Ownership of the Hand
By Joseph Said, MD
In modern times, many specialties fall short of maintaining continuity of care especially after a complication. Skin loss, injured nerves, or complex revision arthroplasties are outsourced to another specialty. By contrast, hand surgeons have taken ownership of the hand in its entirety with few exceptions. We are often the primary care physicians for the hand, taking responsibility for both the medical and surgical management of every structure in the hand. Because of this, we have the capacity to manage our own surgical complications. In this respect, hand surgery excels where other fields fall short.
It’s true that many hand surgeons including myself are not adept in all aspects of the field. The task is overwhelming. The field of hand surgery is too massive to have seen everything in training. However, we should preserve and enhance our ability to manage all things in the hand. Famed hand surgeon Raymond Curtis has said, “I have never seen a case like this before, but I know that [a researcher] wrote something about this.” We have access to the full scope of hand surgery through our peers, national and local conferences, journals, and hand society resources. Our societies have done a remarkable job providing us with the videos, journal articles, and courses on any topic in hand and upper extremity surgery. We should continue to take ownership of the hand by accepting new challenges and safeguarding disciplines like microsurgery, soft tissue coverage, and above-the-wrist procedures that make our specialty unique.