John D. Kelly IV, MD
CUTTING REMARKS
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O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U LY 2 0 1 4
Cut Costs, Not Corners
Shaving expenses in the OR can be a hard pill to swallow.
0
ur ORs have been
striving to reduce over-
head. The days of cost-
cutting are here to stay, but
it's sometimes a bitter pill to
swallow.
• Recycling instruments.
Months ago, when our OR
went on a recycling spree, we used reusable arthroscopic shavers and
burrs. The idea certainly had some merit: Why should an expensive
shaver blade be tossed after only 5 minutes of usage? Several problems
ensued. Some shaver blades sounded as if they were on life support
and removed tissue at glacial speed. Some of the burrs were duller
than a visit from the in-laws. Not to mention, rumors began to circulate
that trace amounts of a previous patient's DNA could be detected in
the recesses of the shaver tips. Great, we saved a few bucks on the
shoulder scope, but the patient contracted mad cow disease!
• Standard shoulder anchor.
Our administration has long urged our
shoulder surgeons to use the same implant system. This is truly a tall
order to fill. One commonly used anchor set has more parts than my hard
drive. A rotator cuff anchor used by a colleague is straightforward and
simple, but it has the pullout strength of sugarless bubble gum. Plus, since
the material science of implants has exploded, the minute I may decide
on one anchor, another stronger, more user-friendly and, yes, more effec-
tive anchor manifests.
• Reusable gowns.
Some time ago, we trialed recyclable OR gowns;
yes, gowns that could be washed and used repeatedly. Truly a throw-
back to my days of residency. Now I have no issues with reusable gar-
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