Our cover focus this month would seem at first glance to be a departure from our usual effort to make you a better-informed, more efficient and more successful surgeon and clinician.
On one hand, there is the feature (p. 30) describing the perspective-altering experience of the surgeon becoming a surgical patient. Going under the knife is a fate we'd all love to avoid but one that awaits most of us at some point, and our article reveals it can have unexpected benefits beyond the immediate surgical outcome.
The cover story too (p. 25), on the issue of age and surgical skills, takes more of a personal approach than our usual fare. One practical reason for that is there is still relatively little research and data on the impact of age on surgical outcomes. What work there is shows, happily, that by itself, age is a poor predictor of much of anything. But there is reason to be concerned about who is and who should be assessing an aging surgeon's skills for signs of slippage. That's because the surgeon himself is likely to be the last to notice.
It was heartening to see the ap-proach taken by one of our subjects to this dilemma. I might even call it courageous. In his mid-60s, this surgeon arranged for a trusted friend and fellow surgeon to monitor his surgeries. No cherry-picking, no advance notice, and an assurance that there would be no holding back of criticism. May we all be so lucky to have such a friend. And may every surgeon have the fortitude to subject himself or herself to such a test.
This surgeon's experience also affirms one of the other early findings in the research on this topic—that the intuitive tendency to cut back on surgical volume may be exactly the wrong approach. For maintaining surgical volume, and in this doctor's case, the willingness to stay at the forefront of research and new technologies, may be a far more effective counter to the passage of time.
So maybe keeping you a well-informed, efficient and successful surgeon and clinician is also paying unexpected dividends. We'll get back to that next month. Happy holidays, and bring on 2010.
