JTO - September 2019
Volume 7 Issue 3
From the Executive Editor
No success without succession; whether it pertains to a species, a religion, an association, a profession or a speciality, this adage highlights the risk of aging without renewal. T&O currently has an environmental niche and there is a young generation who could populate it. However, it is probably better to plan succession than to presume it. We should continue to demonstrate the need for, and value of T&O surgery, whilst also making it look attractive to potential successors.
A constructive response to problems of patient care will maintain the respect and support of patients and community, and consequently secure the niche those groups allow us to occupy. Learning lessons from the setback of being presented with adverse observational data is a presumed consequence of registries. Identifying problems should stimulate progress, not entrenched defence; the article on ‘The experience of an outlying unit…’ (page 36) exemplifies this. This responsive approach to problems can be generalised and an initiative to collate and learn from litigation data has led GIRFT to produce new “BOAST type” guidance for operating theatre record keeping (page 46) to make practice more resilient.
We can revise and smooth the pathway for our successors. The article ‘New era in T&O Training’ (page 58) introduces the changes in training coming along with the new curriculum. A competency rather than a time based approach will be followed. New techniques and technologies also allow new approaches to training and we look at the impact of Simulation (page 54).
The outward concepts and attitudes of an organisation may evolve spontaneously, but what might be regarded as its organisational DNA needs positive action to change or it will lag behind and become outdated. Phil Turner describes the structural changes to committees and strategies that are being introduced to accommodate and allow the BOA to progress (page 10).
An advantage of our in-house journal is that we can be a little irreverent. Illustrating an article on clinical photography with lamb chops (page 48) may seem childish but is practical, cheap and may deliver a message in a way which sticks.
‘Humorous’ messages or phrases can stick when unwanted too. We T&O surgeons may view ourselves as being responsive and caring, but sadly these views may not to be shared by all. Like it or not there is a ‘humorous’ stereotype of an Orthopod which is not necessarily attractive to the public or our potential successors. Recognising the existence of such stereotypes is a start but not an end; there are three articles relating to this (pages 40-43). To broaden our appeal to potential successors we need change our image, not a photoshop patch up, but where necessary addressing underlying, uncomfortable truths.
Should no-one follow us into T&O what would happen; nature abhors a vacuum. Indeed, a vacuum may well be a problem for the profession but not necessarily for an individual patient. Demonstrating this, the specialty section gives three perspectives on negative pressure wound therapy (pages 64-73). No success without succession. Maintain the niche with adaptability and responsiveness, and generate wider enthusiasm by consigning restrictive and unattractive stereotypes to history. Progress and reward should depend on competency not ‘sucking up’, unless of course the objective is wound healing.
Bob Handley, Vice President Elect
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- Closed incision negative pressure wound therapy in orthopaedic surgery
- Keeping the WOLLF from the door or WHISTful thinking?
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