(RCJ: I find it extremely hard to respect Commanders who are 
functionally illiterate...epecially when they have the temerity 
to attempt to use their middle school level of language arts 
skills to correct my spelling and grammar on Officer 
Performance Reports. Here's an excellent example of the 
"Dilbert Principle" in action: promotion of idiots to positions 
WAY beyond their level of competence. I suppose the Air Force 
Academy was too busy with other things 
to teach him basic English composition...)



					24 Nov 99

MEMORANDUM FOR 60th Surgical Operations Squadron Surgeons and Operating Room Personnel 

FROM: 60 MSGS/CC

Subject: Policy for Operating Room Scheduling

1.  For the better part of two years several initiatives have been attempted 
to provide clear and concise methods of communication for the scheduling of 
the operating room. Some have been successful; others have been mired in 
opinionated and tunnel vision discussions doomed to fail. The intent of 
this policy letter is to organize a system that all players will 
understand and abide. The practice of medicine and surgery is however 
fluid, the environment and people change. Therefore an important part 
of this policy is the review necessary, giving the flexibility to 
improve on our methods assuring a systematic approach. 

...5.  Let's talk about specific cases.  Yes, not all Colectomies or 
Total Abdominal Hysterectomies are all the same. Therefore we will 
have different block times for difficult versus easy cases.  simple 
Sigmoid Colectomy 2 ½ hours, scarred/cancerous Sigmoid colectomy 
4 hours, as an example.  This requires surgical honesty when 
scheduling. How about "new" cases, never done before, or when no 
block times have been set. I expect the surgeon to honestly give 
cut time to the scheduler who will add in room perioperative and 
anesthesia time for a block time. No arguments allowed.  This 
should be completed through the flight commanders.  It is important 
to remember.   Honesty means the whole crew wins on the average. 
How about two cases that add more than 9 hours. We take care of 
patients therefore if necessary and capabilities are there, this 
can be worked for special situations, but must be arranged through 
Anesthesia and the OR scheduler by the flight commander or designee. 

	     [I.M. Truly Illiterate], Col, USAF, MC
                                     Commander


(see my book, A Fly in the Hand: Uncensored Military Medical Quotes, 
for a line-by-line critique)