SLOW SURGERY?

Editor,

Some of your readers will have heard of slow medicine. This concept was born in Italy in 2011 and aims to make medicine more measured, respectful and equitable.1 Slow medicine asks health professionals to take their time to allow for a more holistic approach and a careful consideration of new methods and technologies. The movement has expanded, particularly in Europe. 2

This has got me thinking about the surgical equivalent − slow surgery. For example, my Health Board in Wales, a home nation of the UK, has introduced an orthopaedic lifestyle programme for patients who may need a hip or knee replacement and have a Body Mass Index (BMI) of 35 and over. Patients take part in a 32-week programme of exercise classes at Leisure Centres and receive support from qualified professionals such as physiotherapists and dieticians. The aim is to induce weight loss in order to reduce the complications of surgery, as well as to decrease pain to the point, in some cases, where surgery is no longer needed.

The operational standards relating to referral to treatment times in Wales are that 95% of patients should be seen within 26 weeks, and no patients should wait longer than 36 weeks.3 Trauma and Orthopaedics is the largest contributor to long waits, with 66% of total waits over 36 weeks in March 2018 being from this surgical specialty; this is followed by general surgery (9%). Therefore, could it be argued that we are practicing slow surgery by default anyway? I am sure that the picture will be similar in other home nations of the UK.