Minimal access and Obesity surgery – Are we going in the right direction?

What happened to the great Indian Surgeon who would put his firm hand on the abdomen and said, “You have Appendix; you will need surgery.” The patient would look worried which was exactly what the surgeon was expecting as this would mean that his diagnosis has made the right effect and the patient is taking it very seriously. There is no scope of ‘if’ or ‘but’, that is the final verdict and the Judge has given a verdict…. that’s it. The patient almost always had to opt for the knife if the surgeon in his booming voice said so. The era of the ‘Great Indian Surgeon’ is alas gone. Good! that had to happen! The surgeon on the high horse had to come down. The patients’ are no more simple kids to get bullied but they are professionals who rule the world. They are the best in the IT world and they have a big source of alternate knowledge called the NET! So beware guys, these guys can’t be fooled.

But is it having the right effect on the health system or are we getting ourselves into a ‘Tar Baby Syndrome’ which is killing clinical acumen and putting more stress on not only the insurance companies who really don’t know why the cost of surgeries are going up but also subjecting the patients to unnecessary investigations?

A surgeon who has some amount of clinical experience also develops a gut with a sixth sense. Believe me when I say this, most of the additional investigations are done to prove a point or a diagnosis were already known to the surgeons (their sixth sense gut feeling knew!) So where did we go wrong? As a surgeon, I experience it every day, day after day. The pressure is what I talk about! The pressure of too much knowledge, some right, some wrong but it puts pressure. So what do we do? Write more investigation and than more investigations…. When will it stop?

The problem is the communication. The solution is also ‘communication.’ I think the key is not to feel threatened and not to have our egos get the best of us. Let the questions come. The Net is the friend and not a foe. Don’t let the quality of our clinical knowledge come down under the pressure of too much investigations.

May the Great Indian Surgeon survive under this new and improved avatar!