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The loss of one Dr. Miller can not be replaced by 10 younger. poorly trained "surgeons." (i.e. "robotic surgeons). For 2 years I scrubbed and 1st Assisted in the Operating Room. them for 32 Years I administered Anesthesia in hospitals of all size. I first met Dr. Marik at Norfolk General Hospital when he was in Medical School. I had the privilege of working with surgeons who's skill in the operating room was akin to watching a skilled dancer preform a waltz, every movement was like perfection and the patient's tissue was handled, softly, almost lovingly and those patients did extremely well and had minimal if any complications. I also worked with some surgeons who made it a practice to see how "fast' they could do surgery. There was a definite lack of finesse and skill in their technique that showed up in a greater number of post operative complications in their patients.

At the age of 48 I graduated from Law School and spent several years helping defend Physicians in Mal-Practice Cases.

I have noticed that people I know who now have surgeries, seem to have more and more serious complications post surgery than I ever saw in well over 35 years of full time operating room experience.

In the German Language they do not refer to a Physician with the term "Herr Doktor" but with the special term "Der Artz". I believe there is a reason for that definite terminology. The practice of Medicine is not "science" it is a very special kind of "art". A competent surgeon is a special kind of "artist." The competent surgeon had the skill and dedication to know by "feel" what is happening in a patient and to be able to "feel" when he/she has given each patient the best chance of recovery and life.

To depend on a "robotic system" instead of on "skill and touch" is to denigrate the very "so called" Surgeon who is as deficient in his/her surgical ability and is a danger to the very patients who have (mis)placed their trust in that less skilled Surgeon, who's only fall back position is to use a robotic system.

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I totally agree with everything in this article and everything in your comment. I’m an old retired surgical nurse and the young robotic surgeons of today can’t hold a candle to the older surgeons. I had to retire because I couldn’t stand seeing the botched surgeries. So sad… I’ve told everyone I love to avoid surgery if at all possible and if not, be sure to find an old experienced surgeon.

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Very sound advice! It has been my experience that if you're looking for a physician, a good plan is to ask The Nurses. Beware of the young doctor and the old barber.

Benjamin Franklin

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Exactly , as an older retired nurse of 20 years , as a group, we frequently talked about who we would go to see as a doctor- there weren't many overall . Now as a practicing artist and what I've seen over these past few years of so called medicine , those who I'd see are even less in number .

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EXACTLY! The Nurses see on a day to day basis, what level of care the individual physicians provide. Your observations, correlate with mine, there has been an overall decline in the quality of physicians. And don't get me started on the computerization of medicine.

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I left in the 80's when the hospital became more like a business model and was having to spend more time on a computer than with a patient and learning stupid top down theories . Loved it before all that and when I found art as a passion , it was still about the empathy of what I liked to do in my life - was lucky enough to find things that gave me passions .

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Ben Franklin was wise beyond his time!

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Well said!

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Pinned your comment!

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Mar 13Liked by A Midwestern Doctor

Those who have the responsibility to monitor medical ethics of medical personnel as well as hospitals rules, should not be on the payroll. They should be independent and charged with protecting the rights of the patient. The fact that Fauci's wife was in charge of medical ethics of the CDC agency speaks volumes of what is wrong in DC.

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We see this across corporate and government institutions, compounded by the 'revolving door'.

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Mar 13Liked by A Midwestern Doctor

Sad but true!

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I meant to say "regulatory" revolving door!

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Mar 13Liked by A Midwestern Doctor

I closed my practice as a general and trauma surgeon in February 2020, two weeks before the politicians shut the world down. I agree with everything Dr. Miller wrote. Many hospitals will buy the > $1 million robot and incur the > $100,000 dollar/year maintenance plan simply because the hospital across town has one. I call it the Medical Arms Race.

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I added your comment to the article.

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Yep! Remember Oxygen Chambers?

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Yes, if you are referring to hyperbaric oxygen therapy. I actually worked at a wound care clinic years ago. There was some real science there showing real benefit to certain types of patients. I got fired when I limited my HBO therapy accordingly.

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Sounds like prudent medical treatment was supersede by the need to create a return on investment?

