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Management for hospital doctors
Surgery, Vol. 3, No. 1. pp. 49. SO,1995 Copyright B 1995 Elsevier Science Ltd. Printed in Great Britain. Ail rights reserved 096&65X2195$10.00 + 0.00
Ambulatory
UTTERWORTH EINEMANN
Management for Hospital Docturs M Burrows, R Dyson, P Jackson, H Saxton
Butterworth-Heinemann, Oxforcl, 1994, 36Opp,E45.00 ISBN 0-756-00880-3 This book, edited by a group very familiar and experienced in NHS management, gives a first class overall picture of management in the NHS today and how it has evolved. In the UK it will benefit those wishing to have a general knowledge of management issues and also those entering into a management role. Those outside the UK, by reading this book, will gain a good insight into how a nationalized health system works. Perhaps the main shortfall of the book is that too little space is given to financial issues, which clearly are the basis for successor failure of any organization. Some problems in financial management are mentioned, such as the common failure to build costs from the bottom up, but no real strategy for improvement in the future is described. The business planning section, although very accurately reflecting what goes on in the NHS, singularly avoids essential financial aspectswhich are vital to a true business plan. Perhaps in future editions it would be beneficial to have a chapter written by a non-NHS chief executive or financial director, describing how a commercial organization measures its financial position and constructs its business plans. This is a book that describes NHS management accurately and should be read by those wishing to learn about or entering management in that organization. The latter group, however, would be well advised to read it in conjunction with a textbook on private sector management. Paul Jarrett
Operative Strategy in General Surgery James L Chassin
Springer Verlag GmbH, Heidelberg, Germany, 1994, 279Opp, DM268 ISBN 3-540-97968-9 The second edition of this textbook of operative surgery, written with the exception of one chapter, by the same surgeon describes the practice and thought processesof that surgeon. As such it reflects the spectrum of general surgery that he undertakes and, although extensive, does not cover the full range of procedures for conditions that might be considered to be within the remit of a broad cross-section of general surgeons. This book is unique in the way that Professor Chassin describes the way he chooses a particular procedure from amongst those that are possible. In most instances, therefore, only the one operation that he has found to be most valuable and safe for a given condition is described. As well as the pitfalls and dangers that need to be considered prior to surgery, postoperative care is also covered well, though
perhaps an indicative length of stay following all the procedures described would be helpful. The text is clear and well illustrated throughout, with unfussy drawings. Nothing, however, is perfect. In the section on laparoscopic cholecystectomy the text states correctly that the neck of the gallbladder is drawn through the umbilical wound, but the accompanying illustrations show the fundus being pulled out. Referencesare limited but pertinent and as such are preferable to long lists. Personally, although I do not agree with all the recommended procedures, I found this book fascinating to read as it gives an insight into the mind of a thinking surgeon who has clearly and carefully considered his own approach to surgery. Intermixed with the descriptions of operative stsategy and the operations themselves are some valuable tips that only come from experience and are rarely described in other works. Encourage juniors to read this book and read it yourself. Whether you agree or disagree with the particular procedures described, you will be better for the experience. Paul Jmett
Surgical Audit - 2nd Edn Alan Pollock and Mary Evans
Butterworth-Heinemann, Oxford, 1993, 278~~. E32.50 ISBN o-7506-0774-2 Audit of medical endeavour has long been practised by doctors, but the requirement to do so is more novel and the second edition of this book is thus especially welcome. As the forewords by Slaney and Polk suggest, the authors have attempted to stand astride the Atlantic and in this many will feel the book has been too ambitious. There are also chapters on topics of only peripheral concern to audit - but like the majority they reflect the authors’ wisdom and give interesting if somewhat discursive commentaries on, for example, medico-legal issues and the retraining of incompetent surgeons. There is a great deal in the book that will be of practical assistance to those considering setting about audit, as well as information not readily available elsewhere that should influence the practice of audit already underway. Although directed at the surgeon, many of the topics covered have general application to all branches of medicine. “Audit costs time and money and cheap audit - which is likely to be incomplete - can result in wrong decisions being taken’ - is a lesson for all to learn. More could have been included on effecting the benefits of audit and of the integration of the audit process into the management structure of hospitals. Economic considerations and audit as an adjunct to research are also themes common to all disciplines. No book breaking new ground will meet all expectations. There is a brave attempt to grapple with the auditing of outcome. The section on patient satisfaction will, however, particularly disappoint those interested in ambulatory surgery,
