'Satisficing' in surgery: balancing pragmatism against perfectionism?

The pursuit of the supposed best, 'ideal', or 'gold standard' solution, which often involves greater complexity, risks and/or costs, and/or morbidity, is coined 'maximising'. For several reasons addressed in this article 'maximising' suffuses many surgical cultures. The polar opposite is 'satisficing'. The concept of 'satisficing' was articulated by Herbert Simon in 1956 and earned him the Nobel Prize. He advocated a pragmatic approach in which solutions are sought that are 'sufficient to be satisfactory for that situation' rather than relentlessly pursuing the 'single perfect solution'. The tension between these philosophies in maxillofacial surgery is exposed, with clinical examples and the legal responsibility to the patient highlighted.