| Hot Topic |
june-july, 2020 | The Health
09
The surgical principles of triage, adequate
margins and tissue clearance have some
useful lessons in administrating a public
healthcare system of 270,000 people or a
thousand-bedded hospital.
One lesson from pandemic management
and healthcare administration is that
surgeons must leave their narrow
disciplines and embrace additional skills
and education in fields like public health
or public administration. Surgery, just like
all fields of medicine, health and science,
is multidisciplinary. Whether during
“peacetime” or “pandemic wartime”,
we cannot afford to hide in our silos and
narrow surgical operating fields. Our
skills as doctors, leaders and citizens must
be deployed in this global fight against
Covid-19.
“We have to prepare for all potential
scenarios. We need a clear plan and strategy
to succeed. All issues must be addressed
beforehand like doing any major surgery.
No patient should die on table,” said
Professor Dato Dr Ahmad Sukari, Director
of Hospital USM.
Added Associate Prof Dato Dr Mohamed
Saufi, a Neurosurgeon, Director of Hospital
UIAM: "As a surgeon, we have been taught
to stay calm when having difficulty during
surgery. A step by step approach must be
applied.”
The Practice of Surgery,
Beyond Covid-19
This global pandemic is shocking our global
system to its core. While the world is still
grappling with exit strategies, at some
point the world must have uncomfortable
but crucial conversations about the
post-Covid-19 new normal. Some of these
conversations must happen at the nation-
State level, where we as surgeons must
demand greater investments in health and
strengthening of the health system.
It’s not just building more operating
theatres or training more surgeons, but
to find effective system-wide solutions
to prevent the need for surgeries (like
detecting cancers much earlier), shorter
waiting times for surgeries (to reduce
suffering) and to pay for cost-effective
technologies (such as appropriately
deployed robot-assisted surgery).
There are added challenges however.
Assoc Prof Dato Dr Mohamed Saufi.
We have to prepare
for all potential
scenarios. We
need a clear plan
and strategy to
succeed. All issues
must be addressed
beforehand like
doing any major
surgery. No patient
should die on table.”
— Professor Dato Dr Ahmad Sukari
"For surgeons, the decision to bring
a patient into OT or not may not be as
straightforward as it used to be. There
were times when a surgeon may need to
take the risk and bring a patient to the
operating room with unknown Covid-19
infectivity status as an emergency," said
an Eye Surgeon, Associate Professor Dr
Muhammad Mohd Isa, Director of UPM
Teaching Hospital.
At the global level, surgeons must
Datuk Dr Noor Hisham Abdullah.
Professor Dato Dr Ahmad
Sukari.
Professor Dr Tunku
Kamarul Zaman.
Associate Professor Dr Muhammad.
collaborate in deeper and faster ways with
other specialities. Surgery is often seen
as a highly localised specialty, given the
narrow field of highly specialised work.
Collaboration with other branches of
medicine like public health and health
economics will be crucial to enhance the
work of surgeons. Collaboration with other
branches of knowledge like computer
science and public policy will help bring
more accessible, cheaper and more timely
surgeries to the population.
The world will change after Covid-19. The
prevailing medical, scientific, economic,
political and social structures in the global
community have proven to be outdated.
Covid-19 is a crisis not to be wasted, and
surgeons must be at the forefront leading
these necessary reforms to protect against
the next pandemic.
The real heroes in this pandemic are the
health professionals. Their professionalism
and commitment to uphold the highest
standards of care are now recognised on a
daily basis. The field of health is more than
just providing healthcare in hospitals or
clinics.
In the new normal, surgeons must
be present in more places than just the
operating theatre. The onus is on us to
prepare ourselves with the knowledge and
skills needed for us to bring our leadership
to other parts of the health system. — The
Health