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Invaluable Surgeon-Surgeon Advice

By Sonia Chaudhry, MD, FAAOS

We have all had the experience of asking a colleague about a difficult case and receiving prompt advice. Most often we get technical pearls, but just as importantly, one can point out differential diagnoses to consider, crucial diagnostic workups, equipment to have available, or postoperative considerations, to name a few. If our colleague affirms our surgical plan, we proceed with more confidence. When the advice tweaks our plan, resulting in an improved outcome, we may feel mixed emotions. There is the satisfaction of having provided better patient care, gratefulness to our mentors, and a third slightly scary sentiment, the feeling of a “near miss.” 

“Near miss” has become a buzz word in patient safety, but its application should also be for the best possible patient care. What if I had just done it the way I planned? What if I was rushing and didn’t take the time to ask? What if my mentor was in a rush and didn’t take the time to respond? No amount of literature review can replace these invaluable texts, emails, or quick phone conversations with our personal network of go-to hand gurus. It is ironic that expensive and time-consuming national conferences, useful as they are for networking and CME quotas, cannot hold a candle to a couple days spent shadowing other surgeons in the OR in terms of educational benefit. Counterintuitively, it also seems that the further I am into practice, the more I learn every time I observe one of my mentors or confer with colleagues. Perhaps that is why our job is termed “practice,” as knowledge builds upon knowledge. 

Hand surgeons may supplement their clinical income with insurance reviews, litigation work, or industry lectures, yet we would never dream of charging for the most valuable and irreplaceable commodity we have to offer: nuanced patient care advice based on our cumulative experience of study, practice, research, and collaboration. Personal coaching and wellness are increasingly monetized as businesses, yet my personal wellbeing is most boosted when I know I am delivering the best care possible, either affirmed or enhanced by the freely given advice that I can trust. We give our expert opinions generously and endlessly to each other, content to improve care for a patient we will never meet. In our ever-advancing technologic world of apps, virtual lectures, and online modular learning, it reassures me that nothing will ever replace or compare to good old person to person advice given selflessly. A Zen master once said, “always maintain the attitude of a student.” To this I would add, “especially when the tuition is free and the return on investment is high.”

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