A visit from Rockhampton
Dr Kenneth Cutbush hosted Dr Glen Gomez, a Melbourne-trained orthopaedic surgeon who practises in Rockhampton, in May 2015. The two operated together on several complex surgical cases.
Regional surgeons visiting a subspecialty practice, and operating together on the harder cases, is one of the practical ways that complex techniques reach patients outside the capital cities.
What regional orthopaedic practice looks like
An orthopaedic surgeon in a regional centre generally covers a wide range of work. Rather than concentrating on one joint, they deal with whatever comes through the hospital: fractures, hips and knees, hands, children's injuries and shoulders. That breadth is what the community needs, and it also means that the unusual shoulder case may come round only occasionally. Spending time in a unit where those cases are concentrated is a way of keeping up with how they are currently handled, and it works in the other direction too, since a surgeon managing the full range of injuries sees problems that a narrower practice does not.
Why operating together is the point
There is a difference between watching an operation and doing one alongside the surgeon who normally does it. Standing at the table means handling the tissue, feeling how much a stiff joint will release, seeing where the instruments have to be positioned, and talking through the decision at the moment it is being made rather than afterwards. Complex cases are where that matters most, because they are the ones in which the published description of a technique runs out and judgement takes over. Each case is assessed on its own merits. Individual results vary.
How surgeons keep learning after training
Qualifying as an orthopaedic surgeon is the beginning rather than the end of training. Techniques, implants and the evidence behind them change over a working career, and surgeons are required to maintain continuing professional development. Mutual visits of this kind sit alongside conferences, courses and reading as one of the less formal parts of that, and arguably one of the more useful, because the exchange is specific to the cases in front of both surgeons.