Clinical Philosophy and Thinking Are Much More Important Than Surgical Skills?

This is a monologue of a surgeon.

Surgical skills run through the entire career of a surgeon, and to a large extent determine whether the surgeon is good. From the most basic knotting and suturing in the clinic to the special skills in the subsequent specialized surgery, there are skills that can be focused on at each stage. Clinical philosophy and clinical thinking are much more important than clinical skills.

He personally believes that in terms of skills alone, practice makes perfect, practice more, learn more from others, and try to find things on your own, it is certainly not difficult to improve. Which doctor with a large amount of surgery and attentiveness will have poor skills? However, it is rare to see that doctors with a small amount of surgery can perform their surgical skills extremely well. He used to think that in surgery, skills are more important than anything else, but in chats with teachers in various surgical departments, he found that this is not the case. Clinical philosophy and clinical thinking are much more important than clinical skills. Skills can be improved through more practice, but ideas and thinking require you to keep up with the cutting-edge, lifelong learning, review, summary, and contact, and then use them to guide clinical skills. It is the differences in these concepts that have led to the formation of various schools in the discipline, the collision of mutual thinking, and the complaints in each meeting, and then everyone jointly summarizes, analyzes, extracts the essence, removes the dross, and forms the latest and instructive Treatment (including medication or surgical treatment) promotes the development of the entire discipline.

As far as his own professional gastroenterology department is concerned, for example, for gastric cancer, should surgery be done? What is the best technique to choose? What kind of surgery can the patient's condition tolerate? What kind of treatment has the best prognosis for the patient? These are often more important than simple surgery, and the details are constantly being updated. From the early simple subtotal gastrectomy, to the later lymph node dissection, to the subdivision of the different areas of the lymph node dissection in the gastric antrum, gastric body and cardia, and then the development of minimally invasive, laparoscopic, 3D, and rapid maturity of robotic surgery. The current concept of precision medicine is proposed; as well as various updated and iterative chemotherapy, biological treatments, etc., each time a new concept is generated and conflicts with the old concept, and then the new concept gradually gains the upper hand and is used in clinical practice. Develop, mature, and eliminate the original old concept, and then gradually be eliminated by the next updated concept. Step by step, the survival rate and quality of life of patients will get higher and higher. He believes that these things are more important than surgical skills. Of course, it’s not that skills are not important. They are the basis for the realization of the idea. Without this, many things cannot be done. Just like liver tumors, it was considered a forbidden zone in the early days. What about now? In the final analysis, it is also because the skills have been greatly improved, which in turn further affected the update of treatment decisions, and finally reached a new balance: with the current cognition and technology, with the least trauma and cost, the patients can get the most Good treatment results and quality of life.

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