Preface
2013; Elsevier BV; Volume: 40; Issue: 4 Linguagem: Inglês
10.1016/j.cps.2013.09.006
ISSN1558-0504
Autores Tópico(s)History of Medical Practice
ResumoI am very honored to be the guest editor of this edition of Clinics in Plastic Surgery with a focus on local anesthetics. For many years, my staff has humored me each and every time I said, “I have an idea!” I have performed many operations using local anesthesia, from bilateral breast reductions, abdominoplasties, full face and open brow lifts, to microsurgical digital replantation. Plastic surgery is almost by definition an innovative field that inevitably changes with the times. Today, much cosmetic surgery is performed by non-plastic surgeons. This issue of Clinics in Plastic Surgery has a great group of diverse authors with tremendous experience in their respective fields, including anesthesia, dermatology, ophthalmology, orthopedic surgery, otolaryngology, business, and, of course, plastic surgery. The first few articles focus on the use and benefits of local anesthesia procedures. The remaining articles describe, in detail, select surgeries without general anesthesia, in various fields. It seems as if we have silos of information and experience, which are separated only by geography. Recently, in the 21st Century, with the Internet, social media, video conferencing, eBooks, and virtual assistants, the world has become flattened. It is so much easier to learn our own field and everyone else’s with a gentle embrace of technology. Efficient logistic systems of knowledge are now enjoyed by many fields even outside of medicine as some patients are sometimes more aware of current developments than their doctors. Patients want surgical care that is fast, high quality, and inexpensive. Unfortunately, most health systems can only provide two of these three. In order to maintain consistency with a high quality of care, the American Association for Accreditation of Ambulatory Surgical Facilities has helped to establish the expected standard of care in over 2000 facilities. As to cost, economics will always play a role in the practice of medicine. As to time, in a world where there is an economy of time and movement, there are many fixed commodities. We all have the same number of hours in a day. We cannot bank or deposit our time, so we should focus on how we spend it. The entire paradigm shifts, however, when we leave the confines of a hospital setting for a privately run facility. The scheduling, staff cooperation, stresses, and overall friendly environment are all important considerations. Ultimately, patient care should be the final factor. There are tradeoffs in every practice decision or career decision. The hardest practice decision, in my opinion, is really in the change in yourself. A few years ago I took my first golf lesson, as I never learned to play properly. I was the “Happy Gilmore” of golfers. The 85-year-old golf pro asked me a question in the end, “You spent your first 40 years golfing left. Do you want to spend the next 40 golfing ‘right’?” From this, I knew he meant, “correctly.” We are creatures of habit, especially after years of training and even more years of practice. To actually convince an established surgeon to change his practice without a serious impetus is like changing handedness. You really have to want to change. I am deeply indebted to Elsevier for this wonderful opportunity to be a contributor and guest editor to this volume of Clinics in Plastic Surgery. I greatly appreciate all of the authors’ and assistants’ contributions through their unique experiences and expertise. I would also like to thank Ms Joanne Husovski for her tremendous guidance and support in the preparation of this issue. I would like to acknowledge the assistance of my staff, especially, Kim, Vikki, Patti, and Sarah, for keeping the practice together. I thank my loving wife, Dr Sarah Danial, and three sons, Musa, Eesa, and Yousuf, for their unconditional love and continued support during this and many other on-going projects. I thank God, for the ability to see and learn from my teachers and patients and to deliver ideas in this issue that may grow to a significant contribution to surgical literature.
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