40 years of surgery in a general hospital : between pitfalls and passion

The general hospital is authorized to care for surgical patients. The local resources, organization, and skills are detailed. Over the past 40 years, the organization has undergone significant changes with beneficial specialization for patients. The creation of a federation for digestive, medical, and surgical pathologies is outlined. Relations with administration have experienced slow and inevitable deterioration, distancing doctors from decisions regarding organization and recruitment of practitioners. The recruitment and care of patients, with the constraints specific to surgery and private practice, are discussed. The essential importance of teamwork is emphasized, as well as the necessary collaboration with colleagues in anesthesia. The organized collaboration with a referral service, ensuring safety, is highlighted. The value of multidisciplinary meetings (MDMs), guaranteeing appropriate care for cancerous pathologies, is elaborated upon, specifying that they are a crucial aspect of the activity. The increasing litigiousness and its anxio-deleterious effects are mentioned. In conclusion, surgery, a demanding but fascinating specialty, must be reorganized by surgeons themselves.