What determines the *success* of a particular surgical procedure or medical intervention?
Many physicians believe, rightly or wrongly that if they were able to accomplish their goal, the procedure was a success. With all due respect I beg to differ. Certainly there are circumstances where risky procedures are being undertaken for heroic measures… and the success of the procedure may simply be that the goal was accomplished… but I am referring to far more common elective or semi-elective interventions.
I firmly believe that the road to a surgical *success* begins long before you are wheeled into the operating room. It begins in the office — with the proper patient selection and proper indication of a patient for said procedure. We know that many patients present with studies which reveal *abnormalities* … but in many of the those cases, those *abnormalities* are a consequence of aging, overuse, etc and pose no risk to the patient — and are having no significant impact on that patinet’s quality of life.
If that patient is indicated for surgery, should it ever be deemed a success ???
For those patients who are properly indicated for a surgical procedure, assuming the procedure was properly performed, and the intended goal was met… is the surgery a success???
I contend that the answer to that question is no. And I teach my residents that every day. I also encourage them to come to the office with me over the next few weeks to meet these patients and determine for themselves, based on the offered or elicited feedback as to whether or not the surgery was in fact * successful*. If the patient is doing well, and they are satisfied with their pain relief, level of function and quality of life… I think it’s pretty safe to say that the procedure was a success.
Thoughts?
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