04 wint anes alum single pgs - Department of Anesthesiology - Duke ...

DUKE ANESTHESIOLOGY ALUMNUS | 5
Our primary goal is
to have an anesthetic
that would allow
a patient to recover
with a short
post-anesthetic period...
between 90 and
120 minutes.
“All patients evaluated for surgery receive
written information about the pre-operative
and pre-anesthetic expectations, including the
types of medications that they are to discontinue
as well as those medications that we are
going to use. Sometimes, if patients have had
health problems that arose during past anesthetic
interactions or if they have some
unfounded fears regarding general anesthesia,
they meet with me to discuss these matters,
even before they are scheduled for surgery.
The nursing staff is in contact with them on a
regular basis prior to the surgery. It is a very
hands-on type of interaction; so, by the time
the patients get here on the day of surgery,
they are quite comfortable with the staff,”
informed Dr. Scott.
The DCAS has an efficient patient followup
system in place. “Every patient is called
about two to three hours after they return
home on the day of the surgery.
The nursing staff and my
staff call the patient the
next morning to
know if there are
any further anesthesia-related
questions. The
patients’ relatives
are given my office
phone number and
pager number, so that if
they have any post-op questions,
they can contact me directly. Our patients do
very well, and their pain is very well controlled.”
In an attempt to further avoid complications
in the post-operative period, the DCAS
physicians focus on resculpting rather than
body weight reduction procedures.
Liposuction is carried out on younger and fitter
women, who, for example, may have an
It is very rewarding
for the patients to know
who I am and what
anesthesiologists do...
Our patient satisfaction
rate is 4.9 on a scale
of 1 to 5.
accumulation of adipose that they cannot get
rid of despite exercise, according to Dr. Scott.
Part of the pre-operative surgical evaluation
is to recognize what the patient expects
and to give patients realistic ideas about what
they will look like after surgery. “We have a
group of surgeons who are very good at
screening patients. As part of their training,
they learn how to discern patients who may
have a distorted body image or those with psychological
issues who are more likely to be at a
higher risk for problems. Cosmetic surgery is
elective and, therefore, not something that one
has to have. Our surgeons, therefore, have the
luxury of being selective. It would be doing a
disservice to a patient to embark on unnecessary
surgery if the outcome is not likely to meet
their expectations,” she added.
A top-of-the-line digital camera “morphing”
system at the center allows patients to
understand what they would possibly
look like after surgery. This also
helps them to have realistic
expectations, said Dr.
Scott. The finished
results of any type of
surgical procedure
will not look normal to
the patient for several
weeks after surgery
depending on the procedure.
A nose takes several
months to become the final shape that
it’s going to be. “So, to try to assess it in the
immediate post-operative period or even a
week later is foolish because the surgical site
will still have a lot of swelling. A lot of our preoperative
interaction is devoted to patient education,”
she added.
Dr. Scott finds working with a patient in an
office-like environment satisfying. “I see the
patient in the pre-operative period and interact