Ann Thorac Surg 2008;85:368-370. doi:10.1016/j.athoracsur.2007.04.131
© 2008 The Society of Thoracic Surgeons
Special Lecture
Achieving Excellence
Edward L. Bove, MD*
The Section of Cardiac Surgery, University of Michigan School of Medicine, Ann Arbor, Michigan
* Address correspondence to Dr Bove, Section of Cardiac Surgery, F7830 Mott Hospital, 1500 E Medical Center Dr, Ann Arbor, MI 48109 (Email: elbove@umich.edu).
Presented as the President’s Invited Lecture at the Fifty-third Annual Meeting of the Southern Thoracic Surgery Association, Tucson, AZ, Nov 8–11, 2006.
| The first 300 words of the full text of this article appear below. |
Why a talk about excellence? As cardiothoracic surgeons, we are all accustomed to what it means to be "excellent." After all, thoracic surgery is the specialty that is always attracted the best into its midst: the brightest, hardest working, most innovative, and so forth. But it seems that today, more than ever, our specialty is being assaulted from all sides. Patients, payors, even our own colleagues are bombarding thoracic surgeons. Public demands are increasing, and public reporting of individual as well institutional outcome data is being demanded. Even more is on the way as we prepare for pay-for-performance guidelines. So it is perhaps fitting that now is the time for our specialty to define the appropriate metrics and redefine the characteristics that attracted us to this specialty to begin with.
According to Webster’s II New College Dictionary of the American Language [1], excellence is defined as "outstandingly good of its kind, of exceptional merit, virtue ... ." But just what are we to excel at? For most of us, our medical environment includes the hospital, medical school, and the clinic. For each of these areas, we face different demands and expectations (Fig 1). There are educational, clinical, investigational, and even fiscal benchmarks to achieve, often with conflicting incentives. To the classic triad of "teaching, research, and patient care" we must now add increasing financial limitations, what our payors regard as value. Furthermore, we are expected to achieve these goals not just for ourselves but also within the framework in which we exist. A so-called institutional perspective is often at odds with the day-to-day environment where we work. For example, today’s cardiac surgeons have very little in common with our colleagues in other surgical specialties but much more with those working in cardiology and radiology.
Copyright © 2008 by The Society of Thoracic Surgeons.
