What is an operation?

OPERATIONS

ROJoson QI (Questions and Issues): What is an operation based on medical perspective? Since operation and surgery are often used interchangeably, what is surgery or surgical operation?

Here are some definitions from the Internet:

Operation – any action performed with instruments or by the hands of a surgeon; a surgical procedure – https://medical-dictionary.thefreedictionary.com/operation

Operation- a procedure performed on a living body usually with instruments especially for the repair of damage or defect or the restoration of health – https://www.merriam-webster.com/dictionary/operation

Operation – a surgical procedure – medicineNet

Surgical operation – a medical procedure involving an incision with instruments; performed to repair damage or arrest disease in a living body – https://mnemonicdictionary.com/word/surgical%20operation

Surgery – a branch of medicine that is concerned with the treatment of injuries, diseases, and other disorders by manual and instrumental means – https://www.britannica.com/science/surgery-medicine

Surgery – the treatment of injuries or diseases by cutting open the body and removing or repairing the damaged part – https://dictionary.cambridge.org/…/dictiona…/english/surgery

Questions:
Does surgery or operation always involve cutting of a patient’s body? For example, endoscopy just to visualize something does not involve cutting or incision. Is it considered a surgery or operation?

Does surgery or operation as a procedure always involves the uses of some form of instruments or equipment? For example, manual reduction of a dislocated shoulder may not involve the use of instrument or equipment. Is it considered a surgery or operation?

In the PhilHealth Procedure Case Rates, the list includes diagnostic endoscopy and closed reduction of dislocation. Thus, currently, the concept of operation or surgery includes those without cutting or incision and manual procedure without use of instrument or equipment.

What do you think?
Welcome contributions of opinions.

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ROJ@18nov9;18nov10

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Surgery vs Operation

SURGERY VS OPERATION

ROJoson QI (Questions and Issues): In the current setting (modern times), what is surgery? what is operation? What is the similarity? what is the difference?
Surgery (in medical parlance) is a medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury and to help improve bodily function or appearance, An act of performing surgery may be called a surgical procedure, operation, or simply surgery. Thus, surgery and operation are medical terms that are commonly used interchangeably and they connote the same thing. However, “surgery” is more medical in perspective and “operation” is more lay or laypeople in perspective.

Examples of interchangeable usage: “surgical operations”; “surgery”; “operations”; “operating rooms”; “surgical theatre”; “operative technique”; “surgical technique”; etc.

Any other answers?
I welcome contributions, feedback, comments, suggestions and sharing of information.

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ROJ@18nov8

What is a surgeon?

WHAT IS A SURGEON?

ROJoson QI (Question and Issue): In the current setting (modern times), what is a surgeon among physicians managing human beings? in other words, what is the meaning of a “surgeon”? Who is the surgeon?

A surgeon is a physician who manages human beings with surgical operations or manual procedures.

If above is the definition of a surgeon, loosely speaking, practically every physician is a surgeon because somehow he does surgical operations or manual procedures on his patients when he treats manages patients. Injection of medicines is an example of a manual procedure which all physicians are expected to know how to do and he usually does this. Insertion of intravenous fluid is an example of a manual procedure which all physicians are expected to know how to do and he usually does this. In this sense, every physician is a surgeon.

Strictly speaking, in the current setting, a surgeon is a physician who spends more years after his basic medical education to specialize in certain surgical operations or manual procedures. After the further training, he devotes his medical practice in doing certain surgical operations or manual procedures in the management of patients needing such operations or procedures.

Thus, strictly speaking, in the current setting (modern times), a general practitioner, a pediatrician, a family medicine specialist, an internist, a psychiatrist, a physiatrist, a radiologist, a pathologist; an anesthesiologist; and other medical specialists who do not do “special” surgical operations or manual procedures are not surgeons. However, as mentioned earlier, loosely speaking, especially if they do certain manual procedures, they may be considered surgeons also. Examples are gastroenterologists doing endoscopy; cardiologists doing heart stenting; radiologists doing ultrasound-guided biopsy;and radiotherapists – because they train in doing certain surgical operations and manual procedures, may be considered surgeons.

