WORRY WART Our new surgery center is giving us plenty to fret about.

If all goes as planned, by the time you’re reading this, we will have moved into our new ambulatory care center, where we’ll now perform all of our outpatient cases. We’ll convert our hybrid inpatient-outpatient OR to a major-case-only venue. You might not think so, but the transition to the new facility has generated a host of problems, ranging from personnel issues to equipment appropriations. Lots of fun!

• We only hire saints. Once word was out about the new surgicenter, applications were open to any and all employees. Trouble was, the criteria for hire were harsher than the admissions requirements at Harvard. Only the exceptional need apply. Rumors of requisites like “no record of tardiness,” “no prior history of reprimands” and “stellar reviews” ran amok in the OR. Folks were despondent realizing no one short of Mother Teresa would make the cut for employment at our new, gleaming facility. Even Nelson Mandela was reprimanded in his lifetime! Last I heard, the requirements were toned down a bit. Thank heavens. Maybe they’ll even let me in!
• No overnight stays. Since the new center will not be able to admit patients for overnight stays, surgeons must determine beforehand who will likely be admitted. That’s about as hard as predicting the outcome of a visit by one’s in-laws. You must consider such factors as BMI, pre-op medical status and length of surgery. However, you have a better chance of 5 straight days of on-time starts than I have of successfully predicting an admission. Looks like the nerve blocks will be called into permanent active duty. Extended-release morphine, anyone?

• Equipment strife. Since the OR schedule had to be reconfigured, more orthopedic surgeons will be operating on any given day. I envision a scramble for instruments akin to getting the best deal on Black Friday. There will be some growing pains, no doubt, with some surgeons adamantly protesting that they absolutely can’t go on without their custom, pearl-handled and autograph-engraved ACL guide. The “special tray” that Dr. X uses for his lap choles will soon become fair game. I have been proactive in this regard. I have quietly tucked away in my car trunk a tray containing all the shoulder instruments I will ever need. Just kidding.
• Scheduling woes. Finally, scheduling patients ahead of time has given my trusted scheduler many Maalox moments. I am sure that her already taxed brain is being flooded with such thoughts as:

Are we really starting August 25?

Is Dr. Kelly sure this case is not going to be an admission?

What if the patient’s BMI is 35.4?

How sick is too sick?

Who will win the fight over the instrument tray?

Do the patients know where the surgicenter is?

Does Dr. Kelly know where the surgicenter is?

Point me in the right direction
With all change comes the good, the bad and the ugly. I am sure that after the kinks are worked out, the transition will yield mostly good. I hear all the rooms have windows to the outside. My current room has a beautiful view of a scrub sink. Until then, I really do need to figure out where this new place is.