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• Use it or lose it. Some surgeons, delighted that they reached the elite
2-Room Club, decide to kick back and dial down their volume. "Two
Roomers" are often more senior and perhaps more interested in fixing
their golf swings than in filling their schedules. When the 7:30 a.m. to 5
p.m. block ends at 1 p.m., however, it may be time for them to join the
Senior PGA Tour. Their block time is on life support.
• Time release. Our administrators ask surgeons to release their block
time several weeks in advance so that other surgeons can fill the time,
but many ADHD-riddled surgeons simply forget to inform their staff
of absences. Repeat offenders may find themselves on the block time
cutting board.
• Make the grade. Once you earn your block time stripes, you must
maintain them. Surgeons age, many don't keep up with technology and
surgical innovations, and some merely lose their edge. What once took
30 minutes is now an arduous 3-hour affair. Two cases a day just does-
n't make it in today's world. Some surgeons test the system and book
complicated cases that clearly belong in the main hospital. The project-
ed 5 p.m. finish really resulted in an 11 p.m. extravaganza and an,
ahem, unplanned hospital admission. Did the multi-ligament knee
reconstruction with tibial plateau and distal femur fractures really
belong in the surgicenter?
Policing the schedule
The hard calls nurses make to surgeons are by no means easy, yet they
are necessary. Block time is a precious commodity and should be treat-
ed with appreciation and reverence. I do not take mine for granted and
for now, at least, it is far more important than my golf swing. OSM
Dr. Kelly (johndak4@gmail.com) is an orthopedic surgeon/
sports-shoulder specialist who practices in Philadelphia, Pa.
