Monday, September 29, 2008

Surgery as a Team Effort

In the mythology of our culture, the image of the heroic surgeon ranked right up there with Wyatt Earp and the Red Baron and outlasted both of them

But now it seems that even that last bastion of individualism is on the wane.

The September 22 issue of The Boston Globe carried an Op-Ed piece by Douglas Brown reciting the 2005 story of the temporary shutdown of the heart surgery program at the University of Massachusetts following the release of data showing that its mortality rate was twice that of the average of all hospitals in the state. The occasion for the column was the more recent (August 2008) release of data on heart attack survival rates showing U Mass to be ninth among 4300 hospitals surveyed.

Brown credited this turnaround to reforms implemented following the 2005 shutdown. New leadership was appointed, which “grouped all cardiac patients together so staff could develop expertise with their particular needs….[and] created a complete team approach to care, where everyone’s voice is encouraged and welcomed.”

A few days earlier, wife Marilyn and I were in the office of her orthopedist scheduling a knee arthroplasty to be performed at New England Baptist Hospital. We asked whether he was an enthusiastic participant in the hospital’s programs for preventing surgery-related infections and strokes, reminding him of Marilyn’s minor stroke last Christmas. He said he absolutely was. He said that Marilyn would be going to the Baptist for a pre-operative work-up, at which time all such matters would be identified and responsibility for their management assigned to the proper specialist. He said that at the Baptist surgery is a team effort.

We certainly wouldn’t have heard from a surgeon twenty-five years ago.

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