In the current setting (modern times), the following are conventionally considered surgeons:
– General surgeons
– Breast surgeons
– Colorectal surgeons
– Head and neck surgeons
– Hepatobiliary surgeons
– Orthopedic surgeons
– Urologists
– Plastic and reconstructive surgeons
– Neurosurgeons
– Pediatric surgeons
– Thoracic and cardiovascular surgeons
– Ophthalmologists
– Otorhinolaryngologists
– Transplant surgeons
– Obstetricians and gynecologists
– Dentists
– OTHERS (that I may miss)

Traditionally, surgeons refer to the general surgeons. However, surgeons other than the general surgeons, strictly speaking and nowadays, are also considered surgeons (see list above).

In the hospital setting, the medical specialists are usually grouped by departments, such as department of pediatrics; department of medicine; department of obstetrics and gynecology; department of surgery; department of orthopedics; department of anesthesiology; department of ophthalmology; department of otorhinolaryngology; etc. A department of surgery, at present time (these may change overtime), usually consists of general surgeons; breast surgeons; colorectal surgeons; head and neck surgeons; hepatobiliary surgeons; urologists or urologic surgeons; plastic and reconstructive surgeons; pediatric surgeons; neurosurgeons; thoracic and cardiovascular surgeons; and transplant surgeons. Outside the department of surgery, the other departments may contain medical specialists who are strictly speaking, surgeons also, those who do special surgical operations and manual procedures. Examples are the department of orthopedics; department of obstetrics and gynecology; department of ophthalmology; and department of otorhinolaryngology.

As one can sense from above explanations, there is no absolutely correct or wrong answer to the question posed. There is no single definition or meaning of surgeon. It all depends, whether loosely or strictly speaking and on the usage in the community and in the hospital. What will remain as the basic meaning of a surgeon is that he is a physician who manages human beings with surgical operations or manual procedures. What will remain as the essential meaning of a surgeon is that he is a physician who spends more years after his basic medical education to specialize in certain surgical operations or manual procedures. What surgical operations or manual procedures he specializes in will dictate what kind of surgeon he is and the descriptive label he wants to use (cxample, breast surgeons; colorectal surgeons; neurosurgeons; etc.)

Last note: Although the basic meaning of a surgeon is that he is a physician who manages human beings with surgical operations or manual procedures, it does not mean he operates on all patients he sees. He operates only when indicated. For those patients,who do not need operations, he can either treat them with non-surgical means or refer them to the non-surgical medical specialists.

Any other opinions?

I welcome sharing of opinions, feedback, comments and suggestions.

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ROJ@18nov7

Notice to those who want to be my friends in Facebook and who want to read my posts

NOTICE TO THOSE WHO WANT TO BE MY FRIENDS IN FACEBOOK AND WHO WANT TO READ MY POSTS:

I reached my quota of 5000 in May 27, 2017 /June 12, 2017 in my first Timeline – https://www.facebook.com/rjoson2001

I cannot accommodate new requests after the 5000 quota.

I have been regularly cleaning up the list removing the “inactive friends” since then. But there is a limit to the clean-up.

Thus, I created a FB group (Reynaldo O Joson 2) in May 20, 2017 to accommodate those who want to be my FB friends after the 5000 quota.

https://www.facebook.com/groups/1511295612255393/

I have also created another Timeline account, again to accommodate those who want to be my FB friends after the 5000 quota.

https://www.facebook.com/reynaldo.ojoson.73

For those who want to be my friends in FB after my 5,000 quota and who want to read my posts, pls. submit request to either one of the two links provided above.

Those who are already my friends in my first Reynaldo O Joson Timeline need not submit requests anymore to the two new links provided. As much as possible, whatever I post in my first Timeline will be seen in the two new links provided. I also don’t like duplication of subscriptions.

Thank you!

Reynaldo O Joson

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ROJ@18nov7

Cars – when to fill up gas tank

18nov6

Life Notes for me and those who drive cars

Specific issue: when to fill up gas tank

Today, at 550 am, I saw a yellow icon on my car dashboard signifying that I should fill up my gas tank though the level of fullness or emptiness of the gas tank is still 2 lines above the lowest line.

I was trying to decide where to fill up the gas tank – nearest gasoline station, which is in Kamagong, Makati or at UN Avenue, Ermita, Manila, the two gasoline stations where I usually go for gas.  I considered aside from the nearness of the gasoline station, how fast the service (filling up the gas tank, checking the water and oil levels and putting air in my wheels) will be (because I have to reach the hospital in 20 minutes).  At this time,  I decided on Kamagong, Makati as I didn’t want to be caught in an emergency situation where I ran out of gas.  I was fortunate the gasoline station was not busy with customer and I had time to have my water and oil levels checked at least.

