It’s All in the Counseling …

Physicians have a lot of power over patient choices. In theory, physicians present patients with choices and then patients make informed decisions. In practice, this almost never happens. A physician can manipulate a patient into doing almost anything by counseling patients in a biased and skewed way; a doctor may even tell the truth, but…

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How I Lost 40 Pounds

When I talk to patients about weight loss, they usually tell me about their plans to exercise more and eat healthier. Recently, they ask me how I have lost 40 pounds or what magic I used to slim down. Most are sad to learn that there is no magic bullet. That being said, losing weight…

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OB Potpourri 4.0

Stop the tilt I haven’t used a left lateral tilt during Cesarean delivery in years. There has never been any robust scientific data that tilting the table or tilting the mother with a rolled blanket or pillow to approximately 15° has any effect on fetal outcomes. Still, the practice is widespread and most practitioners believe…

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Four Tips for Correctly Diagnosing Vaginitis

Complaints of vaginal irritation and/or vaginal discharge are very common in ambulatory settings, particularly in gynecology offices. Bacterial vaginosis, candidiasis, and trichomoniasis account for about 70% of these complaints. Patients who present with these symptoms are frequently over-treated and misdiagnosed. Those with recurrent symptoms are especially challenging.  Here are four tips for correctly diagnosing women with…

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Four Tips for Initial Laparoscopic Entry

The initial trocar placement at the time of laparoscopic surgery is the most important step: 50% of complications that occur during laparoscopic surgery occur with the initial laparoscopic puncture. Here are four tips to reduce the risk of injury when making the initial entry. 1. Use a direct entry optical trocar, preferably one that insufflates…

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