Critical self assessment--is it too much for a surgeon?

Self-assessment can be performed by each individual surgeon or by a group of surgeons covering a sub-specialty at a hospital. The individual self-assessment programme can be performed by using appropriate soft-ware and a personal computer. In some countries such self-evaluation is an excellent preparation for re-certification examinations. Other parts of the self-assessment programmes should include indications for vascular surgery perhaps in the form of so-called indication conferences. Also morbidity and mortality conferences are of great importance to minimise similar problems after a broad multi-disciplinary discussion of complications and deaths which have occurred in the vascular service. By using vascular registers each individual surgeon can compare his own results with a national average or with the results of his colleagues at the actual hospital. Self-assessment programmes in vascular surgery should also include the results of diagnostic work performed in vascular laboratories. in this way we can get an impression of the sensitivity, the specificity, and overall accuracy for the procedures performed by the laboratory. A self-assessment programme should in conclusion be an integrated part of the practice of every surgeon.