...person or a same group, because these series of cases were stupendously similar to each other. All the decedents were surgeons from many hospitals in this town. And all the surgeons were killed through some sharp tools like scalpels, and their corpses were abandoned in the wild field by the murderer. These incidents caused a impact on all the surgeons in this town, and they felt frightened. They did not know if these nightmares would fall upon their heads. The only one point that confused Richard was that all the crime scenes were left in a undisturbed wild field. He wondered if the surgeons who had been killed had appeared obediently followed the murderer to the wild field without a struggle. The more surprising thing was that policemen could not find any trace of wrestling in the crime scenes. Why surgeons did not try any possible way to resist with the murderer? Were they are bewitched by the murderer? Multitudinous questions plagued Richard. When it came to the surgeons, Richard did not have good feeling for them. One year ago, on a cold night, Richard’s wife Vivien suddenly felt great pain that from her stomach. At that time, Richard was chasing several criminals in the wild field. She had to come alone to the hospital when she was suffering. Nobody knew where to find the surgeon who was supposed to be on the duty. The fact was that the surgeon was...
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...might be impinging on the cortex or it might be too large for the canal. Keep whacking, and you’ll fracture the cortex.” The trainer’s calm, authoritative voice boomed out across the room as a dozen orthopedic surgeons toiled away on the cadaver limbs laid out before them. Pausing to observe the technique of one of the surgeons, he glanced up to see his boss, CEO Peter Walsh, crack open the door and squeeze through, trying his best to be unobtrusive. The trainer glanced at the clock. “Okay, let’s save some of this fun for the afternoon,” he called out. “We’ll meet in the lobby in ten minutes and walk over to lunch.” In addition to making a range of products from artificial hips to scalpels, Crescordia was one of a handful of major companies that developed, manufactured, and sold the steel and titanium plates, nails, and screws—known as fixation devices—that surgeons used to repair broken bones. At least twice a month, Crescordia hosted training sessions like this one for orthopedic surgeons who used the company’s products. Walsh joined the group for lunch as often as possible. It was a great opportunity to connect with the physicians and hear firsthand what they liked and didn’t like about Crescordia’s products. Besides, he just plain enjoyed their company. Trauma surgeons tended to be brilliant but down to earth. With their hammers, saws, and drills, they were as much carpenters as they were doctors. Maybe because so many of the cases they saw were the result of bad luck, they...
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...Surgical technicians assist Surgeons and other medical professionals in hospital operating rooms and similar environments. Chiefly, they prepare patients, rooms and equipment for pending surgical procedures. They also assist during those procedures as part of a team of operating room professionals. Reasons Why becoming a Surgical Tech is worth it? Earning a decent paycheck is important, but you also want to make a difference when you clock into work each day. Lucky, a surgical tech career comes with a high level of satisfaction and higher meaning. Also because i don't think theres in no other way you have a better motivation than knowing you’re helping save lives, I think that becoming a surgical tech is a good career choice. When you leave work every day, you can image and have that satisfying feeling of knowing you have made a difference in someone's life. I look at the job and it’s...
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...surgical outcomes. This led to the adopting of National surgical Quality Improvement Program (NSQIP) by senior surgeon. The senior surgeons had realized they needed improvement after seeing complications caused by infections, blood clots, respiratory failure, etc. These complications increased length of hospital stays, death, and the costs were unbearable. The change was made fruitful by having surgeons aboard. The NSQIP program was created to provide reliable, valid, and comparative information about surgical outcomes across 123VAMCs performing major surgery. The data collected and reported include preoperative patient risk factors, key intraoperative process information, postoperative 30-day mortality and morbidity rates, and length of stay. The mortality and morbidity rates are risk adjusted and compared to observed-to-expected ratios. The VA maintains that the rationale for studying comparative outcomes of healthcare delivery is that the health status of patients after medical treatment mirrors the processes of care that they receive. The benchmark standards established when NVASRS visited 20MAC surgical service sites to understand the characteristics of the best performers compared to the lowest performers. They found that the surgical services with better-than- expected outcomes had higher levels of formal and informal communication among surgeons, nurses, and anesthesiologists in the administration of the surgical service as well as in the direct care of...
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...Executive Summary: Shouldice hospital is a specialized hospital for the treatment of external abdominal hernias in Canada. The hospital was established by Dr. Shouldice the founder of a new and superior surgical technique, now known as the Shouldice method, which yields better medical results as well as a significantly shorter recovery time. Shouldice is operating at its best level of 6850 operations in the year 1982. Over the years the capacity of the hospital is increased from 36 beds to 89 beds. Backlog of scheduled operations of 1200 is a cause of concern even always. Options of Saturday working, increasing an additional floor or new facilities at USA are worked out rigorously and recommended to work on Saturdays (only in peak periods). Total Number of words used : 120 Situation Analysis: Shouldice is a private hospital founded by Dr. Earle Shouldice in Toronto in July 1945. The hospital started out as a six-room nursing home in downtown Toronto. Shouldice offers a new technique to cure the hernia, which is the protrusion of an organ through a weakness in the abdominal wall; this technique was invented by the founder during the World War II. This technique allows the patient to go back to their routine very quickly. Just after four hours of operation patients are encouraged to start walking around the place and feel more comfortable. The typical recurrence rate for the hernia approaches 10%, the gross recurrence rate for all operations performed at Shouldice...
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...Sleep Deprivation The OR is a silent room. My surgical scrubs feel warm, like a pair of comfy pajamas. I sit, holding tools, while the surgeon meticulously dissects the patient's. It's a surgery I've assisted on dozens of times before. I blink and try to remember how long I have been in here. It seems like it has been forever since I have arrived at the hospital. In fact, it's been more than thirty hours since my shift started. During this past day and a half, I've logged more than fifteen hours in the OR and had no sleep in-between. My eyelids feel heavy, as if being pulled down by an invisible force. I begin shaking my knee up and down, an attempt to keep myself awake. My knee stops, and the Heaviness returns to my eyelids. Five minutes...
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...surgery. If you can find happiness in any other career, then do not choose surgery. A few statements I stand by (let’s get rid of some myths): 1. It is never too late to choose surgery as a career. Many do not choose until the end of their third year. 2. Though most students who know they are interested in surgery do it as their last rotation in Year III, whether you do surgery first or last has historically had no effect on your grade or outcome. 3. If you are savvy in your rank list, you will likely match in a program. Most don’t match because they did not rank enough programs (or the right programs). Be honest about your prospects and have a mentor. 4. The majority of general surgery programs are very good. You will graduate being a good surgeon and you will get a good fellowship or a job. Now, the facts (from NRMP book, found lying around in the KSOM Student Affairs Office): In 2004: - 1,042 of 1,044 general surgery spots were filled. The remaining 2 spots filled the day after the MATCH. - Of U.S. grads, 885 matched out of 1,230 applicants (72%), the rest were foreign grads. Note that the national average for all specialties is a 93% match rate. - The average student ranked 12.4 programs. This is too low. More statistics (from FREIDA, NRMP): - 253 = number of G-surgery programs - 5 years + = number of years in training. (May change soon to 4 years +) - 60% = percentage of graduates to move on to fellowships (an extra 1-3 years) What you need in your application: ERAS application...
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...Acute Surgery Centers Stephanie Tolbert HCS/43O April 9, 2012 Siobhan J. Hardy Acute Surgery Centers Acute surgery centers are where surgical procedures are performed on an outpatient basis. Surgery centers are faced with a variety of legal issues at the state levels; they are affected by legal issues on the national level affecting their everyday affairs. Physician’s ownership, safe harbor requirements, out-of-network fees are a few of the legal issue. According to “Robert Mosher, JD, partner at Nossaman, leading expert in health care law, say that the most common legal issue he deals with involves physician ownership and more particularly, the buying and selling of acute surgery centers units”. Physicians Ownership The number one problem is the buying out of retiring owners and bringing in new owners. Some acute surgery centers fight with interpreting their existing agreements concerning buying and with the legal obligation of selling for a fair market value. Finding enthusiastic buyers willing to pay fair market value for surgery centers financially burden can be a tentative course of action. Owners of surgery centers must have an open mind about new partners. They should not wait until there is a predicament or profitability problem. The owners should be constantly evaluating new partners that can progress the productivity of the center. When the centers try to buy or sell units, establishing the fair market value of a facility can be challenging...
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... 29 Table 1 Shouldice hospital is currently only focussed on hernia operations. Their USP is their focus on early ambulation. They also put more emphasis on post-operative care for 2-3 days offering accommodation. Other hospitals do not focus on early ambulation or accommodation after operation. This gives Shouldice a competitive advantage. The procedure is well defined and structured. As it is mentioned in the case, change in procedure usually requires the chief surgeon to be present to look after the proceedings. This fixed procedure ensured that the primary operations got over in 45 mins, and minimal chances of secondary operations on Shouldice operated cases. The secondary operations also take about 90 mins. The number of operations performed by a typical general surgeon is 25-30 per year whereas the surgeons at Shouldice perform 750 operations per year. They are well paid and looked after with a profit sharing plan, and this applies to even the administrative staff along with nurses and surgeons. Some features: Infrastructure - A 17,000 square foot main building on a 130 acre estate with 89 beds for patients with 7600 operations performed per year as of 2004 Theoretical Capacity of operations = [(30+30+29)/3] *5*52 = 7713.33 = 7713 operations per year Total backlog of 2400 patients, increasing by 100 patients every 6 months. Shouldice Hospital is quite successful currently. We can analyse success in terms of measures like Profitability and Capacity utilization...
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...reasons for wide acceptance of Spinal Fusion procedure was may be due to the fact that the procedure doesn’t involve removal of any body part unlike Spinal Discectomy or Laminectomy. While the Fusion procedure is an improvement and better alternative over the other two for back problems, it still is a medical procedure with significant risk. The patient may lose the ability to walk in some conditions and it’s a very expensive procedure. Rate of Spinal surgeries Increase in the rate of Spinal Fusion procedure may be attributed to the incentive for hospital profits. While many hospitals setup separate spinal care units to solve all back pain problems, it still is the surgeon’s decision whether the patient needs a surgery or not. If the surgeon owns a POD, the incentive for the doctor to approve the surgery is high. Hospital profits and revenue due to spinal procedures are a prime factors that drive the increase in rate of spinal surgeries. The invention of spinal fusion procedure set the rate of spinal surgery trend line to a burgeoning growth because it’s a “relatively safer” surgery. The term “relatively safer”, if advertised can mislead the patients suffering from back pain and mask the risks involved the procedure. For most aging humans, back problems are inevitable due to the present lifestyle. Although most problems can be cured by a mere lifestyle change, medication, and therapy, people often have a misconception that it’s easy to undergo a surgical procedure and get...
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...Cardiovascular Center and the entire hospital. He is really professional and technically skilled in his field, which is recognized by most of his coworkers. He is responsible and works hard in the team. He is willing to challenge himself and take toughest cases. He has seen more patients than any other surgeons. He has the lowest rate of complication and unplanned returns to operating room in his cases. He generated a great amount of revenue and reputation for the Mitchell Memorial Hospital. The whole cardiovascular team is improved in caseload and performance since he attended. But he could be a bad influence in this department. He made most people in his team uncomfortable and feel pressure to work with him. He could sometimes be very rude to his coworkers and lose temper. I don’t feel this is the characteristic what a good surgeon should have. Especially, in Mitchell Memorial Hospital, all employees are guided to be patient and friendly to patients and other employees. He disobeyed the Joint Commission Standard L.D.03.01.01, which emphasis on teamwork and respect for other people. He also likes to put everything under control, which always cause conflicts with other surgeons. It made some residents leave and lack of operating experience. There is also some boundary issues with nursing staff. I think, in the long run, he would do no good to the team. This is not himself to operate the surgery in the OR. I don’t think his contract should be renewed. 2. What are the unique...
