How a specialized surgeon may save your life

I am fascinated with this article that just came out from the Wall Street Journal. Absolutely fascinated. There are so few studies out about operating room life, and this is MY life. It’s my home away from home.

But the OR tends to be like Vegas…what happens there, stays there. No patient is told that their surgeon threw a temper tantrum in the middle of their surgery and threw an instrument at the wall. No patient is told that their surgeon sucks and has a higher than average infection rate.

Don’t get me wrong. There are tons and tons of amazing surgeons out there. But just like any occupation, there is a bell curve of excellence. Many are average, some are phenomenal, and others…not so much.

This is why I URGE you to ask questions. How else are you going to know what side of the bell curve you’re getting? A little homework can go a looooooong way, and according to this Wall Street Journal article, it may even save your life.

The article was published in the July issue of the British Journal of Medicine. (Nothing to sneeze at there.) It reviewed 695,000 surgeries by 25,000 surgeons. This is a huge sample size, but narrowed in scope by the type of surgery – they only reviewed eight different types of complex cancer and heart surgeries.

It’s unfortunate that they narrowed their study to only eight surgeries. But IMHO, your surgeon’s skill matters no matter WHAT type of surgery you are about to have. A surgeon’s skill (or lack thereof) can help (or seriously harm) a patient in ANY type of surgery.

From the article: Dr. Wayne Moschetti, left, and his team, including resident Matt Sabatino, right, perform a total hip replacement in the operating room at Dartmouth-Hitchcock in New Hampshire. A new study has found that doctors who specialize in a single procedure may provide the best odds for a successful operation. PHOTO: DARTMOUTH-HITCHCOCK/MARK WASHBURN
From the article: Dr. Wayne Moschetti, left, and his team, including resident Matt Sabatino, right, perform a total hip replacement in the operating room at Dartmouth-Hitchcock in New Hampshire. A new study has found that doctors who specialize in a single procedure may provide the best odds for a successful operation. PHOTO: DARTMOUTH-HITCHCOCK/MARK WASHBURN

The article goes on to specify that patients of highly specialized, busy surgeons fared better after surgery. For six out of the eight surgeries studied, “patients were less likely to die in the first month after surgery when the operation they underwent accounted for a larger share of surgeons’ overall practices.” So more surgeries of a specific kind make for better results. This is true across the board for all surgeons, really, from what I’ve seen in practice. You never want to have a part-time surgeon or be the guinea pig.

Speaking of guinea pigs…I’d like to fill you in on a true story of what happened to me at the start of my cancer battle. I was in Florida and being treated at a teaching hospital. I had undergone a SLNB and was informed that a CLND was necessary, and my surgical oncologist suggested I undergo a lymphaticoveinular bypass at the same time.

I was referred to a plastic surgeon, who explained that a lymphaticoveinular bypass would decrease my chances of lymphedema.

My ears perked.

He went on to explain that he’s done this many times and he has good results with breast cancer patients.

I was intrigued.

So I then asked what his results were like for a groin bypass (since mine would be in the groin). He paused and said something along the lines of “well I’m not sure.”

So I asked how many of these bypasses he’s done on the groin.

His reply? None. I would be the first one.

THE FIRST ONE?!?!? My jaw dropped. He had never even DONE this surgery before, but here he was touting his good results!!! I couldn’t believe it. He was SELLING this procedure to me. He wanted me to be his guinea pig!!

If I hadn’t asked these specific questions, I would NEVER have known these important details.

Moral of the story? First, lots of practice makes perfect. And second, ask questions to see how much practice your surgeon has had!

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