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Mar 16·edited Mar 16

You can get hyperbaric over the counter now. My local magnesium float / infrared sauna place has one, they swear by it (used it to heal after severe trauma - a fall from great height). And cancer.

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Is there a story here? I'm a layperson, so I have no idea what you're talking about.

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Mar 13Liked by A Midwestern Doctor

What would have happened if all the physicians fought as hard as Drs. Marik and Kory? The medical community would have protected us from the skullduggery of the CDC, FDA, NIH, ACIP, and DHS and whatever GOV agencies are trying to kill us. You left us unprotected and I have no respect for most physicians now. My physician grimaced when I mentioned IVM and wanted me to have the modRNA vaccines, which I rejected. He is worthless to me now as many in medicine are.

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That ties into why my profession shot themselves in the foot by giving their power away.

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Mar 14Liked by A Midwestern Doctor

Sadly, this “decoupling” is not limited to medicine. My late husband was a commercial pilot for a major airline and also instructed for them on the Airbus. He was deeply dismayed at the young guns who had no love for the machine. In his words, they didn’t have ‘good hands’, depending instead on new, computerized, fly-by-wire systems.

I pray daily I never need to visit a hospital. My primary care doctor has not once, in eight years, touched me, except to place her stethoscope on my heart. Beautiful essay and thoughts from Dr. Miller. Thank you both.

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I feel a lot of this is the result of our education system (e.g., college and highschool) being completely dysfunctional and not encouraging or teaching critical thinking.

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I’ve had SO MUCH material to talk with my homeschooled teenagers about this past 3-4 years… so many conspiracy facts to discuss… 👍🏽👍🏽👍🏽🤔😌

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Our kiddo is so tired of hearing us talk about health and politics. They are a bit younger than yours, and we have a lot of our own stresses within the household aside from the external crap show. Some of our own internal stresses are a direct result of the medical mispractice and misinformation that we’ve been fed for the last 60 years regarding diet and how to manage health. Resulting in a chronic, limiting health condition for my spouse. It’s been very maddening.

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I’m sorry Copernicus about your spouse’s health condition. About the kiddos… Sometimes we make a lot of sarcastic jokes about it all… They can be very creative. Sometimes you have to laugh to keep from crying. 🙏🏽🙏🏽🙏🏽

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Jokes indeed.

Kiddo had to do a descriptive writing assignment at beginning of the year, finding adjectives to describe the expression on the faces of several magazine photos. One was of the current White House resident. Kiddo wrote appropriate adjectives reflecting confusion. Lol.

We too homeschool so didn’t have to be concerned with any adverse responses to their answers. 😂

Just finished a biography of Sitting Bull. SOOOO many parallels between gov treatment of the Indians and treatment of people who now hold inconvenient views, most obvious being the unjabbed. But more broadly applicable as well. Stunning to read.

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It’s a wonderful time to homeschool… 👍🏽👍🏽👍🏽🙏🏽🙏🏽🙏🏽 Our big discussion today was the attempt to ban TikTok, and how it’s such a “Trojan horse” kind of legislation… They don’t really care about TikTok… They want to be able to ban anything that they disagree with on the Internet, whether it be a website, an app, or anything else that disagrees with their narrative. They want total control of the web! Quite a slippery slope this is going to be if they can get this passed! 😵🤦🏽‍♀️🤦🏽‍♀️🤦🏽‍♀️

They are going to have to hurry with web 3.0. 😱😱😱 Hopefully using Blockchain technology will prevent censorship in the future. 🙏🏽🙏🏽🙏🏽

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Oh, and I love the idea of writing appropriate adjectives on some of these government bozos… lol 😆🤣🤣🤣

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Mar 14Liked by A Midwestern Doctor

I was going to write something similar: my spouse got private pilots license in 70s, and was taught to Fly The Airplane first and foremost. Nowadays, too many pilots at all levels don't get their eyes off their electronics and can't handle basic stick-and-rudder work. Many have already died because if this, and with DIE hiring, many more deaths are coming.

