By Shailesh Gupta, MD

Sitting down to write the article got me contemplating if there is even anything novel in what I’m doing. It’s the ever-so-same microsurgery, same wrist surgery, general hand surgery, etc. I was struck by this question again and again on what is something specifically special to me worth sharing. 

An average surgical procedure outcome can come out to be exceptionally well by taking a good post-op care and you all know good post op care is key to good result. 

You know what? You can also provide a great hand surgery solution at a community basis at low cost. I’ve been practicing this model for more than a decade now and I believe this model can be an efficient one to look upon for any hand surgery service provider. Working with limited resources and on a low investment of real estate is a plus. I am also attached to the bigger hospital where I choose to undertake the complex surgical procedures.

I run a small day care centre on the ground floor of my residence. I do out-patient consultation, surgical procedures, and I have my own own splint work shop with just a total of 5 staff (all of them are multipurpose – they change the responsibility according to need).

The entire setup is constructed in around 2600 square feet, which has 2 consultation rooms, 2 operation theatres, and a few more necessities. 

With the experience I can list out multiple advantages of this model:

1 – Time wasted is minimal.

2 – Your work family life balance is excellent

3 – With WALANT, you can provide very cost-effective service.

4 – Multipurpose staff change responsibility as per need.

5 – Better monitoring of patient care.

6 – You can still operate bigger cases at larger setup.

7 – Oftentimes, in many countries, there is limited availability of hand therapist and orthotic personal. Establishing your own splint workshop is a very cost-effective way to deal with this challenge. (See the photo below and how a small mobile unit for making thermoplastic splint has been designed)

8 – There are several physiotherapy assistance devices you can create to replace the need of therapist (but not always)

With benefits come certain disadvantages:

1 – This sort of a setup blurs the personal and professional lines. Knowing that it’s your residence, sometimes patients do come at odd times, leading to disturbance in personal life (if you lay down a strict guideline of practice from the beginning then still it is manageable).

2 – During your routine hours, if any major emergency arises, then it becomes difficult to manage them simultaneously

3 – Running on limited human resources can pose a challenge if one or two of the staff goes on leave. (I personally feel any staff who saves your time and reduces your stress is worth keeping)

Having followed this for the last 14 years and assessing the pros and cons, I’d say it’s a worthwhile venture to work with the above mentioned model to make your life comfortable and economically cost effective, both for the patients and the doctors.

Dr. Shailesh Gupta
Hand Surgeon
MS (Ortho)
Former Fellow Kleinert Institute Louisville (USA)
Micro vascular Scholar (Taiwan)
Fellow, American Society For Surgery Of Hand
Fellow, Wrist Arthroscopy, Giessen, Germany.
Life Member, Indian Society for Surgery Of Hand

Gupta Hand Surgery Centre
9, Anand Nagar
Chitawad Road,
Indore MP – India – 452001
www.handsurgeryindore.com