Out with pacey surgical ward rounds; pain controlled, E+D, BO, OE – alert, obs stable, neurovascularly in tact, plan – drain out, fluids down, OT/PT, home when safe, OP 6/52. Out with debates about thromboprophylaxis, clotting and bleeding. Out with preadmission clinics. Out with being the crash team leader – I’ll not be sad to relinquish that duty. And in with a new hospital, a new team, and a new specialty.  I packed my bag after my night shift as the orthopaedic SHO oncall, left for good, and began preparations to start in paediatrics the next day, whatever that entails. more…

JAMA  1 Feb 2012  Vol 307
467    We of a physicianly disposition may not like to admit it, but throughout history surgeons have been well ahead of physicians at looking critically at their outcomes. For example, rates of re-operation have appeared in case series reports for well over a hundred years, so this paper on re-excision in breast-conserving cancer surgery is less innovative than it might seem, except that it goes further and looks at variability between centres and surgeons. more…