Zhao Emily, Tiedeken Nathan, Wang William, Fowler John
University of Pittsburgh Medical Center, PA, USA.
Evergreen Building, Pottsville, PA, USA.
Hand (N Y). 2019 Nov;14(6):819-822. doi: 10.1177/1558944718770206. Epub 2018 Apr 17.
The term for a surgeon is generally used to describe someone who is unusually busy compared with his or her counterparts, and it is a superstition that tends to pervade the medical world. The purpose of this study is to investigate whether black clouds exist in hand surgery. We examined one academic year's worth of hand surgery-specific call at a level I trauma center and tabulated the number of hand-related patient transfers and add-on cases per surgeon. Each surgeon was given a black cloud rating by the fellows who were in training that year. Correlations were made between the black cloud rating and the surgeons' call volume. There were 12 surgeons who shared 365 days of hand call, and 5 of them are hand surgery fellowship trained. Those 5 surgeons tended to be busier on their call days, with more cases added on overnight and the next day, and also had worse black cloud ratings than the 7 non-hand fellowship trained surgeons. In regard to hand surgery, while true emergencies occur and require emergent intervention, how busy hand surgeons may be during call may be influenced by a variety of factors not related to their patients' problems but rather their daily schedules, their hospitals' ability to facilitate add-on cases, and their rapport with their fellow surgeons to share case loads.
“外科医生乌云”这一说法通常用于形容与同行相比异常忙碌的人，这是一种在医学界普遍存在的迷信观念。本研究的目的是调查手外科领域是否存在“乌云”现象。我们在一家一级创伤中心检查了一学年的手外科特定值班情况，并统计了每位外科医生手相关患者转诊和追加病例的数量。当年接受培训的住院医师为每位外科医生给出了一个“乌云”评分。对“乌云”评分与外科医生的值班量进行了相关性分析。有12位外科医生分担了365天的手外科值班，其中5位接受过手外科专科培训。这5位外科医生在值班日往往更忙碌，夜间和次日追加的病例更多，而且他们的“乌云”评分也比7位未接受手外科专科培训的外科医生更差。在手外科方面，虽然确实会出现紧急情况并需要紧急干预，但手外科医生在值班期间的忙碌程度可能受到多种因素的影响，这些因素与患者的问题无关，而是与他们的日常安排、医院处理追加病例的能力以及他们与同行分担病例量的融洽程度有关。
