Perfection in Surgery

Brad’s Gab--->

Should your surgeon be perfect? No, but in all cases, surgeons must strive for excellence. This is true in all aspects of care, not just in the operating room. There is also preoperative and postoperative care. Following this, there is long term follow up. In all these aspects of care, the surgeon must persevere for then highest quality care.

Preoperative care is important to not only diagnose the surgical problem, but the surgeon must also know when not to operate. There are many times in the clinic when I talk to the patient about their problem, how it could be fixed surgically, and what would happen if it is not fixed. I mostly work in the elective general surgery world. Emergency, or acute care, surgery is quite different; however, in all cases the risk and benefits of the surgery must be as clear as possible. Low risk surgery that will benefit the patient is ideal, but rarely is the case so easily discerned. Therefore, while the patient is a key person in the decision making process, the surgeon must use best judgment to determine when and when not to operate.

In the operating room is where perfect excellence is most important. Tedious attention to detail, complete focus on the task at hand, and always moving toward completing the task at hand are the basic principles for good outcomes in the operating room. Surgeons are expected to be gifted, technically skilled, and good at what they do. Knowing your surgeon’s experience and complication rates are a good way to judge his operative perfection.

Once the surgery is done, postoperative care is extremely important. Your surgeon must be aware of all the possible outcomes from your surgery. It is imperative that there remain a high level of suspicion for complications. It has been shown over and over again that most complications, when handled early, have good outcomes. Surgeons must not let their pride get in the way of diagnosing a postoperative problem. Surgeons are not perfect in all things all the times, and no matter how good your surgeon is, he has complications. These are not always his or her fault, but if a surgeon is slow to accept his complication, then the problem can be compounded. Humble surgeons make good doctors.

Long term follow-up depends on the operation you had. Obviously, chronic disease like cancer, reflux, obesity, to name a few, require life-time follow-up. Gallbladder removal, for example, may not require long term follow up. However, just like you may have a family lawyer, a primary care physician, or an insurance man, I believe most families should have a surgeon. We all hope to never use them, but when you do, having a long standing relationship with a surgeon can make for a more pleasant and peaceful experience. If you need a surgeon, find one you really like, and keep his name and number forever.

So while surgeons should be perfect, who is? We surgeons strive for excellence before, during, and after surgery. We are often humbled by our job, and that is a good thing. Like most industries that serve their community, surgeons must provide a good experience to their patients. Unlike many industries, the stakes are high when there is surgery involved. All involved expect as close to perfection as possible, as we should.

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