Why do so many in academic health care tend to assume that subspecialty surgical training begets higher quality health care than general pediatric surgical training?

BACKGROUND

The author spent all his attending level practice in general hospitals, resulting in early exposure to developing technologies, allowing early adaptation.

ILLUSTRATIVE EXAMPLES: The adaptation of balloon dilation of arterial stenoses to treat esophageal strictures in children, and the use of MRI in anorectal malformations.

RESULTS

Balloon dilatation of esopageal strictures and MRI assessment of anorectal anomalies became routine care.

CHANGES IN ETHICAL LANDSCAPE: Both of these innovations were discussed with the Ethics Committee. Neither were subjected to further ethical oversight as they were transitioned into standard practice.

CONCLUSIONS

Neither innovation would have happened at that time in a pediatric hospital, as neither technique was available in pediatric institutions. Such opportunities need to be recognised and acted upon for progress to be made.