Strategisches Denken als Schlüssel zu chirurgischer Exzellenz

"Sapere aude! