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Medical Mythbuster: Mold in Saline Breast Implants

I read online a woman telling about how her saline breast implants got mold and she had terrible problems. Does this happen very often?

A few years ago I put up a YouTube video of my experience with silicone gel breast implants. Now every six months to a year somebody posts a comment about how saline implants are just as dangerous. A frequent portion of that response is a statement about a moldy saline implant. My response is and always has been, if saline implants are so often affected by mold, then why have I never seen it?

I have been implanting (and at times removing) breast implants for over 15 years. You would think if something was a dangerous and common phenomenon that I would be seeing it. I haven’t. Not even once.

A saline implant when left on a table outside of your body can develop mold, but this doesn’t seem to happen inside patients. The difference is probably that when implants are properly placed inside a woman’s breasts, her immune system helps protect them from such problems. Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

The Myth Of The Rich Doctor

This is my column in June’s EM News.

‘But you’re a rich doctor, right?’ Have you had that conversation? There’s a certain expectation of physicians, that we’re all just filthy rich, overflowing with boxes of cash tucked neatly away beneath our gilded beds.

When we were building our house, our builder talked with my wife: ‘Jan, I want you to meet me to look for counters and cabinets. Don’t bathe the kids. Put them in dirty play clothes and don’t wear anything nice. Don’t ever tell them your husband is a doctor.’ He’s a wise man. What he knew was that the word ‘doctor’ means ‘cash.’ Or at least, means ‘cash’ to the popular mind.

I wonder if this perception is the reason patients come to the emergency department and say things like this: ‘I don’t have any money to go to the dentist, so I came here.’ It’s the belief that we come to our jobs already in possession of large amounts of money. Granted, there are some physicians who come from wealthy families. The majority, however, do not. And no one does that to any other professional. ‘I’d like a house built to order, and I know you’re a rich contractor. I can’t pay you, so get to work! Or else I’ll sue!’

Nevertheless, from patients to insurers, real-estate agents to contractors, attorneys to government and hospital officials, the belief is straightforward. MD means ‘Mucho Denaro.’ Witness the hospital in Pennsylvania that recently began Read more »

*This blog post was originally published at edwinleap.com*

Myth Buster: Seafood Allergies Do Not Increase Risk Of Allergies To CT Contrast Dyes

It is a prevalent belief out in the medical (and lay public) community that patients with iodine or seafood allergy can not receive contrast when undergoing certain radiological tests like CT or MRI scans. The concern is that contrast contains minute amounts of free iodide and as such, IV administration of this material puts the patient at risk of a life-threatening anaphylactic reaction.

Contrast is often given in these tests as it traces out bloodflow enabling the physician to see organ and mass architecture much more clearly allowing for improved accuracy in seeing anything abnormal.

Well… rest assured that patients with iodine and seafood allergy CAN receive contrast without any significant increased risk of an allergic reaction as compared to other allergies.

In a large study encompassing 112,003 patients, Read more »

*This blog post was originally published at Fauquier ENT Blog*

Health Insurance Coverage And Leaving The Hospital Against Medical Advice

There is a huge myth being unknowingly  perpetrated against the general public when it comes to their rights and responsibilities as a patient.  It’s a myth that I can remember hearing as far back as my first few weeks of clinicals during medical school.  It was a constant presence during my residency training and even now, as a private practice hospitalist I hear misinformation being handed down day after day, month after month.

This myth is perpetrated by doctors, nurses, and therapists of all kinds.  What is this myth?  That their health insurance company will not pay for the care provided if they want to leave against the medical advice of their physician.

Will my insurance company pay if I leave against medical advice (AMA)? Yes.  They will pay.  Medicare and Medicaid pay for services that are medically necessary.  For example, if you go to the ER and the doctor recommends a CT scan of your chest and you decline, this does not mean the insurance company will deny payment for your visit to the emergency room.  This is what  the informed consent process is for.  If you have been admitted for a medical condition that requires hospitalization and your care plan meets Medicare medical necessity muster, your care will be paid for whether you leave the hospital when your physician believes it is safe or not.   Read more »

*This blog post was originally published at The Happy Hospitalist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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