In my 50 years of driving cars, there was only one occasion in which I ran out of gas in the middle of the road and in which I had to look for a gas container and a tube to channel the gas into the gas tank and I had to take a public transportation to go to the nearest gas station to buy gas.  This was probably in my early years of driving.  Because of this bad experience, I have been cautious  ever since in ensuring that I do not ran of gas in the middle of the road.

I had a Lancer before in which the gas gauge was defective.  I would fill up full-tank, list down on a small notebook the date I filled up my gas tank, and then refill the gas tank after every 6 to 7 days (full-tank) to ensure that I would not run out of gas.  Fortunately, for the more than 20 years that I had been using the Lancer with defective gas gauge (before I disposed of the car in 2018), I did not encounter a situation in which I ran out gas in the middle of the road.

My advice is to prevent the emergency situation of running out of gas in the middle of a road trip by constantly monitoring the gas gauge.   If the yellow warning appears, fill up the gas tank as soon as possible.  It is a hassle to look for gas in the middle of a road trip when you run out of gas.

One bad experience is enough.  It teaches me this lesson on emergency prevention.

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ROJ@18nov8

 

 

ROJoson’s Facebook Project as a Legacy to the Filipino People

I officially started using Facebook on June 16, 2011 with the goal of Education for Health Development in the Philippines.

In November 3, 2018, my Facebook Project is 7 and a half years old already.

Three months before my graduation day on January 31, 2019, I make this evaluation. (November 3, 2018)

In the past, I already made several evaluations (2011 December – 6 months after usage; 2013 – 24 months after usage; 2014 – 3 years after; 2015 – 4.5 years after; 2016 – 5 years after usage).  The overall result has always been positive and my friends have consistently wanted me to continue my Facebook Project or Postings.

In 2014 and 2016, I asked for formal feedback through a survey from my friends in Facebook.  The results can be seen in the following links (with 38 and 119 respondents respectively):

https://docs.google.com/forms/d/1-Fk7dQw4e8P08dPL_zpcs30AuyLJ41EFvp5Pt0B7Dv8/viewanalytics

https://docs.google.com/forms/d/1VCMZ0iYpDfLNDxkerOCtri-Y40kVdzzH6UuS0OVNkaU/viewanalytics

The following was my first post in my homepage (profile page) in Facebook on June 16, 2011, spelling out the objectives and contents of my Facebook:

“My Facebook will contain my thoughts, perceptions, opinions, and recommendations (TPORs) on things of interest to me and on things that may be of interest and concern to my patients, to my colleagues, to my friends, and to my family.” 

Evaluation:

I have fulfilled all the objectives that were set at the start, namely:

“My Facebook will contain my thoughts, perceptions, opinions, and recommendations (TPOR) on things of interest to me and on things that may be of interest and concern to my patients, to my colleagues, to my friends, and to my family.” [I have “likes” and “comments” from all of my intended readers.]

I have been using the Facebook as a personal blog to:

o   Facilitate communication and keeping in touch with my patients, students, colleagues in the medical profession, classmates, friends, and with my family;

o   Advance my advocacy on “Education for Health Development in the Philippines,” which I started in 1989;

o   Share on my personal thoughts, perceptions, opinions, and recommendations (TPORs) in the following four areas: Medicine; Hospital Administration; Medical Education; and Life. (with focus on the following specific topics: Breast Wellness; Thyroid Wellness; Hospital Quality Management  System; Hospital Safety Promotion and Disaster Preparedness Program; and Problem-based Learning in Medicine and Surgery.) 

The missions of my Facebook Project are spelled out as such: to infoshare; to inspire; to improve.

Infoshare means to inform and share information and my TPORs (Thoughts, Perceptions, Opinions and Recommendations) which will lead to the other missions to inspire and to improve.

Inspire means to motivate changes for the better or learning on the part of my friends or readers.

Improve means to produce positive changes in behavior (learning) which is the ultimate target of my Facebook Project and Blogs, that is, Education for Health Development in the Philippines Program.

