Confessions of a Surgeon

The Book of the Week is “Confessions of a Surgeon” by Paul A. Ruggieri, M.D., published in 2012.

These days in the United States, with the landscape changing for the worse in some ways in the medical community, all sorts of factors threaten the progression of the livelihood of a surgeon; namely– bad luck, lawsuits, increasing stress and diminishing financial returns. The author details those factors in the context of patient cases he has seen.

The conventional saying about a surgeon’s career is that the first decade is spent learning how to operate; the next, learning when to operate, and the next, learning when not to operate.

With the rapid advancement in imaging technology of late, more and more patients are accidentally learning that they have certain medical conditions. Such incidental findings generate extra worries and expenses, especially if the conditions are life-threatening. The word “cancer” on a medical report automatically stokes a surgeon’s fear of being accused of medical malpractice. The surgeon feels compelled to order more tests for legal protection and containment of medical malpractice insurance costs (which rise even in cases where the surgeon is exonerated) even when there is only a tiny likelihood of malignancy. Yes, the author writes, there are plenty of greedy surgeons who order more tests (or perform unnecessary surgery) just to make more money.

The author is in private practice at a hospital, so he gets all his business through referrals from other medical professionals or patients. Therefore, he is under pressure to “play well with others” in his community, lest he lose business.

“Surgeons frequently have conversations with body parts or organs they are trying to remove. They also have conversations with themselves. It’s a way to blow off steam while your mind scrambled to deal with the unexpected.”

Read the book to learn more about the trials, tribulations and triumphs of people who perform medical operations for a living.