"What is a vision"
What is a vision? Tim Wallace, MD FRCSC Otolaryngology – Head and Neck Surgery Deputy Chief of Perioperative Medicine Cumberland Regional Health Care Center Lecturer, Department of Surgery Dalhousie University “Why Are You Here?” It all started with a woman…a thought…and a dream Married the woman… Still thinking… Making the dream a reality… Let’s start with the thought… Practice good medicine Treat people with care Make positive changes Help colleagues Train Students, Residents, and Physicians Maybe do a little research John Hunter 1728-1793 Scottish Anatomist and Surgeon William Halsted 1852–1922 Father of American Surgery Father of Surgical Subspecialities Inventor of Surgical techniques of breast removal, thyroid/parathyroid surgery, and abdominal surgery First for surgical gloves Local Anaesthetics – Cocaine/Morphine Father of Surgical Residencies Ear Surgery (Hearing and My Practice… Dizziness) Nose Surgery (cosmetic) Sinus Surgery Cancer Surgery of the Head and Neck Facial Trauma Surgery Vocal Cord Surgery Minor Surgery of the Upper Esophagus Thyroid Surgery Surgery for Skin Cancer Pediatric Surgery for Apnea Sleep Disorder Surgery Treatment for other non-surgical disease states Vocal Polyposis The Four Doctors 1906 John Singer Sargent The start of a small little hospital…John’s Hopkins Hospital The Vision Credibility Accountability eNergy Dr Chris Oung – a pioneer Dr Marquis Okon – Obstetrics and Gynecology Dr Aqeel Al-Aqeel – General Surgeon Dr Paul Van Boxel - 10 years ago Dr Andrew Orr - Ophthalmologist Dr Allan MacDonald – General Surgeon Dr Jagadish Baliga – General Surgeon Dr Manju Abeysekera and Dr Ruidong Sun Anaesthesia In the last 18 months… How are we getting there… Treating the people that have always been there Treating those who were previously going to other places Treating those from away…who are looking for quality care Repatriation Stats Between 2001-2002 and 2004-2005, there was a 50% decrease in the number of Cumberland County patient days in Colchester (Truro). In the last two fiscal years, a total of 3512 patient days were repatriated from New Brunswick hospitals. (A $950/day average cost equals savings to the taxpayers of NS of approximately $3,336,400) People just keep coming to see us… 2002-2003 2005-2006 Percentage Increases Ambulatory Care 9585 10,363 8.1% Births 135 194 43.7% Total OR Volume 2644 3496 32.2% Patient Days 18,766 20,637 9.9% Bursting at the Seams… 2003-2004 2005-2006 Percentage Increases Day Surgery 478 707 47.9% Inpatient OR 2122 2789 31.4% THE RIPPLE EFFECT More Services… More Physicians… More Nurses… More Beds… MORE MONEY… What keeps the place ticking… Initiatives Epidural Service Recruitment…a constant OR Efficiency Study National Study – open vs endoscopic Minimally Invasive surgery Initiatives Human Resources (Recruitment – a constant) Dr Barry Neuchterlein – Anaesthesia Dr Andreas Knoblich – General Surgeon Pathology, Other Surgical Subspecialities Ophthalmology and Obstetrics Clinical (Epidural service, TNE) Research (National Study – Open vs Laparoscopic Surgery) Teaching (Medical Students and Residents) Sir Astley Cooper 1768-1841 English surgeon and anatomist “…eye of an eagle, heart of a lion, hand of a woman… mind of a scholar” Ambroise Pare 1510-1590 French Royal Surgeon Why Surgery… The diseases The patients The people The history of medicine is, in fact, the history of humanity itself, with its ups and downs, its brave aspirations after truth and finality, its pathetic failures. The subject may be treated variously as a pageant, an array of books, a procession of characters, a succession of theories, an exposition of human ineptitudes, or as the very bone and marrow of cultural history. As Matthew Arnold said of the Acta Sanctorum, “All human life is there”… Fielding Garrison, 1913