Are you measuring risk from overlap? Or are you inadvertently measuring complexity? The other key feature is that emergency surgeries with overlap had a much more rapid time to increased risk - this suggests overlap doesn't work well with complex cases.
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But in elective, planned cases, if the surgeon has a mature, efficient system and well trained support staff, senior residents and assistants, the evidence instead suggests the attending surgeon does not need to micromanage the less complex parts of an operation.
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I have no dog in this fight. I do not overlap surgeries or have any interest in it.
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Oh, now I see who York is, it's our chance to mock a patient for DIY sex toys. I take this mildly personally, guess who gets called when things get stuck. General surgeons. It's all fun and games until you need an ostomy.
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We could use this as an opportunity to educate people on the importance of a flange.
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Nurse insists that Dr. Sociopath is the best for patient dragged in by her son. That is debatable, he's a creep. She has a "abnormal pulsation in her abdomen" and orders a CT. Maybe ultrasound first? That's standard. I guess if you had high clinical suspicion...
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New plotline, HODAD selling his technological device. Crudite used as sign of eminent corruption.
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Back to mom dragged in by son. I'm impressed he knew that mom needed an aneurysm repair. That's usually a pretty silent killer. But yes, 7cm aneurysm? In a woman? That young? Get that fixed. EVAR time.
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Ok, back to DIY anal toy guy, they have left the intern to remove the object from an awake patient! What?!/!11!. No. Anesthesia, twilight at least required. It is also not a simple prospect, risk of perforation is significant. Again, intern torture for drama.
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Now HODAD is forcing a postcall resident to stay for an afternoon case. Granted I trained after the new rules. But I have never, ever, seen that happen. It probably helps that in house residents (1,2,3s) are junior and are pretty ancillary when it comes to complex cases.
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Under the new rules (well, not so new anymore—it's been at least seven or eight years now, I think), that'd be a work hour violation for sure!
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