“@Atul_Gawande: #Surgical skill reduces #complications, operative time, death rate. Duh. http://bit.ly/1cAAqdb prob true in #ortho too
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@Atul_Gawande@dr_coops one of the best ratings of#surgical skill is to ask the OR staff.They see the daily reality and deal with the comps -
@DrSWeinstein@Atul_Gawande@dr_coops More difficult with long term outcomes eg continence post-prostatectomy. Theatre staff love speed too.
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@Atul_Gawande@dongyue Old adage: there are good fast surgeons/ bad fast surgeons, but no good slow surgeons.Thanks. Twitter will use this to make your timeline better. UndoUndo
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@Atul_Gawande So do high volumes make better surgeons or do better surgeons just attract higher volumes? I've always suspected the latter. -
@PaedNeurosurg@Atul_Gawande you need Both to make better surgeons -
@AANeurosurgeon@Atul_Gawande. But throwing lots of cases at poor tech surgeon not solution. Clearly not linear relationship vol vs outcome -
@PaedNeurosurg@Atul_Gawande absolutely!! There's a bit more to it.. See my other tweet where I reveal#thesecret ;)!!
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@Atul_Gawande Any evidence to help a trainee become more skilled? More elegant? Numbers, obviously. But how can one learn style?Thanks. Twitter will use this to make your timeline better. UndoUndo
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Message is if there is a high death rate, asses the technical skill before assuming it's the surgeon to blame and re-train
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@Atul_Gawande 5th quintile surgeons might be shocked to learn their rank, as most people think they are above ave. That info might motivateThanks. Twitter will use this to make your timeline better. UndoUndo
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@Atul_Gawande UK dogma:'y'% of practice must be procedure 'x' to maintain quality is nonsense & outcome data confounded by skill variationsThanks. Twitter will use this to make your timeline better. UndoUndo
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@Atul_Gawande But how can the average patient tell good from bad when picking a doctor for weight-loss surgery?#obesityThanks. Twitter will use this to make your timeline better. UndoUndo
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@Atul_Gawande What can be done to increase surgical skills and improve patient safety? Mentorship? Simulations?Thanks. Twitter will use this to make your timeline better. UndoUndo
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HT
@Atul_Gawande Sur Skill Complication Rates after Bariatric Surgery@nejm http://www.nejm.org/doi/full/10.1056/NEJMsa1300625?query=featured_home#t=abstract … cc:@TomVargheseJr#ACSCC13@jcolbertMDThanks. Twitter will use this to make your timeline better. UndoUndo
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