RMV->)A Hair Out of Place
Re: "The Art of Fast OR Turnover" (December, page 42). While the article contains some good ideas, the accompanying picture on page 43 is disturbing. The scrub person has loose hair hanging over a sterile field on an eye case. Whether staged or real, this is a break of sterile technique and a poor image. Does the emphasis on time come at the expense of proper technique and patient safety?

Rita M. Julius, RN, MSA, CNOR
Director, Surgical Services, Botsford General Hospital
Farmington Hills, Mich.
writeMail('rjulius@botsford.org')

Cheryl Stanley, RN, replies:
It wasn't until you called this lapse to our attention that we looked closely at the picture and noticed the hair out of place. The instrument tech and I were both mortified because we put the highest emphasis on quality. In the five years that the Medical Group Surgery Center has been open, we have not had a single eye infection.

Most Abusive Surgeons Are Usually Most Productive Ones
Re: "Dealing with Difficult Surgeons" (December, page 58). I enjoyed reading this article and I feel that it did a good job addressing the issue. The example of the difficult surgeon lost some of its validity because the surgeon in question was responsible for only about 20% of the ASC's volume. I think that in more cases than not, the surgeons who are most abusive are the ones who provide 80% of the caseload and therefore feel that they can do anything they damn well please. It would be nice to see if and how a center or hospital deals with that situation. When one brings in 80% of the revenues, he is king. And as the saying goes, "It's good to be the king."

Rodrick Stevenson, MD, FACS
General, Vascular and Laparoscopic Surgeon
Brookville, Pa.
writeMail('rsteven156@aol.com')