I am achieving the missions of my Facebook Project as evidenced by the responses of friends in my Timelines and the increasing number of requests to be connected or to follow me.

I have reached the 5000-friend Facebook Timeline quota in June 2017. 

I have created an extension in the form of group page (Reynaldo O Joson 2). I have now 961 friends as of November 3, 2018 in my Group Page Reynaldo O Joson 2.

I have created a second Timeline or Profile with the same name Reynaldo O Joson and same theme (my profile picture in coat and tie vs medical gown on the first Timeline) on September 13, 2018 after I was blocked by Facebook.  As of November 3, 2018, I have 35 friends with 94 on the request list (I will screen them as I don’t want double membership in my two Timelines).

I am also achieving my OCIL objective in my Facebook Project.  OCIL stands for Online Collaborative and Interactive Learning. I started this in 1999 to conduct online learning sessions particularly with surgical residents, medical students, and students in hospital administration. Google “Online Collaborative and Interactive Learning ROJoson” and you will see the links.

One link is: https://rojosonocilonhospitaladministration.wordpress.com/2014/03/07/online-collaborative-and-interactive-learning-program-in-a-hospital-setting-rojosons-recommendations/

OCIL is learning being effected collaboratively with online interaction not only among the learner-participants but also with the facilitator. As the facilitator, I work on the premise that I don’t know everything though I know something on the learning topic and I recognize the importance of the help of my learner-participants through collaboration and interaction in coming out with a most fruitful learning session.

I have extended this OCIL (though informally) when I started using Facebook in 2011. 

Honestly, I say I have achieved the goal of Education for Health Development in the Philippines.  Friends have been positively influenced by my posts and advocacies.  Friends have been informed, inspired and improved by my posts and advocacies.  This is a legacy I want to leave behind for the Filipino people.

For details of my Facebook, visit these two timelines:

https://www.facebook.com/rjoson2001

https://www.facebook.com/reynaldo.ojoson.73

See also the album on “Delightful Feedback to Me“.

Starting October 28, 2012, I will put up a photo album that will contain all delightful feedback to me as a person,…

Posted by Reynaldo O Joson on Saturday, October 27, 2012

Some samples of feedback to me:

For the longest time that I was blocked by Facebook in posting from September 13, 2018 to October 13, 2018 (one month), I have a lot of Facebook friends telling me they missed my posts in Facebook.  This is a blessing in disguise as I got to feel the pulse of my readers.

See the feedback here – https://www.facebook.com/rjoson2001/posts/10155562556255800

Note the 75 likes.

Sample feedback from 2016 survey:

Continue with what you are sharing thru FB. It does not only help your colleagues but it also helps us be aware of everything. Your knowledge of writing is your tool to reach other people. You educate us by your writing and it motivates us to be aware, be alert, and be conscious of our health. Commendable to all people either patients or colleagues. And with your writing it really is mightier than sword. Kudos!

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Sir, Thank you so much for sharing yourself to us. You helped me to be the surgeon that Iam now. Your teachings during our residency were valuable that up until now we are using. Even the MAR, lahat po ng nangyayari po sa akin, profession or otherwise,I learn to reflect tulad ng MAR po natin. Maraming marami salamat po Doc. More blessing po and God be with you always at sana po marami pa po kayong matulungan weather po patients or doctor. Salamat po Doc!

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I have not met yet a Doctor like you. Please continue your great mission. You inspire us. You educate us. I always read your post. Everything on your wall. Thank you Dr.Rey.

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Topic Categories of Interests by Friends (2014 and 2016 surveys):

For details on my FACEBOOK PROJECT, visit: 

https://rojosonfacebooknotes.wordpress.com/category/facebook-project-rojoson/

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ROJ@18nov3

ROJoson’s Usage of Facebook in the Department of Surgery of Ospital ng Maynila Medical Center

I officially started using Facebook on June 16, 2011 for my Timeline or Personal Profile.

I instructed the surgical residents of the Department of Surgery of Ospital ng Maynila Medical Center to use Facebook in August 30, 2012 (Secret Group) and November 2012 (OM Surgery Page).  The former was used as an internal communication system and knowledge management system aside from the Yahoo egroup.  The latter was used to promote the Department of Surgery.

Profile picture of secret group of OMMC Surgery

Profile picture of page of OMMC Surgery

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ROJ@18nov3