The Surgeon

The throughput committee met quarterly. Each quarter, the data showed the same thing: his rooms ran long.

He did not dispute this. He ran long because he did not rush the setup. Setup was when errors happened. Not during the procedure — before it. The count of instruments. The positioning. The drape. He had a checklist. He had used it for twenty-one years.

The committee explained that other surgeons met the time targets.

He said he was glad for them.

He was asked to review his process for efficiencies. He reviewed it. He found none. He told the committee he had found none. The committee suggested he consult with a process improvement specialist. He consulted. The specialist suggested he eliminate two steps from the checklist. He did not eliminate them.

He was passed over for the department chair position twice. The second time, the chief of surgery told him the decision had nothing to do with his clinical outcomes.

His clinical outcomes were, she acknowledged, excellent.

He retired at sixty-eight. At his retirement party, a resident asked him what he’d do differently.

He said: nothing about the checklist.

She wrote it down.