order cheap levitra I am very lucky to have a group of 50 hand surgeons, all of similar vintage out of fellowship, who are part of a travelling hand club. Multiple such clubs exist. We meet for drinks and discussion at the ASSH Annual Meeting, often at AAHS, PRS and AAOS meetings, and then have an “away” meeting on a yearly basis. We recently convened in Washington, DC for a conference on Practice Management. The 20 or so members who were able to make it to the meeting shared stories, both good and bad, of our experiences in our first 5-7 years of practice.
We shared difficult cases and sought each other’s opinions on controversial topics and problems with no clear solution. We shared clinical pearls, as we often do when we are together. We discussed finer points of making both private and academic practices better and more efficient. Most of all, in a highly specialized field, we provided each other support, context, and empathy. Many of us have spouses, partners and friends who barely understand what we do, the difficult decisions we are faced with on a daily basis, the nature of our conversations with patients, and the joy of a good outcome and the agony of responsibility when things do not go well.
The ASSH is a larger community, but within it are many smaller communities – the Listserv provides an electronic network of colleagues who know each other intimately by electronic signature but who only have a chance to meet once a year. Committees and Task Forces provide smaller communities of colleagues with shared focus to those who take the time to volunteer. Locally, there are academic departments for those lucky enough or cursed enough, as the case may be, to have partners who are also hand surgeons; and there are local and regional hand clubs and journal clubs.
As much as I try to base my practice upon the principles of evidence-based medicine and shared decision making with patients, few journal articles have as much impact on my practice as my conversations with friends and mentors within the hand surgery community. Few voices are as comforting to me when my life is consumed by stress and difficult decisions as those of my fellow hand surgeons.
I had the fortune of having one of my colleagues present to me his tips and tricks for percutaneous scaphoid fixation at our recent meeting a week before a fracture presented itself to me. Fixing it with his technical pearls in mind cut down both my operative time and my frustration with an often fidgety case. Just as helpful was a discussion about physician extenders and how to use them to increase practice efficiency. As soon as we finish residency and fellowship, many of our practices start to crystallize and become more brittle, less informed, and less expansive than they were when our minds were open and our focus was on learning. Find a community of hand surgeons to share with. Having a community of colleagues keeps us fresh and open and gives us both insight and empathy when they are hard to find.
