9/0 Nylon

Consultant Surgeon

- honest tweets from the operating theatre -

Hands | Microsurgery | Career Strategy | Intellectual property

[9/0 Nylon @9Nylon]

Surgeons are among the few people left who manage to switch off from all the pings, notifications and alerts, and truly focus an a single, focussed task for a prolonged period.

In an age of attention deficit, our operating lists are therapy.

[9/0 Nylon @9Nylon]

If you want sudden, non obvious leverage in your work or your career you need to import some insights from a different field.

Are you an endocrinologist?

Read a basic primer on software debugging.

Are you a surgeon?
Read some architecture.

[9/0 Nylon @9Nylon]

Similar experience in many specialties

[George Tolis @georgetolisjr]

Many young cardiac surgeons think that most acute dissections need a total arch and all AVRs need a “root enlargement” unless they can get a Ross. That is the direct result of grandstanding “giants” in national meetings, often with very detrimental outcomes for patients.

[9/0 Nylon @9Nylon]

@georgetolisjr Would disagree.

It is safer to tweak an existing process for better outcomes (even if only aesthetic) if the track record is already proven

Perhaps look again at reimbursement to find your entry.

[9/0 Nylon @9Nylon]

Methanol poisoning

[Ryan Feldman (empoisonpharmd.bsky.social) @EMPoisonPharmD]

graphs just hit harder in 1940

[9/0 Nylon @9Nylon]

Rushing never helps. Methodically going over the same steps each time, in the same sequence (eventually) saves time.

[9/0 Nylon @9Nylon]

Things that helped me become a better micro surgeon.

[9/0 Nylon @9Nylon]

As in any surgery, fewer movements and less tissue handling are honed over many years of operating.

[9/0 Nylon @9Nylon]

@nntaleb @hjluks Good to hear.

I think there is a temptation to think that surgical intervention is always a good thing.

Physio (and much patience) are a better option in so many situations.

[9/0 Nylon @9Nylon]

@BladeDoc @georgetolisjr Depends whether lifestyle trumps skillset.

[9/0 Nylon @9Nylon]

Our training is too long.

The system is demands a heavy service commitment.

[Mary-Ann Fox @maffygirl]

@aribindi We love them in Australia!
Extremely well trained and all free to us!
Never met a poorly trained POME.

[9/0 Nylon @9Nylon]

@theveindoc @FunctionsZeta How would you improve or change this David?

[Anthony DiGiorgio, DO, MHA @DrDiGiorgio]

Doctors in large centers don't realize what a life-changer fast operating room turnover times are.

For those that don't know, the turnover time in OR's varies widely between hospitals. That's the time it takes to clean the room and set up for the next case.

In efficient hospitals, especially those that are physician owned, it can be as quick as 20 minutes. In large academic hospitals, it can push 4 or even 5 hours.

Think of the difference that makes for quality of life, patient care, and revenue.

A doctor who has a large waitlist of patients might be at the hospital until 8pm and still only get two surgeries done because the turnover time is so long. That same doctor could get 3 or 4 surgeries done in a more efficient hospital, getting home in time to have dinner with his family.

A physician owned hospital would never tolerate a 4 hour turnover time. That's money being lit on fire. Yet hospitals tolerate this all the time because they don't face competition. There's no incentive to run efficient.

So the patients have to wait longer for their surgery, the doctors get frustrated, and everybody loses.

[9/0 Nylon @9Nylon]

@JHandSurg I vote for lag screws. Neutralisation plates if needed.

The phalanx does not need to withstand the same sort of load as a femur or tibia.

More important considerations include scaring around tendons.

[9/0 Nylon @9Nylon]

What if I told you there’s a hospital department where the most senior consultants voluntarily do the weekend on-call rota?

Not because they have to.

Because their colleagues have young children.

[9/0 Nylon @9Nylon]

@surgeonramirez @SAGES_Updates Beautiful.

[9/0 Nylon @9Nylon]

This is not said often enough or loudly enough.

Bad for surgical training but also bad for producing good quality research.

[George Tolis @georgetolisjr]

The current surgical education system forces all candidates to claim that their goal is to be an academic surgeon engaged in research and teaching, when in fact they may just be interested in a quiet rural general surgical practice that greatly benefits a local community.

[9/0 Nylon @9Nylon]

Eye opening.
We know this what happens…

[Anish Koka, MD @anish_koka]

Better things to do than spend Saturday morning writing this, but important since there aren't enough actual journalists who can do their job. (link in reply)