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Mar 14Liked by A Midwestern Doctor

Very perceptive, this is a problem that transcends the culture. It is my opinion we are lurching into a new Dark Age. Hunter could see it coming: The downward spiral of Dumbness in America is about to hit a new low.

Hunter S. Thompson

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Just remember, for the price of an airline ticket, you can usually fly to one of the good surgeons, they do exist, and have your work done there.

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If you're happy with the pilot, that is (see above, and add injections).

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I was planning on finishing up my new Covid book (almost) tonight ("SANCTIONED: The COVID Murders") but I read your article instead. I guess with the passing years, I have become one of the "old surgeons" referred to in the article. Actually, I was in the sweet spot where we learned the old way for a couple years and the new way, which for us was laparoscopic surgery for all sorts of procedures for the remaining 4. When I later did plastic and reconstructive, there were no robotic or laparoscopic techniques superior to hands on so we never used them. Many years later when I went back to do hearts on babies and small children, we did them all the old way. Divide the sternum with scissors and away you go. 12 years in residency total with the last 2 in my 50s. I don't recommend it to anyone.

Instead of I'll let you judge me on the merits. Here are a couple videos from my days doing plastic and reconstructive cases rebuilding faces of two badly burned women through my charity work in Cambodia. Don't worry: there are no gory or bloody scenes. They are much more mathematical in nature than you might think. I hope you like them. Then I'll tell the story when someone asked me on Quora , "As a surgeon, what's the scariest thing you've seen in the operating room?" It was when I had to deliver a preemie from a mother who had been stabbed in her 7th month, I think, and then after I delivered the little girl, I had to do surgery on her on a separate table because the knife thrusts got her too.

The videos: https://www.youtube.com/watch?v=BsNkAhEe2SY and https://www.youtube.com/watch?v=Sjr4Q3zgf6Y

The story: I don’t know about “scary” but it was a watershed moment in the career of an about-to-graduate general surgery resident. Had I learned anything in five years of walking around here in a daze, utterly exhausted, cramming for in-service exams, stealing a quick nap in the middle of Morbidity and Mortality conference, eating out of vending machines in the middle of the night because the cafeteria closed while I was in the OR, never combing my hair because it cut into my morning sleep time?

In the early morning hours of a warm summer night in inner-city Cleveland many years ago, a deranged man repeatedly stabbed his 7 1/2 months pregnant girlfriend in her abdomen. She came in and was taken to the operating room immediately, bypassing the E.R.. An abdominal stab wound can be a serious injury depending on which internal organs are affected but in this case, the injury was compounded to the nth degree by the certainty that the fetus would abort from the trauma of whatever procedure we needed to perform on the mother. We had to deliver that baby and then address the injuries in the mother. Luckily, I had performed countless C-Sections as an intern 4 years before. In I went… Meanwhile, our circulating nurse was fast at work calling the neonatal team on call from nearby Rainbow Babies and Children’s Hospital. By the time they arrived, I had delivered the preemie and set up another operating table next to her mother’s because, sadly, one of the the knife thrusts had pierced the uterus and opened a long through-and-through gash in the little baby’s right thigh. Upon exploring the wound, I was relieved to discover that her femoral artery was NOT severed by the knife blade. Still, the blood loss was extensive and I feared losing that little baby. Ordinarily, you would open up IV fluids to keep the pressure up in a case like this but I feared she would get pulmonary edema due to the lack of lung maturation we see in preemies . It was a delicate balancing act between just enough fluid to keep her perfused but not so much as to flood her lungs. As soon as I was finished repairing the little girl’s wounds, we handed her off to the Rainbow Babies team and off she went.. out the door of the operating room and down to the ambulance for the short trip to their most excellent neonatal intensive care unit. The other team wrapped up the bowel repair in her mother shortly after her baby had left in the ambulance. I’ll never forget that little helpless baby and her translucent skin, so delicate that I had to tie her knots gently so as not to have them tear through… Update: The mother and her beautiful little baby survived the tragedy. The little girl would be 24 years old this year… I wonder if she’s ever curious about the long and beautiful, parallel scars on her right inner thigh…

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That is an amazing story, thank you for sharing. I had a few friends who trained at that time in Ohio and most people now can't imagine how dangerous some of the places were.

