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MY PHILOSOPHY IN SURGICAL DECISIONS

My Philosophy

All surgical procedures, however routine, have risks. I regard the primary role of a surgeon is to manage that risk.

Many patients are surprised, and often relieved, when their surgeon does not recommend surgery. However, most ailments which affect the body are best treated with conservative, non-surgical remedies. Such is the case for conditions which affect the hand and arm. Conservative care, which includes custom-splinting, hand therapy, injections, and medication, is often very successful in improving the lives of patients with hand disorders.

Occasionally, an injury or disease process is severe enough to warrant surgery. In these cases, the potential benefits gained by surgery outweigh the potential risks of surgery. I carefully evaluate the need for surgery based on a patient’s condition, medical history, activities, and desires.

One of my most important roles as a doctor is to educate patients, while listening to their expectations and concerns, in order to help them make informed decisions. I encourage patients to ask questions and be involved in the decision-making process.

 

My goal is to improve a patient’s quality of life using proven and reliable treatments tailored to individual needs. In most cases, I recommend the least-invasive method possible, and surgery is only recommended after considering the non-surgical alternatives. My treatment approach balances traditional, conservative medical care with current surgical procedures.

 

 I am humbled and honored when a patient entrusts me with their care. 

 

Not all surgical conditions require an operation. In fact, I consider a competent surgeon is one who knows when NOT to operate.

 

Surgical procedures may be necessary in some asymptomatic patients for preventative measures.

 

Treatment options ought to begin with the least invasive options first.

 

 

I consider a good surgeon is one who has the following attributes –

  • A good listener
  • A good communicator, who involves all the stakeholders in the decision-making process
  • A competent operator
  • One who knows their limitations and will refer patients onto other medical professionals when necessary
  • Has sound knowledge and keeps abreast with latest surgical developments and skills

The main question I contemplate whenever I see a patient is –
What is the risk of operating versus the risk of not operating on this patient ?

Surgery should only occur if
Risk of NOT operating > Risk of operating

 

 

 

 

Risk of operating on a patient

 Factors I consider –

  • Patient risk profile for general anaesthesia& surgery –
    • Medical conditions
    • Patient’s present quality of life
    • Medications
    • Previous surgery
    • Allergies
  • Pathology factors –
    • How symptomatic is the pathology ?
    • Is the aim of surgery curative or palliative ?
    • Is the pathology potentially life threatening ?
    • Is the pathology affecting one’s quality of life ?
    • Is the pathology likely to progress with time ?
    • Is the pathology curative or manageable by non-operative means ?

 

 

 

Risk of not operating

Factors I consider –

  • Is the pathology likely to progress with time ?
  • Is the pathology likely to become life threatening ?
  • Is the patient likely to develop other risk factors (eg other medical conditions) if surgery is delayed ?
  • 2016-09-28T11:17:50

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