Wednesday, January 25, 2012

Confessions of a Surgeon

Confessions of a Surgeon is a book best read at home, not as a gift in a get well basket for any recovering family members or friends. An eye-opening read of health care systems (past and present) and the flaws that exist due to surgeons being human and health care systems being systems. The road to becoming a surgeon is a long and painful one resulting in a God-like complex in many a surgeon.  This surgeon defends his kingdom while shedding light on the problems inherent in such deification.

Your insurance company, your hospital, and your government know more about the skills of a surgeon than you will know in the present system. All of these bodies tabulate figures on outcomes because bad outcomes cost more money. The likelihood of success of one's surgeon would be desirable for a patient to know going into a prospective surgery, but this data is not available to the general public.  (This information is provided quarterly to all surgeons, however.) The best advice the author can give is to ask your prospective surgeon what his/her complication rate is on the procedure you require (and then hope to compare it with the national average for the same, if you can obtain such a figure.)

Surgeons being human, there are good ones and bad ones. Nice ones and mean ones. Lucky ones and unlucky ones. They all worked very hard to get where they are today.  But you probably don't want the brand new one, or the one who all of his/her colleagues know should have retired ten years ago. And remember, the ones with crappy bedside manner may have the best technique in the world. 

This author does not want to see increased regulation of his practice, and is an unabashed old school kind of guy. A bit of a male chauvinist brought up in the residency days of working with no sleep for days on end he has little patience for the next batch of surgeons coming up the ranks. But as he points out with burn-out being so high from the rigors of the job one can only hope that they are quick learners as more surgical services are needed for an aging population. You can pick your surgeon to the best of your ability for your elective surgery. But in the middle of the night when an emergency requires surgical intervention it is a crapshoot .  Whomever is on call will provide your services to the best of their ability, with the best equipment provided to them by the hospital (and allowed by the insurance company), with whatever sleep they managed to get before your procedure.

 An interesting read for any persons involved in health care as an occupation or as a prospective patient. The reader will appreciate surgeons more for what they have endured and endure on a daily basis. The reader will also wish for a more transparent system to provide for the safety of the general population after reading some of the stories contained within these pages.

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