The Upper Hand: Chuck & Chris Talk Hand Surgery Local Only Hand Surgery, Pearls and Challenges
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Oct 26, 2025 Delve into the world of local-only hand surgery as Chuck and Chris share insightful pearls and address unique challenges. They weigh the pros and cons of performing procedures in the OR versus clinic settings, and find ideal candidates for local surgery. Discover patient persuasion techniques for choosing local anesthesia and the complexities of dealing with insurance issues. The duo also discusses training residents during awake procedures and shares valuable technical tips for successful outcomes.
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Batch And Prep Locals For Efficiency
- Do schedule local-only cases efficiently by batching blocks and alternating rooms to maintain flow and reduce fatigue.
- Do mark patients in clinic if adding cases later so you don’t waste time re-marking during a busy day.
OR vs Office: Tradeoffs Beyond Comfort
- Performing locals in the OR preserves surgeon routine and support but shifts costs to patients via facility fees.
- Office procedure rooms can reduce system costs but require upfront logistics and equipment planning.
Plan A Dedicated Clinic Procedure Day
- Try office-based procedure rooms for high-volume minor hand cases and create dedicated half-days for efficiency.
- Negotiate for facility compensation and plan supplies, lighting, and instrument sets ahead of opening a clinic procedure room.