Sunil Sahai, M.D., has dedicated his career to assessing and improving patients’ chances of surviving surgery. He wants the patient’s surgical course to be free of as many avoidable hurdles as possible.
A service surgeons appreciate
“We frequently operate on patients who are considered high risk due to the complexity of their surgery, their medical risk factors, or both,” says Randal Weber, M.D., professor and chair of Head and Neck Surgery. “Poorly controlled or unrecognized medical conditions that are not appropriately managed preoperatively can lead to a poor outcome for the patient.
“Multidisciplinary care allows us to achieve optimum outcomes,” he adds. “We work closely with our colleagues from IMPAC, who thoroughly evaluate our patients before surgery.”
Jason Fleming, M.D., professor in Surgical Oncology and specialist in pancreatic cancer, agrees, “IMPAC has been an extremely valuable resource for determining risk and ensuring comorbidities are accounted for. Ultimately, it allows us to perform personalized, safe and effective surgery.”
Compiling each patient’s medical history
While Sahai is the only physician dedicated to the center, the other internists in the department rotate through; there are generally two physicians and an advanced practice nurse on duty each day.
The IMPAC service operates as a “center within the center,” staffed with two nurses and two patient services coordinators dedicated to the clinic. The IMPAC team searches records, contacts community doctors and puts together the most accurate and comprehensive medical history possible. Then, they coordinate medically complex patients with the surgery and anesthesia teams .
“We see about 20% to 25% of patients going for surgery or close to 6,000 patients a year,” Sahai says. “Some patients don’t need to be seen by us because they have few medical issues, and, in general, the better a patient’s physical condition, the better the potential for successful surgery without complications.
“The best news is that due to the time we can spend with patients before surgery, the less time they spend in the post-operative setting, dealing with medical complications that could have been avoided, allowing them time to heal and focus on their recovery from cancer,” he says.
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