In the world, the physician’s job is teaching research and patient care. For practical purposes, we categorize physicians into one of 3 branches of medicine: 1) research scientist 2) clinical physician educator & role model and 3)biotech business executive.
In plastic and reconstructive surgery, every diagnosis and actually each individual physician concentrates his efforts in one of these classifications. In the physician educator role, cleft lip and palate is part and parcel of the job description. Almost more than other diagnoses, Etiology, is the broad knowledge of the interesting historical aspects in medicine and the part in spiritual, social and physical life – as well as its usual nature and incidence of the condition, and its physical and social disability are intimate to our knowledge, education and skill base as physicians.
Each specialty has its own psychological profile. Part of the profile of plastic and reconstructive surgeons as a species is an abiding desire to fulfill the needs of the patient’s chief complaint of their problem. Perhaps this derives from the concentrates on pleasing the patient in the aesthetic part of the specialty. And it certainly relates directly to the fact that plastic and reconstructive surgery were the first to address the cleft lip and palate diagnosis with international humanitarian surgical efforts.
Mention of the three models for addressing the world problem of cleft lip and palate is made here:
1) the efforts of great individual physicians Schweitzer, Dooley, and Turpin, and preceded the great plastic surgeons.
2) Barsky, Gorney, Millard, Horton who were pioneers individually. These plastic surgeons were on the frontier and were motivated by their internal code, by their basic way of life in reconstructive plastic surgery, their interest in service to other people.
3) the Team Model was perhaps born with Horton who was the role model for Laub in 1968 to begin multidisciplinary short-term trips to “medium resource” sites with features of regular scheduling, returning, individual, to get follow up and are care of complications, with a written statement of intention signed by the professionals from both countries, more complete archiving records, and integrating teaching and research, for everyone involved. This model has been replicated over 5000 times with good general success, and in short time has solved the problems of “parachute trip” and itinerancy in responsibility for complications and follow-up.