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Thank you. I almost can't believe some of the memories when I think back on them, myself. Did you like the videos?

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Mar 26·edited Mar 28

My experience did not work out as well. Working an ER shift, the RCMP had brought in the male after the woman was dead.

The consulting plastic surgeon in the referral centre did not want to accept the male for repairs to the flexor tendon lacerations in his hands because of the situation (FAS in the male .etc.) I was saved court appearance because they found an expert in knife injuries to testify.

From Ben Casey to House, the reality of the work is not what people see or believe. Thank you for your story and conscientious practice.

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Just watched the video. Spectacular.

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Thanks, Pamela. There are two videos... The second one is even more extreme.

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Mar 15·edited Mar 15

Dr. Sheftall, those videos are so inspiring and fascinating. What skill and artistry. I was left breathless and very moved by each case. The ZPlasty and especially the Vector mapping is genius. Thank you so much for sharing them.

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Thanks, AR. While I think ability to draw and paint helps, there are still good plastic surgeons who can't draw at all. I've always been able to, for some reason. I wish I could post some pictures here. Oh, I did 2 posts of my paintings ...I forgot. Here they are: https://drreidsheftall.substack.com/p/perpetrator-portraits-part-2-and

https://drreidsheftall.substack.com/p/perpetrator-portraits

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founding

your story, dear doctor, is appalling though beautiful. thank you for your service to human kind.

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Mar 13Liked by A Midwestern Doctor

Great article! I had already decided on no vaccines ever again for anything. No surgery either if I can avoid it. I'm doing my best to taper off of and d/c most of what prescriptions I take. There really isn't any way to be sure you're getting the medication prescribed for you anyway! I had bilateral knee replacements in 2011 and the artificial joints will probably last longer and I could possibly avoid revisions if there isn't so much of me! I want to thank you very much for the time and space to figure that out for myself!!

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Mar 16·edited Mar 16

Take good care of those knees! I've got one, too, and I keep it strong and guard from infection, which could be ugly. If I must dentist (I try to keep clean, though am less enamoured of the procedures than ever before) - I have to antibiotic because the bloody mouth cleaning is dangerous. Take good care of those knees, so that they last as long as you do. (I was 58 when mine was done - I wonder what the world will be like when I'm 78?)

Relevance: This was a robot surgery, performed by a skilled surgeon, who constantly griped that the robot was a better surgeon than him. I like to believe it was the TEAM (I've met people who experienced his work before the robot came alone) - of him and the robotic scalpel that got my excellent results. I'm very pleased with my results compared to my mates who got manual surgeries - one of whom was in hospital for 6 months for severe double infection.

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Mar 13Liked by A Midwestern Doctor

Very compelling article especially 2 days after I had a total knee replacement assisted by robotics. I’d never even heard of electrocautery, I will ask the surgeon which was used. As a patient you don’t even know what questions to ask. Other than childbirth decades ago,I haven’t been to a western doctor. For 18 years I managed knee pain with acupuncture, Chi Gong and an anti-inflammatory diet. I’m strong and healthy but I think of my 93 year old mother and the multiple bad surgical results she has suffered. She’s always had complete trust in what any doctor tells her or prescribes for her.

Thank you so much for this important information

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Mar 14Liked by A Midwestern Doctor

I’m referring a friend, my husband, who is a very thoughtful surgeon. He was the first to tell me that vaccines are not necessary. He also went along with my decision not to vaccinate our children. I will always love him for marrying me, a crazy RN, who trusts very few physicians.

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: )

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Mar 13Liked by A Midwestern Doctor

After a steady diet of noodles my partner formed two hernias. I did some research and found that in the entire country there was only one surgeon offering traditional hernia repair. Every other surgeon simply glues in the mesh fabric that has been the cause of so much misery in women, and now quite a few men. When I requested the referral my GP had never heard of just stitching the torn tissues back together, though there is a brisk trade in quick turnaround tourist hernia ops in India.

