018: Case Selection Versus Case Complexity
Case Selection Versus Case Complexity
Hey ya'll. In a recent post on X (formerly Twitter), I proposed that case selection is one of the most critical factors in achieving good surgical outcomes. Today, I want to dive deeper into that idea and explore some common pitfalls that can lead us astray.
Why do we sometimes struggle with case selection?
1. Ego and overconfidence: We overestimate our abilities and take on cases that exceed our skills and experience.
2. Inability to admit limitations: We're reluctant to acknowledge when a case is beyond our current scope of expertise.
3. Lack of self-awareness: We have blind spots and don't recognize areas where we need improvement.
4. Ignoring feedback: We dismiss constructive criticism from patients, team members, or colleagues that could help us grow.
5. Financial incentives: The prospect of higher fees for complex cases can cloud our judgment.
6. Institutional pressures: Quotas or expectations from employers (academic, military, DSOs) may push us to take on more than we should.
7. Fear of losing referrals: As specialists, we worry that referring out challenging cases will diminish our referral base.
The dangers of poor case selection include: choosing case complexity that exceeds our skills and experience sets us up for suboptimal outcomes. Negative results can damage our reputation and lead to a loss of referrals.
8. Focusing on successes while downplaying failures gives us an inflated sense of capability. Dunning-Kruger effect: Early-career practitioners may not recognize their limitation.
9. Inadequate training in specific areas (e.g., an OMS skilled in craniofacial surgery but undertrained in implants)
10. Stress, rapid pace, decision fatigue, and burnout can skew our judgment
The key to success is aligning case complexity with skills and experience.
When skills/experience exceed the complexity of the case, success is likely.
When they're evenly matched, consider patient factors and personal readiness.
When case complexity exceeds skills/experience, refer out or pursue additional training.
This topic resonates with me, as I've personally experienced the consequences of misaligned case selection, including burnout.
By sharing these reflections, I hope to spark meaningful conversations and encourage thoughtful decision-making.
I'd love to hear your thoughts.
Follow me on X @RussellKirkDDS, where I post daily on oral surgery topics (I promise, no controversial tangents).
As always, feel free to reach out at [email protected].
Talk to you next week!
