Two years ago I went to see Sir Chris Hoy lecture in London during his preparation for the 2012 Olympics. His repeated mantra during the lecture regarding his training for the Olympics (which were hugely successful obviously) was ‘control the controllables’
Hoy knows that he will get ill from time to time and also perhaps get some injuries. He knows that once a year he falls off his bike on the track. These things are out of his control and not worth worrying about. He deals with them as they come up and moves along.
The things he does worry about are the things he has absolute control over. How often he trains, how often he sleeps, how often and what he eats and his equipment.
This principle can be applied to clinical care all the way through. There are aspects of clinical care that we can control and aspects that we can’t. Implants will fail from time to time and patients will get infections which arrive unbidden. Some patients will do daft things following surgery (put their fingers in the wounds, not rest, not take their medication)
Many of these things are out of our control and will affect the outcomes of our implant surgery or other clinical care from time to time. I believe the trick is to control the controllables and measure what works and what doesn’t.
Patients will bring their own risks with them when they attend for clinical care. These are, for example, their oral hygiene, their ability to follow post operative instructions or to take medicine with compliance, their ability to look after themselves following detailed procedures, their anatomical situation. As long as we explain to patients in advance that the risks they bring with them to surgery are there risks and not our risks then it’s fine to progress with surgery with the patient fully consented. This is part of the process of controlling the controllables.
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