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Careful Preparation

By Joseph M. Sherrill, MD

I appreciate the opportunity to discuss or share with the ASSH Perspective Audience how I emotionally handle bad treatment outcomes, and how these experiences have shaped me as a surgeon.

I am 70 years old and have worked in a busy private practice model since 1980, and more recently in an academic university practice as the hand fellowship director. I, like you, place great pride in the opportunity and privilege of treating patients with hand and upper extremity conditions or pathologies.

The first and greatest step in the handling of bad treatment outcomes obviously involves taking all measures possible to avoid such outcomes. Negative or bad outcomes can be diminished but not completely eliminated by careful practice habits or treatment protocols.

Basic treatment of each distinct patient includes a thorough medical history, including any existing comorbidities and a carefully detailed examination, as well as appropriate imaging. Before any conservative or surgical treatment is initiated, the patient needs to be carefully informed of their diagnosis or condition, and of the treatment options available to them including the risk, benefits, prognoses, and possible complications associated with each treatment option.

If surgical treatment is indicated and recommended, the proper surgical procedure must be performed skillfully, and supplemented with appropriate hand rehabilitation protocols.

However, despite careful evaluation and the skillful execution of appropriate surgical (or conservative) treatments, bad or negative outcomes do occur and must be acknowledged and openly discussed with the patient including available remedies or further treatment options.

There is always something to be learned from a bad or negative outcome, which can serve as an opportunity for self-improvement.

Bad or negative outcomes force me to evaluate my strengths and weaknesses, and to consider opportunities for improving my skillset as a hand surgeon.  Thankfully, through the educational opportunities available by ASSH, such as Hand e; annual self-assessment exams; annual ASSH meetings and monthly periodicals such as The Journal of Hand Surgery, there is much to be considered and learned.

As long as I am confident that I have made a satisfactory evaluation of a patient’s problem or condition and I have openly and carefully discussed treatment options and the risk and benefits, and following informed consent, have performed the appropriate surgical procedure skillfully without intraoperative complications, I am better able to emotionally respond to bad or negative treatment outcomes.

Thank you.

Joseph M. Sherrill, MD
Precision Sports Medicine and Orthopedics
200 Montgomery Hwy., Suite 125
Vestavia, AL 35216

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