Physician surgical assistants are an essential component in the success of many surgeries

My standard party joke is that, as a physician surgical assistant, I get a full-body orthopedic workout in the OR multiple times a week. When I’m assisting a surgeon performing a bipolar hip replacement, for example, I’m supporting the patient’s leg with my legs to keep theirs straight so that the prosthesis can be inserted correctly. At the same time, I’m holding the surgical retractors with two hands to hold the incision open and optimize visibility for the surgeon. Sometimes, I’m holding the retractor with one hand and keeping tension on a suture with the other to protect the wound. Either way, there are many days when I’m literally using all four limbs at once. An amusing image, perhaps, but being a surgical assistant is a serious business. Read: The pain of paperwork comes in many forms I’m sharing my experience as a physician surgical assistant not to aggrandize my role in the operating room. Everyone in that space has their own crucial role. My purpose is to challenge the incorrect assertion made recently in your publication by a retired GP who now works as a surgical assistant. It’s his belief that surgical assistants only follow surgeon’s orders; that since they make no decisions regarding care or treatment, they shouldn’t be required to collect continuing medical hours. The reality is that every day the 5,000 physician surgical assistants in Ontario step up for patients, making decisions and anticipating the needs of surgeons to improve the outcome for the person lying on the table. We are a second set of hands and a second set of eyes for the surgeon in an arena where time is of the essence and mistakes or oversights can contribute to a good outcome or a poor one. In some cases, these decisions can make the difference between life and death. While every healthcare professional in the operating room holds value, it is the surgical assistant who stands next to the surgeon for the duration, equally laser focused on each step, each incision, each extraction, each staple and each suture. A good surgical assistant learns to follow the surgeon, and most surgeons rely on us to speak up if we see a problem they didn’t notice Our first job is to make the surgery possible. Our second job is to make it easier. Our third is to be a backup. If the surgeon is about to cut something they haven’t seen or if they’re having trouble finding a bleeder, the surgical assistant might see it. This doesn’t mean the surgeon is a bad surgeon. It just means that they can’t look everywhere at the same time. To reach that level of excellence, it’s essential that physician surgical assistants—like all doctors —keep up with advances in medicine. New technologies and research mean a constant evolution in how things are done. We invest time in learning how to use new tools and understand new approaches to surgeries. Part or our role is to know surgical procedures well enough so that we can anticipate what’s coming next and to be prepared for it. We attend interactive lectures where we learn the intricacies of various surgical procedures. We take part in workshops where we test out new equipment like the latest in shoulder replacement sets. Manufacturers demonstrate how their particular brand of staplers works, and we are there to learn and translate what we have absorbed in the OR. Our commitment to continuing medical education means that when we are assisting in a bowel resection, we use that new stapler to correctly reconnect the severed sections of the organ so that the patient’s bowel doesn’t leak. So that it doesn’t get infected. So that the surgeon doesn’t have to remove more bowel later. It means some of us have the knowledge to harvest grafts from a patient’s leg or arm in cardiac bypass surgeries, freeing up the surgeon to attach them to the vessels on the heart sooner, in order to keep blood flowing. It means when a baby delivered by emergency C-section needs resuscitation, there is another highly trained professional in the room to assist. Traditionally, when a patient required surgery, their family doctor assisted the surgeon in the operating room. To this day, primary care doctors volunteer to take a day out of their practice to assist in surgeries in smaller communities where scarce resources mean there is no one dedicated to that role. Doctors who spend their career as surgical assistants are physicians first. Like any other physician, we are required to fulfil the requirements of a physician’s license to practice, and that means completing continuing medical education activities to increase our knowledge, skills and professional performance. Like any other physician, we are called upon to use our knowledge and skills to make decisions that affect patient well-being. Like many other physicians, we function in a highly stressful, high-stakes environment where missteps have life-altering consequences. Physician surgical assistants are an essential component of the success of many surgeries. Surgeons recognize our value, and I have no doubt that the patients who know about our role do as well. It’s disappointing when members of our own profession devalue it. But I’m grateful for the opportunity to provide better insight into what surgical assistants really do. Dr. Martha Riesberry is a physician surgical assistant in Cambridge, Ont. and chair of the Ontario Medical Association’s surgical assistants medical interest group.

Physician surgical assistants are an essential component in the success of many surgeries

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