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What makes someone a bad surgeon?
#1
I hear this more often that I would have anticipated -- "X has a reputation for being a bad surgeon" 

What usually makes an attending bad surgeon? 
I don't hear people talk about differing levels of competence as much in medicine. Are surgical fields more prone to having a greater variance in skill level -- or is it just more noticeable? Just surprised a notable proportion can make it through PGY1-7/8 and still be considered incompetent by people (some who have are not yet attendings)
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#2
Someone who has no insight into their capabilities thus doing surgeries they shouldnt be doing and putting patients in danger
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#3
Also, poor decision making. Sitting on an obvious surgical lesion or operating on something that could have been better managed with a different intervention or observation.
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#4
(07-08-2022, 08:48 AM)Guest Wrote: Someone who has no insight into their capabilities thus doing surgeries they shouldnt be doing and putting patients in danger

This is easy for a med student/resident with no skin in the game to say.

How do you think the Spetzlers, Al-Meftys, Heros(es), Yasargils et al of the field got that way? They are definitely gifted but they also hurt some people, thought really hard about why it happened, practiced more, and made themselves better. But they couldn't even be in that position unless they took on the tough cases.

Yes community spine surgeons shouldn't be doing petroclivals but to build a practice, reputation, and skill set you have to take on cases that will make you a little uncomfortable especially early in your career

The only way you can justify doing a case that you know someone else can do better, is to learn all you can from it.
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#5
(07-08-2022, 09:53 PM)Guest Wrote:
(07-08-2022, 08:48 AM)Guest Wrote: Someone who has no insight into their capabilities thus doing surgeries they shouldnt be doing and putting patients in danger

This is easy for a med student/resident with no skin in the game to say.

How do you think the Spetzlers, Al-Meftys, Heros(es), Yasargils et al of the field got that way? They are definitely gifted but they also hurt some people, thought really hard about why it happened, practiced more, and made themselves better. But they couldn't even be in that position unless they took on the tough cases.

Yes community spine surgeons shouldn't be doing petroclivals but to build a practice, reputation, and skill set you have to take on cases that will make you a little uncomfortable especially early in your career

The only way you can justify doing a case that you know someone else can do better, is to learn all you can from it.
This is true. Nobody starts practice and is immediately at peak capability. Those that do graduate know enough to practice, and we trust those people to know when they can manage a condition and when they should pass something off to someone more knowledgeable. The bad surgeons are those who don’t think of ways to improve, blame complications purely on external factors, or truly don’t know what they don’t know.
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#6
(07-08-2022, 09:53 PM)Guest Wrote:
(07-08-2022, 08:48 AM)Guest Wrote: Someone who has no insight into their capabilities thus doing surgeries they shouldnt be doing and putting patients in danger

This is easy for a med student/resident with no skin in the game to say.

How do you think the Spetzlers, Al-Meftys, Heros(es), Yasargils et al of the field got that way? They are definitely gifted but they also hurt some people, thought really hard about why it happened, practiced more, and made themselves better. But they couldn't even be in that position unless they took on the tough cases.

Yes community spine surgeons shouldn't be doing petroclivals but to build a practice, reputation, and skill set you have to take on cases that will make you a little uncomfortable especially early in your career

The only way you can justify doing a case that you know someone else can do better, is to learn all you can from it.

The surgical profession is shit. You should be doing the case in collaboration with the more qualified surgeon in order to not harm the patient and learn at the same time. and ethically you know that is what you should be doing. fuck you all
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#7
Do we have a psychosurgery DBS candidate in our forum?
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#8
(07-09-2022, 04:07 AM)Guest Wrote:
(07-08-2022, 09:53 PM)Guest Wrote:
(07-08-2022, 08:48 AM)Guest Wrote: Someone who has no insight into their capabilities thus doing surgeries they shouldnt be doing and putting patients in danger

This is easy for a med student/resident with no skin in the game to say.

How do you think the Spetzlers, Al-Meftys, Heros(es), Yasargils et al of the field got that way? They are definitely gifted but they also hurt some people, thought really hard about why it happened, practiced more, and made themselves better. But they couldn't even be in that position unless they took on the tough cases.

Yes community spine surgeons shouldn't be doing petroclivals but to build a practice, reputation, and skill set you have to take on cases that will make you a little uncomfortable especially early in your career

The only way you can justify doing a case that you know someone else can do better, is to learn all you can from it.

The surgical profession is shit. You should be doing the case in collaboration with the more qualified surgeon in order to not harm the patient and learn at the same time. and ethically you know that is what you should be doing. fuck you all
I dont think you can justify doing a dangerous or unqualified surgery by saying it will help hypothetical future patients. The masters u mentioned may have done it but was a completely different era.
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#9
(07-09-2022, 09:23 AM)Guest Wrote:
(07-09-2022, 04:07 AM)Guest Wrote:
(07-08-2022, 09:53 PM)Guest Wrote:
(07-08-2022, 08:48 AM)Guest Wrote: Someone who has no insight into their capabilities thus doing surgeries they shouldnt be doing and putting patients in danger

This is easy for a med student/resident with no skin in the game to say.

How do you think the Spetzlers, Al-Meftys, Heros(es), Yasargils et al of the field got that way? They are definitely gifted but they also hurt some people, thought really hard about why it happened, practiced more, and made themselves better. But they couldn't even be in that position unless they took on the tough cases.

Yes community spine surgeons shouldn't be doing petroclivals but to build a practice, reputation, and skill set you have to take on cases that will make you a little uncomfortable especially early in your career

The only way you can justify doing a case that you know someone else can do better, is to learn all you can from it.

The surgical profession is shit. You should be doing the case in collaboration with the more qualified surgeon in order to not harm the patient and learn at the same time. and ethically you know that is what you should be doing. fuck you all
I dont think you can justify doing a dangerous or unqualified surgery by saying it will help hypothetical future patients. The masters u mentioned may have done it but was a completely different era.

There’s the one “best” surgeon in the world and all the rest. There is a wide chasm between unqualified and the best. Just because you aren’t the best in the world doesn’t mean you can’t operate safely. If you get to operate independently, you will know what you are able to do safely and what cases you shouldn’t touch without more training. Advancing the field is now done with patients’ informed consent and IRBs.
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#10
Research as shown that women make significantly better surgeons and medical doctors than men

https://jamanetwork.com/journals/jamaint...ct/2593255

https://www.bmj.com/content/359/bmj.j4366

It is deeply unfortunate that women continue to face discrimination despite these facts. Considering these outcomes, we should be actively promoting a 50:50 M:F ratio in surgery--as other fields are doing. And having >50% women surgeons would be even better in terms of patient outcomes.
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