Interest 108
Child Abuse 108
16 HIPAA 
110 
Suggestions for HIPAA Compliance 111
HIPAAat a Glance 112
What Is HIPAA? 112
Hippocratic Oath-Classic Version 115
17 Assorted Affairs 
117 
OnCall 117
On Call in the Hospital 117
Research 117
History 119
Left Handedness 120
Libraryand Filing System 120
Cameras 121
Computers 123
Ethics 124
Charity 125
Missions 126
Political Action Committees 126
Insurance 126
Medical Malpractice Insurance 127
Life Insurance 127
Disability Insurance 129
Health Care Insurance 129
Long-Term Care Insurance 130
Family and Friends 130
Your Health 131
Vacations 133
18 The Transition - Part 2 135
Introduction 135
The Start 136
Fellowship Training 137
Private Practice 138
1. Where do You and Your Spouse Want to Live? 138
2. Solo, Group, Mu1tispecia1ty or Clinic? 139
Academia? 140
Pros: 140
Cons: 141
The Search 141
The Decision 142
The Investigation 142
Due Diligence 144
Obligations 145
The Beginning 145
19 The Mentor's Wrap-Up 
147 
Appendix A 
152 
Commonly UsedWeb SItes 152
Medicine In General 152
Surgery 152
PDA 153
Finance 153
Appendix B 
154 
Books of Interest 154
Surgery 154
Atlases 154
Handbooks 155
Resources 155

"11 The Mortality and Morbidity Conference (p. 73-74)

Tell me and I forget. Show me and I remember Teach me and I learn. -BENJAMIN F RANKLIN The Mortality and Morbidity Conference (M & M) is certainly the most important hour of the week for residents and their teachers. Here is the last bastion of medical intellect, competition, showmanship, and debate. And, the most important component in the M & M is the absolutely perfect presentation, which requires extensive preparation.

Preparation

1. Collect all of the facts of the case. If certain historical information is not readily available , search it out. If necessary, call previous doctors, clinics, hospitals, and if appropriate, the patients family. The data, regardless of how trivial, must be sought.

2. Discuss the case to be presented with your attending. This is not only a matter of courtesy, it may also give you additional, detailed information, and it will also prevent you from getting blind-sided by questions from. that attending. If the attending for that case cannot be present for the conference, the case should not be presented.

3. Only residents who thoroughly know the case, the main issues, and the controversies surrounding the complication, should be presenting. Thus, the case should be presented by the most senior resident who will conduct himself as if he were the attending surgeon and the patient was from his private office.

Presentation

Each institutions M & M Conference has its little idiosyncrasies not limited to specific seating arrangements, attendance, and the precise way in which the case is presented. While some (very few) places do not take the conference very seriously, you have the opportunity to elevate it to a new level by preparing your presentation in the following format.

1. Prepare a brief, printed summary to serve as a.sort of "database." Do not waste time reviewing facts. Members of the audience will have more time to formulate their thoughts and questions. Include line drawings if applicable.

2. Have audiovisual aids available (overhead projector, slide projector, microscope projector, etc.). A picture is worth a thousand words, and it certainly makes your discussion more objective."