My partner crossed the country to Sydney for the procedure, and after examination the surgeon threw in a third hernia repair the GP and ultrasound technician had missed. We were provided with post surgery diet and supplement recommendations. None of my friends receiving treatment from general or even specialist surgeons locally had ever received post op diet and supplement advice. There was also an exercise regimen for athletes to get back up to peak performance. My partner healed well with only slight scars to show for it, and has never eaten noodles again. Not every surgeon who does a good job will be one who views patients holistically, but I'm willing to bet that every surgeon who does, does a good job.

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The meshes cause a lot of problems

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Mar 14Liked by A Midwestern Doctor

I've just been reminded that a friend had a horrible experience with a gynaecology surgeon who did not perform the procedure she described for my friend's apparent ovarian cysts. My friend took more than a year to recover and in fact only did so after faithfully taking the DIM supplements I gave to her. Directly after her surgery she woke up unable to breathe and was unable to get anyone's attention until an orderly came by to collect lunch trays. Suddenly she had her chest exposed to a room full of people carrying on and acting very worried. Afterward, they conspired to gaslight her that it was a panic attack, and nothing to do with the fact that no one had taken her through standard breathing exercises post surgery.

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Do noodles cause hernia's? I'm serious. Never knew that.

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When I say noodles I'm talking about what Americans call ramen. White flour, hydrogenated vegetable oils, salt and here, MSG. So a whole lot of non foods and no nutrients. When you have a large toxic burden and no antioxidants to deal with it your connective tissue doesn't form as quickly as you need. People with genetic predisposition to poor methylation get this, but it catches up with everyone eventually. My partner had three hernias in his early forties. If he had not also been exposed to heavy metals from several years of grinding mining drill bits and stress from management that epitomises the Peter Principle he might have got away with it longer but I'm actually glad it happened so early so we could correct course.

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OK, thank you. I have a hernia above my navel. Can't remember exact term;

Felt it in 2012. Went to doc in 2013. Watch and wait.

It's larger now but I just did not want the mesh. at the time I did not even want stitches.

I'm in good shape. Very petite. Don't do the exercising I used to. So hopefully I will be OK. My primary care examined it this year. It shows up on scans. But on one has suggested I get it fixed.

Here's hoping.

And I don't eat noodles so that's good! lol

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Sorry to hear that Judith. The supplements that the surgeon recommended were sea sourced collagen, a good antioxidant multivitamin and a high quality spirulina supplement. I have also been giving my partner protein shakes with organic whey since that time, with the bonus that protein is high satiation. There is a website called something like 'heal your own hernia' where a surfer used diet and exercise to heal his hernias and also used strapping to support them till that occurred. If you have the one under the navel maybe a stretchy belly band could make you more comfortable? My cat has had a hernia since her botched speying in China. At the time we could see her innards oozing around in there. It hasn't stopped her living a good life. There's always Joe Dispenza, it's free to meditate and has the benefit of no side effects like too much iodine or something else to which you may be intolerant. I would avoid surgery of any kind these days but especially that mesh 😥

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Oh I should also say I switched him from milk in his morning hot chocolate to ghee. If you're gonna have greens and things that release toxins then you need fats for them to grab on to and hopefully depart the body. The people I know who have had hernias, they've all been skinny and fit. If your body stores toxins and heavy metals away in fat to protect you and your genes don't do that then those things are going to be acting on you. Worst case scenario is your lovely fatty brain.

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Thanks, Tilly. I'm good for now. I eat very healthy. From all the reading I have done I understand you cannot bring the tear back together without surgery but I will look into that site.

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Mar 14Liked by A Midwestern Doctor

Beautiful article. I am a surgeon, and some of the wisest words I heard in training were this: ‘Respect the tonsil’. It is so easy (and commonplace) to forget the respect that is owed each and every patient who places themselves in our care- either in the clinic or operating room. The ‘Surgeons are gods’ mentality is destructive- to both the surgeon and patient. The excellent surgeon is one who fully honors and respects the patient for whom he or she serves.

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Mar 14Liked by A Midwestern Doctor

Thank you sir!!!! I love smart, thoughtful surgeons.

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I added your comment to the article!

