Embrace the new by keeping the patient front and center

Editor’s note: This is the conclusion of the address given by Dr. Goldsmith during the 2012 annual clinical assembly of the American College of Osteopathic Surgeons (ACOS), Sept. 30-Oct. 3 in Chicago.  His one-year term as ACOS president concluded during the assembly.

Eirc Goldsmith and President Franklin I remember a time when physicians were respected members of their community, and physicians respected and were responsible to their community. I remember when a family physician would come to your home, examine you, maybe give you a shot of penicillin – and tell you everything would be okay. I remember when physicians would leave the phone number of the restaurant they would be dining at or check in after a movie with their answering service.

I remember a time when few knew who a D.O. was or what they did….

I will never forget the long days and sleepless nights blending back into day of my surgical residency, my brain and my body being forced to function. When there was no function, we would slip quietly into a corner chair and pull out our “peripheral” brain notebook, and slowly thoughts of patient care would creep back and orders written. There were grand rounds, lectures, questions and answers where no matter how perfectly you thought you had prepared, you ended up standing hapless and helpless as everyone took their turn at you only to be finally questioned by the chief of the surgery, better known as the Grand Inquisitor.

I remember a time when everyone worked for the benefit of the patient, day and night, tired, hungry – but always together.

Today we have cell phones, work-hour limits, kinder and gent-ler physician and resident education meetings, electronic medical records, robotic surgery, computer-based learning. This week, a D.O. will sit beside an M.D. in a panel discussion at the 100th American College of Surgeons Annual Clinical Congress.

Today we are poised to cross that boundary into a new world of the Accountable Care Act, Pay for Quality and Outcome, and the American Osteopathic Association’s Osteopathic Continuous Certification Process, or OCC, designed to meet the standards for ongoing physician assessment through lifelong learning and continued practice improvement.

I feel we as surgeons can embrace the new. We can do this by never forgetting the past.

Do we really want to harass house staff, work 36 hours straight, scribble something no one can read? Do you want to type into a computer with your back turned to your patient? Would you like to work a robot, or do you enjoy performing laparoscopic surgery?

What about obtaining a CAT scan in lieu of an exploratory laparotomy? Do we need patient-centered care, or was the patient always at the center of your care and caring?

The ancient Chinese philosopher said, “The first step to knowledge is to be aware of our own ignorance.” Thus, the greatest lesson I ever learned in my life was to TAKE A STEP BACK. A step back from a situation provides a more clear understanding of the circumstances at hand. Only then can we proceed with renewed perseverance, fortitude and vision.

Remember we as surgeons have been given the training to repair the human body. An awesome responsibility afforded to only a few; to be so privileged is the highest honor!

Let us not ask what will maintain the status quo, but what we as individual surgeons can do to preserve the sanctity of our patients and of our professional future.

In these difficult times to ponder these challenging questions – let us all take a step back.

Eric A. Goldsmith is a board-certified surgeon in Fort Myers, FL, and medical director of academics and medical education at the Lee Memorial Hospital System. President of the District 11 Society of the Florida Osteopathic Medical Association, he has served in several teaching and director roles over the past two decades. He is a fellow of the International College of Surgeons and the American Society of Abdominal Surgeons as well as of the ACOS, which he has served in leadership positions. In the photo above, DMU President Angela Walker Franklin, Ph.D., presents Goldsmith with a certificate of achievement from the University.

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