The evolution of the hospital : a surgeon speaks out

• Laurent SEDEL
  Surgeon, Lariboisière Hospital, Paris
  Laboratory director in orthopedic research, CNRS
  
• Dominique TONNEAU
  Professor, École des mines, Paris
  Project leader, MeaH (Mission expertise et audits Hospitaliers) pilot programmes for surgical
  

Summary

At the end of 2007, Laurent Sedel published a letter in the newspaper 'Le Monde' entitled A surgeon's concern to alert people to the changes appearing in hospitals. A surgical operation is similar to a play : actors, each of whom have different roles, have to interact in a very precise manner. The failure of a single actor to perform correctly may seriously jeopardise the situation. And yet, various actors are managed in an increasingly business-like way which makes teamwork difficult. Reduction in the number of working hours, absenteeism, and varying timetables depending on the medical specialisation, all add to the problems of coordination. Some reforms fail because of the lack of knowledge about the day-to-day workings of a hospital. Furthermore, fear of being brought to court for medical incompetence increasingly becomes more important than fear of failure. Consequently, there is a decrease in the number of surgeons, and an increasing number of foreign surgeons with insecure job status. Nonetheless, Laurent Sedel remains convinced that not a great deal of extra effort is needed to make hospital medicine more dynamic and efficient, which would be a real asset.

Summary translated from French by Rachel MARLIN.

• The entire article was written by Élisabeth BOURGUINAT.

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