Sunday 11 November 2012


WARNING: I may word this post slightly in my favour, so there's a small chance I'll end up looking like a braggart. It isn't my intention, I assure you. But I do have a point. Stay tuned.

One of the worst parts of surgery is that patients really have no idea what actually goes on in the operating theatre. I don't mean the shenanigans and hijinx (just kidding...sort of), I mean the actual operation. The only parts of my work that the patient can see are the bandage and the scar. If those looks good, that seems to be all that matters. Your surgeon could be the biggest hack in the world, but if he can close your skin nicely, he's a superhero. But heaven forbid you get a drop of blood on the bandage, because then you're clearly a butcher. So the only real thing on which a patient can judge their surgeon is his personality - his bedside manner, attentiveness, attention to detail, mannerisms, etc. These things are important, but not as important as his skill in the OR. That's not to say it isn't a wonderful compliment when a patient tells me that she was referred by another patient of mine (I took out her friend's gall bladder, so when she needed surgery, her friend told her to come see me). I even had a woman track me down several years after I took out her appendix to do her breast biopsy when she found a lump. But how do they know if I'm actually any good?

One of our local magazines has their annual "Best Doctors" issue, in which they mail surveys to doctors and ask them who they would go to see if they needed medical care. But here's the problem with that question - I almost never see my colleagues operate. I know who's nice and who's an arrogant asshole, but I don't know who's good! I wouldn't have a clue who to see if I needed surgery. In that regard, I'm no better off than my patients! So who the hell can you trust to judge a surgeon's skill?

Anaesthesiologists and OR nurses, that's who. Think about it - all they do is watch surgeons operate, so you know damned well they know who is good and who is much more likely to remove the wrong kidney.

A man came to see me last week about getting his hernia fixed. He had no primary care doctor, so I wondered how it was that he got my name and number. Did he go to the ER? Did I operate on a family member or friend? As I was about to ask him, his wife knocked and stepped in the room - she's one of the anaesthesiologists I've worked with the past few years. And of all the surgeons at the hospital, she had him come to see me.

I've gotten some nice compliments over the years - it's great when someone tells me that my suit is nice or my haircut looks good. But I think this was one of the best compliments I've ever received.

Wait a minute, what was the point I was trying to make? Oh right, now I remember - don't sprain your shoulder when you pat yourself on the back. Make sure you stretch first.


  1. So now the question is, who would you use? Hopefully you never need surgery though.

    1. I think he addressed that question when he said he didn't know who he would use.

  2. You may not know who you would like operating on you, but I'll bet you know who you would like to be handling the anaesthetic!

  3. When my dermatologist's wife needed a mastectomy he called me to find out who did the reconstructive surgery. My surgeon called and thanked me for the referral. I found that whole situation a bit creepy. Sometimes it's what is seen that makes a difference. My surgeon is an arrogant assume with a Babies doll collection for his office staff.

    1. Sorry auto correct went overboard. I meant arrogant ass with Barbie dolls for his office staff.

  4. a friend of my brother in law is an anesthesist, and when i needed surgery for my knee it was him who i asked for a recommendation for a surgeon. i didn't even think of what you wrote, that he spends his time at work watching surgeons do their job, he was just the only person i knew that works in that hospital.

    the surgeon he recommended did an excellent job with my knee. and by that i don't mean that the scar looks nice and is almost invisible two years later despite being almost 10cm long, honestly, when i went there i couldn't have cared less about the scar. i mean that my knee is really stable again, which it hasn't been in years before, and it doesn't hurt at all when i do sports, despite he warned me it could, since the years of instability have strained the tissue inside the joint. so, even though i have not SEEN what he did inside my knee, what i CAN tell is that it now works as good as new, so he must have done a good job.

    thank you for pointing out who can really evaluate the work of a surgeon, that is really helpful advice.

    and, being the hard working and caring doc that you are it is ok to pat your own shoulder occasionally. congratulations for being recognized by someone who has seen your work.


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