What does ‘falling behind’ mean… and how can I avoid it?

I had the great fortune learning laparoscopic surgery from Dr Tony McCartney, a gynaecological oncologist and surgical pioneer in Perth, WA. He invented the McCartney Tube, that many of us use often to perform Total Laparoscopic Hysterectomies. Tony once told me: “Andreas, if you your surgical technique has not changed in the last 10 years, you are doing something wrong.”

What he meant was: In medicine and surgery, advancements over time keep raising the bar. New technologies and better methods improve how doctors treat patients, making treatments safer and more effective. From minor surgical procedures to major ones, progress means patients have better outcomes, recover faster and complications become less frequent. As doctors learn more and use better equipment, patients and consumers expect even higher standards of care. So, each step forward in medicine and surgery pushes the limits, making healthcare better for everyone. But each advancement also raises the standard for surgeons to keep up with.

Imagine if we would still suture vascular pedicles; or keep patients on sips of water until they pass wind? Surely anyone still doing that would be considered have fallen behind.

Remaining at the same level of practice standard will guarantee you fall behind over time. If you are pre-retirement, you might be able to get away with outdated practices. If you are early or mid-career, the chances are you will not. 

The purpose of me sharing Dr McCartney’s invaluable lesson, is that I also want to share a relatively new way to avoid falling behind, that pertains to managing patient wellbeing and happiness, and ultimately better relationships with them.

One of the hallmarks of practicing modern medicine is consumer involvement and patients having their say. I appreciate there are always two sides to this, but most medical professionals would agree that the ultimate aim of our surgical procedure (and the patient’s reason for undergoing it) is that the patient experiences some improvement. 

Many of us check up on our patients via phone calls. I still have a clinician employed who rings patients postoperatively to make sure our patients are doing OK. But overall we have scaled phone calls back a little because we have a better tool that we started to deploy five years ago. 

A new tool to avoid falling behind, that pertains to managing patient wellbeing and happiness

The tool we use (ahead of phone calls) is SurgicalPerformance PROMS, which is an automatically generated SMS survey sent to the patient’s phone. 

Here is what we have learned in my practice using PROMS versus phone. 

  1. PROMS get answered by 75% of patients, which is a very high participation rate. 
  2. By contrast, our phone answer rate is sometimes less than 50% and that includes leaving messages on voicemail and playing phone tag and finally – finally – get the patient on the line. 
  3. When I ask my patients what they prefer – phone versus PROMS – they all say PROMS. They can answer the questions in their chosen time. By contrast, when we call them, sometimes the time is not convenient, for example when they are standing in the checkout line in the grocery store. 
  4. We continue to call patients with poor PROMS scores or with lower than expected patient satisfaction scores. And those are the calls and conversations we are keen to have! Some of those patients include those who are elderly (I treat many of these) and who are not familiar with smartphones (“Please call me on the landline”). 

I realise, as surgeons we are a target group for sales people. I also agree that we should not participate in every innovation and apply all modern technologies just because they exist. 

However, SurgicalPerformance PROMS has now been utilised for many years; its technology is mature and tested widely; adoption amongst surgical colleagues is very high; and feedback from patients as well as from medical professionals has been very positive. 

Maybe it’s time to give up on some of the phone calls, do less chasing of patients on the phone, and instead give your staff more useful tasks to do… in order to stay at the forefront and not, heaven forbid,  fall behind.