In my hospital, this month has such overuse of capacity that every surgical ward is now littered with acute medical patients - it is what they denote as "Code Black status". Most of November was a "Code Red". Following from my previous post, now the medical teams have to leave their comfort bubble of their home ward and embark unto various surgical wards - but which medical team is responsible for medical patients on the orthopedic or general surgery ward?
Even more interesting is that the medical director feels it is necessary that the surgical SHOs assist the medical take during "Code Black." This is absurd! It is understandable that suddenly, their teams are stretched and now end up with Safari ward rounds. I argue, surgeons have always been doing this. However, asking me to review and manage a medical patient admitted with IECOPD on a background of CCF and CKD is out of my depth. If I prescribe something for a medical patient, what is my medicolegal stance - will the medical consultant support my error? I doubt it. Instead, it'll go back to the GMC and state I'm incompetant and risk losing my license.
Would you want to be seen by a surgeon if you came to the A+E with acute chest pain? Imagine the conversation:
Me: "Hi I'm the surgeon on call today, Mr Steth. I understand you have some chest pain..."Patient: *horror face- at the thought of needed an operation for his suspected heart attack*
What purpose do I fill seeing such patient in A+E when I have no role in the medical post-take? Surgeons chose surgery for a reason - not to be demoted back to acute medicine.
Interestingly, I haven't found any regulations regarding the cross-covering of medical-surgical specialties. This is a gray area that will need clarity. I don't deny that managing medical take is a challenging task - but there is a reason I chose to be a surgeon. Being involved in the medical take is not one of them.
