Surgery is challenging and complex. This is not just the immediate demands of surgical technique.  While the need for surgery may be clear, the decision to operate is often not straight forward.

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Sorting out what is in the best for our patients and most likely to help must be balanced by the surgical risks.

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I remain a fan of the term 'patient' rather than the supposedly more egalitarian 'client'. Patients and doctors understand the terms and implications. Interesting most patients prefer being called patients. While this has been much debated recently it has not added to the pool of therapy available to the 'patient'.

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There is no doubt that acummulted surgical experience is of enormous value. Surgeons are usually better at things they do repeatedly. The surgical results will usually reflect this.

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Good surgical results depend on having a great committed team of colleagues who respect each others skills and work in an institution that genuinely believes in good patient care.