As Surgeons we are trained to “fix” a problem. If a bone is broken we can use plates and screws to realign it and relieve pain. If someone cuts their finger, we can repair their nerves, tendons, and arteries to restore its appearance and function. If you have an arthritic joint, chances are we have a replacement that we can implant to improve your motion.
But one of the hardest things to do as a Surgeon, is to tell a patient that you cannot help them with an operation. Just think about this… Your patient has worked up the courage to make the appointment, then taken time out of their busy schedule to attend and share their personal story and problems. They have paid to come to you, looking for a solution and you have to tell them that you do not have one? It makes it all seem a waste of time and money right? It’s enough to make you want to just offer a procedure just so it seems like you are doing something.
Just because you can operate, does not mean that you should.
Surgery is traumatic, and not without significant risk. Even the shortest and simplest operation can have complications, and we need to weigh up the risks and benefits based on clinical evidence rather than anecdotal advice. The saying “it works well in my hands” is not scientific enough. We will all be patients one day, and I would like my Surgeon to be honest enough to say they cannot help me, rather than just “give it a go”. Confidence in one’s ability is a necessary part of being a Surgeon, but it should not be clouded by ego. None of us are bigger than Nature.