He said working according to strict hour limits is not a mirror of reality in the medical world. It’s important, he said, to “instill in our residents that occasional self-sacrifice is, and has always been, a fundamental principle of being a physician.”
Open vs. Endoscopic Surgery
Albert Merati, MD, professor and chief of the laryngology service at the University of Washington in Seattle, argued for open procedures in cases of Zenker’s diverticulum, saying it puts patients in the best position for complete symptom relief after just one procedure.
In a 2002 study of 197 patients, open surgery was compared to endoscopic procedures, with the percentage of totally asymptomatic patients significantly higher after open procedures than after those treated endoscopically, no matter the size of the pouch (Ann Thorac Surg. 74:1677-1683). Eighty-five percent of patients with pouches smaller than 3 cm were asymptomatic when treated with open surgery, compared to 25 percent undergoing endoscopic treatment. For patients with pouches of 3 cm or greater, the numbers were 86 percent compared to 50 percent. Other studies have found similarly favorable results for open procedures.
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