Epstein Nancy E
Department of Neuroscience, Winthrop University Hospital, Mineola, New York, USA.
Surg Neurol Int. 2016 Jan 25;7(Suppl 3):S57-60. doi: 10.4103/2152-7806.174884. eCollection 2016.
More and more, no one seems to be in charge of taking care of patients with spinal disease both before and after spine surgery. Yet, as spine surgeons, we should not have to direct basic medical clearance prior to surgery, or direct basic medical postoperative care.
As we as spine surgeons did not complete medical residencies, why are we now being asked to take care of all postoperative issues in our patients undergoing spine surgery. As "captains of the ship," we are increasingly managing hypertension, diabetes, deep venous thrombosis/pulmonary embolism, and other basic medical issues.
Although our medical colleagues perform the preoperative clearance, too frequently they are not involved in the patients' follow-up treatment. Often, our medical colleagues are nowhere to be found after surgery for any of the postoperative problems; therefore, "tag" we are it. Nevertheless, this should not be the case.
So I ask again, who's in charge? Are we as spine surgeons now supposed to become the patients' primary care physicians, their pulmonologists, cardiologists, pain management specialists, much less their psychiatrists. Unfortunately, if we don't do this, no one else appears to be willing to step.
似乎越来越没有人负责脊柱疾病患者在脊柱手术前后的护理。然而，作为脊柱外科医生，我们在手术前不应负责指导基本的医疗检查，也不应负责指导基本的术后医疗护理。
由于我们脊柱外科医生没有完成医学住院医师培训，为何现在要求我们处理接受脊柱手术患者的所有术后问题。作为“船长”，我们越来越多地要处理高血压、糖尿病、深静脉血栓形成/肺栓塞以及其他基本医疗问题。
尽管我们的医学同行进行术前检查，但他们常常不参与患者的后续治疗。手术后，一旦出现任何术后问题，我们常常找不到医学同行；因此，“责任”就落到了我们身上。然而，情况不应如此。
所以我再次发问，谁来负责？我们脊柱外科医生现在难道要成为患者的初级保健医生、肺科医生、心脏病专家、疼痛管理专家，更不用说还要成为他们的精神科医生了。不幸的是，如果我们不这么做，似乎没有其他人愿意接手。
