Do you define start time as in-the-room time or as cut time? We're trying to condition our surgeons to think of start time as cut time. Trouble is, they've long thought that being on time for a 7 a.m. case meant being in the room at 7 a.m., not making their first incisions at 7 a.m. Big difference between the two, especially when the same surgeons who work in your main ORs work in the outpatient ORs, as is the case at my hospital. Here's how I'm trying to get them to set their watches to cut-time-equals-on-time.