To whom
Dear sir or madam,
Editor’s note: The following
letter was submitted regarding
a recent article published in the
Bulletin. A response from the
authors of the article follows.
Letters should be sent with
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Letters to the Editor
*Ballard DH, Samra NS, Griffen FD.
Evolving insights for preventing surgeon
errors: Balancing professionalism and
cognition with knowledge and skill.
Bull Am Coll Surg. 2017; 102( 3): 10-18.
Surgeons do their best
to prevent errors
I was dismayed to see the title
on the cover of the March issue
of the Bulletin. “Preventing
surgeon errors” is the worst
admonishment you could issue
to the busy surgeon working
day in and day out trying to
survive the onslaught of demands
that define surgery today. The
plaintiff attorneys will love
you for the title, though.
As you are well aware,
surgeons are humans and making
mistakes will always be a part
of being a surgeon and being a
human. There is a bell-shaped
curve for everything in life, and
no matter how hard we try, some
surgeons will always be at the top
and some at the bottom. The title
is reminiscent of the foolishness
of “never events” and how the
American College of Surgeons
(ACS) never stood up to the use of
this ludicrous phrase to say there
is no such thing in medicine.
Although the authors present
some excellent ideas to help
decrease errors in surgery, these
ideas will never prevent errors for
the reasons stated above. Some
attorneys and patients are taught
that the practice of medicine
should be perfect and that any
time a complication occurs it is
due to negligence and error.
We surgeons who operate day
in and day out face this hostility
and these expectations every
day. Most of the article puts all
the blame and responsibility
on surgeons, stating what they
should do, and none of the
burden on the noncompliant or
hostile patient, on the operating
room that does not have the
staff or the materials to properly
care for the patient, and on
the insurance companies that
control everything. The entire
article is about negative results
and negative thoughts, when
the vast majority of surgery
leads to positive results.
We need a College that is
ready to lead and not follow.
We need a College that is ready
to think outside of the box and
use what we do as surgeons as
a leverage to truly represent
working surgeons and their
patients. I don’t believe this can
be accomplished by playing nice
and being politically correct, as
it seems so much of the College’s
efforts revolve around today.
The ACS led the fight to get rid
of the sustainable growth rate’s
yearly threats to reimbursement
only for it to be replaced with the
Quality Payment Program under
the Medicare Access and CHIP
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