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Tomaino Arm Care Network

Dr. Tomaino's Blog

Will you be doing my surgery?

October 11th, 2008
This is a common question in the office when I schedule surgery. And my answer is, as you might expect, "Yes---I will do every aspect of your surgery, from ensuring that you are comfortably placed on the operating room table until the last stich and dressing are placed."

You might ponder the basis for the question; it stems from the reality that at many University Centers, Resident-physicians in training are "leveraged" in order to "extend capacity". In other words, there is only so much time in a day, so if a System is unable to "reengineer processes" to improve "operational efficiency" another strategy is used to increase the amount of work that can be completed in a day. One common method is to assign certain components of the work required to others---thereby increasing the total amount that can be accomplished.

Understandably, if you are the patient, and components of your surgical procedure are being assigned to someone other than your surgeon, this may cause you concern. Afterall, isn't every stich placed, every detail of your procedure critical to you?

Obviously you deserve and expect a level of safety and quality that is not only "best practice" but acceptable to the man or woman charged with your care--your surgeon.

So, ask the question---"Will you be doing my surgery?" Look your surgeon in the eye and be comfortable with the answer. Most importantly, feel comfortable in requesting accountability.

Can a physician in training close your incision or put your dressing on? Ofcourse. But, when it comes to the entirety of your surgical procedure, isn't it intuitive that your surgeon, with his/her years of experience, wisdom, skill and judgement, should either be performing your surgery or, at the very least, carefully supervising it?

During my 15 years of serving as a
Teacher,Professor, and Surgeon at two University Medical Centers, I never failed to appreciate how important each and every surgery was to the person--my patient-- on the other end.

Since leaving the University of Rochester to start my own Specialty Practice in Shoulder, Hand and Elbow , the question of who will be doing my surgery persisits, nonetheless. And my answer is the same as it has always been. But, now that my Name is on the door, I have a keener appreciation of why the question is asked. When your destination for Care is a Person and not a Place, there is an unparalleled degree of accountability and commitment to you. That's a given. No leveraging someone else. No extending capacity by shifting work to others.

It's my privilege to treat you, not the other way around.

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