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One person's innovation is another's experiment

BMJ 2000; 320 doi: (Published 03 June 2000) Cite this as: BMJ 2000;320:1548
  1. Robert Wheeler, consultant paediatric and neonatal surgeon
  1. Southampton

    Surgical innovation is necessary, but there is pressure to impose standards on to the innovator normally associated with formal research.

    Developments in surgery often involve minor refinements and adaptations of well recognised techniques. For such developments, a surgeon can rely on his good standing, peers, and peripheral evidence for support if complications arise.

    There is a conflict of interest between the innovator and the doctor

    Occasionally, however, surgeons may be faced with an emergency situation for which there is no complete conventional solution. The ingrained teaching would be to do nothing controversial. This doctrine, however, may result in the prospect of further surgery, and possible complications. The operating surgeon may have a bright idea offering a better solution, albeit neither tried nor tested.

    Alternatively, a specialist surgeon may be struggling with a small population of elective patients with a particular unsolved surgical dilemma. The surgeon has …

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