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your OR schedule on any
given day might include a total
thyroidectomy, an ultrasound-guided partial mastectomy
with sentinel node biopsy, a
with common bile duct
exploration, a components
separation incisional hernia
repair, or a laparoscopic
hysterectomy, staying current
can be daunting. Without the
Internet, I could never manage.
I limit the patients I treat and
the procedures I perform to
those I believe are within my
areas of competence and the
capabilities of my facility.
When complications occur,
I try to recognize and admit
them and arrange for transfer
to an appropriate level of care,
whether across the hall to our
intensive care unit or across the
state to a tertiary care facility.
Finally, we have begun to
expand the measurement of
outcomes and to participate
in collaborative quality
through the Illinois Surgical
Collaborative, a major new
initiative for my facility.
To paraphrase Vince
Lombardi, perhaps perfect
practices will make perfect. ♦
The trip to a staffed surgical intensive care unit with a full
complement of subspecialty consultants is not an elevator
ride for CAH patients, but often a helicopter ride.