Sometimes not doing surgery makes you a better surgeon

Having been surgically trained and surgically-minded, I’ve had expression ingrained in my psyche such as “a chance to cut is a chance to cure,” “when in doubt, cut it out” and “nothing can heal like cold, hard steel.” Indeed, as a surgeon, I see patients in my office and in the hospital with the specific question of whether or not surgery is indicated, what type of surgery and how urgently it needs to be performed. But coming up to my 20-year anniversary as a full-time faculty member at an academic medical center, I’ve noticed my own sea change in recommendations. Yes, I have seen the beneficial outcomes of even the most minor of surgeries, as well as the literal life saving from major ones. I’ve also seen the disastrous consequences of delaying surgery or from holding off on surgery altogether. But I have also seen surgical disasters. Because as most surgeons know, there is more to surgery than simply “cutting it out.” Perioperative morbidity is how we term it. What are the anesthetic risks, the risks of immediate and delayed postoperative complications? And the larger questions: Will this surgery really change the ultimate outcome of the patient’s prognosis? Quality of life? While there are countless research articles, data sets and population norms on who makes the best surgical candidate, some of these answers come simply with time and experience. And sometimes the better surgeon is the one who recomm...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Hospital-Based Medicine Surgery Source Type: blogs