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...be a successful trauma surgeon? In fact, what is trauma surgery? Trauma surgery is a surgery that treats the most severe life threatening injuries. Trauma surgeons need to know what to do with these positions and think quick about it . Most patients are in life threatening positions and need care immediately ("BestMedicalDegrees.com"). Most trauma surgeons that are not on call, work from fifty to sixty hours per week (Www.facs.org). Sometimes it is worth the hard work because the standard trauma surgeons are paid on an average of $301,774 each year (Study.com). To become a trauma surgeon one needs to know the qualifications, compensations, and responsibilities of that medical practice. Trauma surgery is one of...
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...05/01/2014 Dr. Joshua Landes is a board certified general surgeon, who received his premedical and medical education at Brown University. He completed his residency at Tulane University School of Medicine, and is a member of the American College of Surgeons. He now works as one of two general surgeons for the Hamilton Medical Group in Lafayette, Louisiana; which is where our first interview took place. I remember sitting in his office waiting for him to come in, and staring at a coat rack located in the corner. It held only two white lap coats, which looked as if they hadn’t been worn for some time; there were no rumples or creases out of place, and as crisp and wrinkle–free as they were, you could assume they came straight from the dry cleaners. It also held a green scrub cap that was obviously worn quite often, which actually looked slightly yellow due to it being washed so many times. Directly across from the coat rack stood a bookshelf filled with books that all contained the word “surgery” in its titles. The books were triple the size of a holy bible, and weighed so much that the shelves bent downward, like a meniscus in a graduated cylinder. When he walked in I noticed he wasn’t wearing a white lab coat, so I asked him about it. “I don’t need a lab coat to remind me that I’m a physician,” he said as he smiled and took a seat behind his desk. That’s when I realized my hypothesis of who I thought surgeons were would be challenged, and everything I expected them to be...
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... There are different fusion techniques, and results vary, depending on the patient’s individual pathology, the operation performed, and the skills of the surgeon. The option of an alternative that would replace the disc, and allow continued motion was greatly and widely anticipated within the United States. Some countries were allowing lumbar disc replacement, also termed arthroplasty, to be performed. The Charité disc was developed in Germany. It had been used in over 6,000 patients in Europe with satisfactory results. The disc was a three piece composite, with a metallic top and bottom, and a polyurethane central member that was intended to help simulate the normal motion of the spine when the patient would bend their back. Success rates in Europe were reported to be as high as 90% of patients with “Good” or “Excellent” outcomes. Clinical Studies would be required for approval by the U.S. Food and Drug Administration. Depuy Spine, a division of Johnson and Johnson, bought the Link Spine Group, LLC for 325 Million USD in order to acquire rights to the Charité. They sponsored a clinical trial, and were granted approval by the U.S. FDA in October of 2004 by a unanimous vote. It was estimated that the U.S. market alone for disc replacements could reach 1 Billion dollars by 2010. The device was to be rolled out with a surgeon training campaign, at a price of 11,500.00 per disc. The cost of devices used in spine surgery for a one-disc fusion, the alternative procedure, varies widely...
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...up his own hospital. His hospital, Shouldice Hospital, specialized in external hernia cases and proved to be a big success. Dr. Shouldice died in 1965, but his hospital continued to grow, and by the end of 1982, his hospital had 6,850 operations per year. Issue Statement The Shouldice Hospital is a successful and admired organization. However, due to its unique surgery method, and without the assistance of mass advertisement, they are operating close to 100% capacity. Thus, Shouldice fears not being able to meet future demand. Moreover, “competing” hospitals and surgeons utilize and perform the Shouldice method (and advertise as such), although they often perform the method incorrectly, ultimately giving the Shouldice Hospital a bad reputation. Shouldice’s critical concerns are meeting future demand, dealing with outside abuse of the method, which is being utilized by competing hospitals and surgeons, and potentially expanding their “business” while continuing to maintain the Shouldice Hospital quality. Analysis To increase their output and maintain their quality, Shouldice Hospital would likely need to increase their presence in the medical field. This would involve large capital...
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