One Stop Surgery Would Save Time and Money
A number of minor surgical procedures could be performed under a single anaesthetic, saving time, and expense for both the patient and the health care system, according to an article published in the current issue of the Medical Journal of Australia.
Author of the report, Dr Raymond Wilson, general practitioner and visiting surgeon at the Hurstville Private Hospital, says there's a place, at least in our major cities, for appropriately trained and recognised general surgeons, to treat patients who have more than one minor condition requiring surgery.
Once the domain of the general practitioner, simple surgical procedures have been referred to specialist surgeons, because of training, indemnity and bureaucratic issues.
The number of general surgeons has dropped by 20 per cent over the last nine years, and at the same time surgeons are becoming increasingly specialised.
"In the metropolitan setting today, for example, general practitioners find that colorectal surgeons are loath to perform gastroscopies at the same time as colonoscopies, and the reverse is true for upper gastrointestinal surgeons," Dr Wilson said.
"Ear, nose and throat surgeons would baulk if asked to remove some troublesome skin lesions while performing a tonsillectomy.
"This may be because they recognise the rights of their fellow specialists and are reluctant to intrude into their subspecialty.
"A surgeon prepared to treat all of the patient's current surgical problems is more likely than one who is focused on a subspecialty to consider the patient as a whole, and spend more time taking a history and doing a comprehensive physical examination.
"Such a general surgeon, provided he or she did not stray into major or complicated specialist surgery, would win the confidence of both GP and specialist colleagues, and generate a demand for this lower-level multi-specialty service," Dr Wilson said.
On the downside, the author says there is the possibility of unnecessary surgery. Increased complication rates from multiple surgery are also a possibility, although highly unlikely.
The author outlines a number of cases in point, where patients could be offered the convenience of a single operation and anaesthetic for multi-specialty procedures.
In the same issue of the journal, Dr Martin Bruening and Professor Guy Maddern say advantages to patients of a single anaesthetic for more than one operation are obvious, but attracting generalist surgeons, training them and ensuring they have adequate credentials remain hurdles.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT Dr Raymond Wilson 0418 402 372
Judith TOKLEY, AMA Public Affairs, 0408 824 306 / 02 6270 5471