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Becoming a Breast Surgeon

Surgeons are often Type A personalities, the ones who sit in the front of the class, who volunteer for everything, who stay scrubbed in the OR all day with appendicitis and do a post-op check before checking themselves into the emergency department (yes, that was me.) As such, surgeons are often dismissive of the subspecialty of breast surgery. The surgeries are not as complex as cardiac bypass surgery or Whipple procedures for pancreatic cancer. In fact, it’s often a rotation for interns. I was a Type A personality. I had no plans to do breast surgery.

Then, a funny thing happened. I had my first son during residency. Planned with military precision, of course, to coincide with the beginning of my designated research years, as I had hoped to squeeze another baby in there somewhere. After his birth, I would breastfeed, because that is what Type A mothers do these days. It’s the best! Of course, I would do the best! However, like many mothers out there, we had an incredibly rocky start. Poor latch with inadequate weight gain. Triple feeding with pumped milk. Cracked nipples leading to mastitis. As a Type A person, I threw myself into research in an effort to solve the problems. Not just the many, many baby books out there, but Medline searches on breastfeeding management. I learned more than I ever had in my surgery textbooks about the breast, the physiology of lactation that is both incredibly simple and enormously complex, and most importantly, miraculous. I was reminded constantly in my reading of the importance of preserving this ability to breastfeed my son, for his and my health, and how challenging that could be.

I would sit in my office, working on surgical infections research, as I pumped and read about normal breasts and infected breasts and cancerous breasts. Antibiotic rotations in ICUs and glucose control became less exciting than being able to offer targeted medical advice to a frustrated friend in Boston, whose refractory mastitis was being met with shrugs from some of her local doctors until we correctly identified MRSA as the source. Maybe it wasn’t saving lives, but it saved her breastfeeding relationship with her child. Who knows, maybe in the end it would be saving lives! I read more ....

Why standardization?

You may be hearing more talk about standardization in medicine these days. What does it mean and why is it important to everyone? People who are not in the medical field may worry that standardization will result in their care being less personalized and more “cookie-cutter.” Nothing could be further from the truth.

For several years, medical providers, healthcare administrators, healthcare quality experts and others have been talking about improving medical care and health outcomes through increased use of data and standardization. The term “evidence based medicine” is used to indicate that medical recommendations and decisions are based, to the extent possible, on data – rather than just doing things because they have always been done that way.

Data can be obtained through clinical trials (where patients are randomized to various treatments and then the outcomes are compared), observation (where the outcomes of various treatments are analyzed to see which are more effective), or expert opinion (where experts in the field agree on best treatments based on experience or “best practices”).

Standardization means that patients will be offered treatment based on the best available knowledge. Those treatment recommendations are also influenced by the patient’s individual situation, so that care is personalized.

For breast cancer patients, this may be evident in various ways. We know that ...

6 Simple Steps to Prevent Medication Errors

Our medical director for quality and patient safety, Mary Gregg, MD, MHA, blogged for the Washington State Medical Association about medication safety - what we as patients can do to help keep us safe:

Medications fight illnesses, prevent disease and help improve quality of life. But it’s important to take them safely and as directed.

Dr. Mary GreggAs a cardiac surgeon, I’ve seen the consequences of not taking medications properly. I once had a heart attack patient come to the hospital. After a successful surgery inserting a stent to prevent blockage in his artery, he was discharged with a prescription for a medication to prevent clots. For one reason or another, the patient didn’t fill his prescription as instructed for several days and he ended up in the ER for emergency heart surgery.

Some easy simple steps to prevent medication errors:

Bring out your meds!

We teach our kids to say no to drugs, but did you teach them about the dangers of prescription drug abuse?

According to the Centers for Disease Control and Prevention, more teens abuse prescription drugs more than any illicit drug other than marijuana - more than cocaine, heroine, and methamphetamine combined!

It’s not just your kids you need to worry about, from the baby crawling to the teenager who babysits for you, your own teenager and their friends, even the workmen in your house. If your medications are kept in the bathroom, it’s very easy for someone to access them behind the privacy of the closed door.

This weekend, take time to....

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