Why do we behave as we do?
It is important for surgeons to have insight into themselves, their life stories, and the rationales they use to convince themselves that their actions are unselfish and well motivated. The battle between Philanthropia and Philotechnica was recognized by Hippocrates and is still a source of internal strife for many surgeons: the need to perform an operation that they are poorly equipped to do offset against the knowledge that it could be better done by someone else. In the treatment or referral for treatment of children with craniosynostosis and craniofacial syndromes, appropriate referrals are often not made or are made only after some problem has occurred as a result of surgical intervention. Several instances of children receiving extensive surgery for wrongly diagnosed craniosynostosis are explored. The thesis is that only by knowing our own internal motivations can we avoid falling into a posture that is good for our own egos and pocketbooks but bad for our patients.
Bruce
Derek Andrew
DA
Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, George Washington School of Medicine, Washington, District of Columbia, USA. derfran@mac.com
D000329:Advertising; D002648:Child; D002983:Clinical Competence; D019465:Craniofacial Abnormalities / Q000175:diagnosis* / Q000191:economics / Q000601:surgery*; D003398:Craniosynostoses / Q000175:diagnosis / Q000191:economics / Q000601:surgery; D003951:Diagnostic Errors; D004502:Education, Medical, Continuing; D004992:Ethics, Medical; D006625:Hippocratic Oath; D006801:Humans; D009042:Motivation; D010820:Physicians / Q000523:psychology*; D012017:Referral and Consultation / Q000191:economics