BMJ  2003;327:564 (6 September), doi:10.1136/bmj.327.7414.564

Letter

Surgeon is only one influence on outcome

The first 150 words of the full text of this article appear below.

EDITOR—Carter's editorial on the surgeon as risk factor is an interesting assessment of the various determinants of surgical outcome.¹ The surgeon is not, however, an isolated factor but one of many interrelated factors determining surgical outcome. Good surgical results are the result of interdependent multiple factors, including anaesthetic, intensive care, medical, nursing, and paramedical support, and a culture in search of excellence.

The most important progress in the surgical management of patients during the past 100 years has resulted from non-operative components of surgical care: anaesthesia, antisepsis, and asepsis. However, just as all credit for success should not be attributed to the surgeon, neither should all the failure.

Surgeons and patients like to think that the surgeon is the most important ingredient in the surgical outcomes cake. That surgeons account for many referrals to the National Clinical Assessment Authority in England and the Health and Disability Commissioner in . . . [Full text of this article]

frank.frizelle@chmeds.ac.nz

University Department of Surgery, Christchurch Hospital, Riccarton Avenue, Christchurch, New Zealand

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