Ambulatory
UTTERWORTH EINEMANN
Management for Hospital Docturs M Burrows, R Dyson, P Jackson, H Saxton
Butterworth-Heinemann, Oxforcl, 1994, 36Opp,E45.00 ISBN 0-756-00880-3 This book, edited by a group very familiar and experienced in NHS management, gives a first class overall picture of management in the NHS today and how it has evolved. In the UK it will benefit those wishing to have a general knowledge of management issues and also those entering into a management role. Those outside the UK, by reading this book, will gain a good insight into how a nationalized health system works. Perhaps the main shortfall of the book is that too little space is given to financial issues, which clearly are the basis for successor failure of any organization. Some problems in financial management are mentioned, such as the common failure to build costs from the bottom up, but no real strategy for improvement in the future is described. The business planning section, although very accurately reflecting what goes on in the NHS, singularly avoids essential financial aspectswhich are vital to a true business plan. Perhaps in future editions it would be beneficial to have a chapter written by a non-NHS chief executive or financial director, describing how a commercial organization measures its financial position and constructs its business plans. This is a book that describes NHS management accurately and should be read by those wishing to learn about or entering management in that organization. The latter group, however, would be well advised to read it in conjunction with a textbook on private sector management. Paul Jarrett
Operative Strategy in General Surgery James L Chassin
Springer Verlag GmbH, Heidelberg, Germany, 1994, 279Opp, DM268 ISBN 3-540-97968-9 The second edition of this textbook of operative surgery, written with the exception of one chapter, by the same surgeon describes the practice and thought processesof that surgeon. As such it reflects the spectrum of general surgery that he undertakes and, although extensive, does not cover the full range of procedures for conditions that might be considered to be within the remit of a broad cross-section of general surgeons. This book is unique in the way that Professor Chassin describes the way he chooses a particular procedure from amongst those that are possible. In most instances, therefore, only the one operation that he has found to be most valuable and safe for a given condition is described. As well as the pitfalls and dangers that need to be considered prior to surgery, postoperative care is also covered well, though
perhaps an indicative length of stay following all the procedures described would be helpful. The text is clear and well illustrated throughout, with unfussy drawings. Nothing, however, is perfect. In the section on laparoscopic cholecystectomy the text states correctly that the neck of the gallbladder is drawn through the umbilical wound, but the accompanying illustrations show the fundus being pulled out. Referencesare limited but pertinent and as such are preferable to long lists. Personally, although I do not agree with all the recommended procedures, I found this book fascinating to read as it gives an insight into the mind of a thinking surgeon who has clearly and carefully considered his own approach to surgery. Intermixed with the descriptions of operative stsategy and the operations themselves are some valuable tips that only come from experience and are rarely described in other works. Encourage juniors to read this book and read it yourself. Whether you agree or disagree with the particular procedures described, you will be better for the experience. Paul Jmett
Surgical Audit - 2nd Edn Alan Pollock and Mary Evans
Butterworth-Heinemann, Oxford, 1993, 278~~. E32.50 ISBN o-7506-0774-2 Audit of medical endeavour has long been practised by doctors, but the requirement to do so is more novel and the second edition of this book is thus especially welcome. As the forewords by Slaney and Polk suggest, the authors have attempted to stand astride the Atlantic and in this many will feel the book has been too ambitious. There are also chapters on topics of only peripheral concern to audit - but like the majority they reflect the authors’ wisdom and give interesting if somewhat discursive commentaries on, for example, medico-legal issues and the retraining of incompetent surgeons. There is a great deal in the book that will be of practical assistance to those considering setting about audit, as well as information not readily available elsewhere that should influence the practice of audit already underway. Although directed at the surgeon, many of the topics covered have general application to all branches of medicine. “Audit costs time and money and cheap audit - which is likely to be incomplete - can result in wrong decisions being taken’ - is a lesson for all to learn. More could have been included on effecting the benefits of audit and of the integration of the audit process into the management structure of hospitals. Economic considerations and audit as an adjunct to research are also themes common to all disciplines. No book breaking new ground will meet all expectations. There is a brave attempt to grapple with the auditing of outcome. The section on patient satisfaction will, however, particularly disappoint those interested in ambulatory surgery,