Surgery—On Call: Day-to-Day Surgical Care Sunil Ravinder Paul K
Chapter Notes

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The ABC's of a surgeon are:
A – Availability
B – Behaviour
C – Competency
Surgical practice depends on: (WARS)
Responsibility and
Skills acquired, bestowed or incurred.
Remember the ‘6 Cs’ which will help in avoiding litigations and lawsuits.
  • Care
    Is one's medical knowledge and technical skills that are used to benefit the patient.
  • Concern
    Is one's responsibilities to the call and needs of the patient.
  • Consideration
    Is an extra measure of personal input initiated by the surgeon which he would have appreciated if he himself were a patient.
  • Communication
    Is essential between all grades of staff and patients. Obtaining information and communicating the information to appropriate persons is important.
  • Consent
  • Clear and precise documentation
    Good attitude, caring response, and thoughtful explanations will extinguish many lawsuits. Many legal suits can be avoided and losses minimized by simple adherence to the principles of compassionate, competent and thorough care of the patient.
Other words of wisdom
  • Surgeons should treat patients as they want to be treated.
  • Thorough discussion about the rationale of treatment and forms of management, maintaining communication with the patient and family throughout the course of treatment, and comprehensive medical record documentation are of vital importance. Acting honestly and prudently reflects diligence and concern for the patients welfare above all other considerations.
  • Guarantees of outcome should not be made and the patient and family should be included as an integral part of all decision making.
  • The implied request of a patient on the operating table is “my life is in your hands—be cautious; use all the skill, knowledge and acumen you possess to cure me if possible and give me back to my loved ones”.
  • The greater the indications for surgery, the better the results.
  • Any operation may be dangerous to life and can be followed by distressing side effects.
  • It is as important to know when not to operate upon a patient, as it is to know when to operate.
  • The more mature and accurate the diagnosis, the less a surgeon will have to explore. Therefore, careful medical and surgical diagnosis is essential.
  • Choose the case well, cut well and the patient will get well.
  • Tissues, should be handled with gentleness and kindness, and they will heal well.
  • Appropriate traction and countertraction help anatomical planes to be better demarcated, making surgery easier.
  • Perform surgery carefully. Often people talk about the surgeon regarding his speed. It is not the speed which counts most but it is the way you perform the surgery safely. Be a safe surgeon.
  • Do not operate on a patient you have not seen pre-operatively.
  • In this era of laparoscopic surgery let your indications for surgery remain the same.