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Thank you! Your work, especially this article, are confirmations to me about my vision to open a surgical practice that honors each patient that comes through the doors. Not as a commodity or a means to an end, but a person with both a body and soul that comes to me seeking healing. If you are aware of any resources or other like- minded surgeons (like Dr. Miller), please let me know. The day is far spent, and the time has come to bring dignity and honor back into medicine.

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Mar 13Liked by A Midwestern Doctor

As a person who just only happens to "juggle" with steel, wood, plastics, etc. with his own hands (and various tools) on a daily basis, I'm moved by your deeply disturbing & compelling article !!

To read what havoc the "cool" but soulless robotics is creating in medicine and what pain it is inflicting on its "victims and cash-cows" (formerly called patients) makes me shudder.

Better not to spend a thought about what upcoming AGI will be causing in general society with outcomes on a scale magnitudes worse ...

Bleak times ahead ... let us detach from the madness and keep trying our best in an independent, human way.

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Mar 14Liked by A Midwestern Doctor

Hospitals already racing to sign up for AI to create clinical summaries. This can only be a disaster.

https://www.statnews.com/2024/03/13/hospitals-ai-clinical-note-summaries-accuracy/

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AI is already running the algorithms of medicine - even if it's to maximise profits, not patient outcomes. It just has a face, right now, behind the computer, who might talk to you. That's your doctor. I'm afraid s/he is soon to be easily replaced.

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Excellent article

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Mar 13Liked by A Midwestern Doctor

The physical touching of the patient is what the Medicare “wellness” exam fails to do. This is Government-directed negligence.

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How many doctors are terrified of sexual harassment lawsuits? (please, all you docs, feel free to chime in, because I am not a doctor - but have listened to my doctor mates speak in fear of the legal profession)

It's gotten ugly to touch in our culture.

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In light of this excellent article, I have to ask, how does a patient, who knows the state of medical care, find a truly skilled physician, much less a surgeon?

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I am not sure how to without word of mouth. I've worked at numerous places where one surgeon was bad and other good, but almost none of the patients in the community knew that.

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Mar 14Liked by A Midwestern Doctor

A very difficult task if you're not connected to the "system"! As an "insider", I had Nurse Friends and they knew.

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Just ask a nurse… they know! Especially the surgical nurses of which I was one. Usually the general population is unaware of the “bad” surgeons. I always warned my family and friends of which surgeons to avoid. When in doubt, ask a nurse!

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A bit away from surgery, but there is a way to tell a good dental practice from a bad one. If they have machines to make dental caps in their office, run away! Those caps are vastly inferior, along with the adhesives used to bond them. They fall off and they break. You will spend $1000 on a cap and then another $1000 to replace the broken cap 15 years later. The specialist, hard fired ceramic caps can last a lifetime. I still have my first one after 40 years. A half dozen of the machined caps have failed, and I had to pay for good replacements.

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Keep reading and reading everything detailed online that you can find about the several surgeons you're considering. I think there are hints when you read certain things that a particular surgeon has achieved. Sometimes if you talk to their PA or other medical team member in their office, you can hear the pride in their voice when they talk to you about the doctor. Be willing to fly to see the right doctor. If someone asked me, "Would you be willing to spend an extra $1000 for a flight to know you're getting a truly excellent, top-notch surgeon?" I'd say "Yes."

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So true...with all the incompetence and neglect, how do we know? Makes one want to know, at least, which are good medical schools. Of course, we actually do need to know who the competent v incompetent graduates are. I do like the "ask a nurse" idea. Maybe we all need to touch a surgeon and muscle test!

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Mar 13Liked by A Midwestern Doctor

https://www.imdb.com/title/tt0386792/

This movie was great. The great esteemed doctor couldn't do the surgery correctly but his handyman could.

I'm one of those guys that's very good with small things.

But yet, I cannot memorize tons of words and charts to become a doctor. They pretty much turned medicine into how law became... A club.

And that leads to inventions that create bullshit, yet medicine thinks it's useful for their pseudoscience experiments.

https://robc137.substack.com/p/pcr-fails-logic-from-the-start-sorry

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Just 👍👍 !!

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I watched the movie, a true story, last night and found it to be excellent! TY!

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