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					EDITORIAL           Scandinavian Journal of Surgery 93: 175, 2004




QUALITY


I guess that most of our readers are up to their ears hearing about money (or, rather, shortness of money)
and listening to demands for better cost-effectiveness. Incessant discussions on the need to cut expenses are
probably a major cause for discomfort and burn-out among hospital employees, nurses as well as doctors.

  For academic doctors it is puzzling to follow how colleagues work from dawn until dusk without massive
protests against the maddening pace of surgical interventions, the minimum of hospital staff available for
pre- and postoperative care, the need of asymptotic shortening hospital stays etc. – all of this just in the
name of money saving.

   Anyone who dares talk about the quality of our treatment and care is either looked down upon or seen
like an alien from Mars (where there is no life). The same people who make decisions on how to disperse
our limited resources expect first-class treatment if they would happen to need some kind of hospital services.
Naturally, these people should – and hopefully will – receive the same treatment as all others patients. This
must be understood by all physicians, especially surgeons.

  A minimum of quality control is needed for all treatments, if a hospital is to function properly, but re-
search on improved quality is also urgently needed. Quality does not come free, and this is true for medical
and surgical care as well. To buy a cheap car with all the latest technical equipments and safety aspects is as
impossible as to find high quality medical care at a low price. Quality comes, however, at reasonable costs,
and it would be simply nonsense to tamper with quality to make savings!

   Several countries within the European Union, Finland among them, have decided to guarantee legally its
citizens treatment within a certain time period – very nice on paper, indeed. Patients waiting for elective
operations (e.g. arthroplasties, hernias, varicose veins, cataracts etc) will exercise this right to treatment. But:
Who will provide the treatment? Who will do the operations? Where? Today, there are no extra resources
stowed away anywhere – rather, every euro and cent is being used and precisely allocated.

 THERE IS A RISK THAT QUALITY WILL BE MANIPULATED WITH BUT THIS WILL NOT BE
ACCEPTABLE!!


Peter J. Roberts
Editor-in-Chief

				
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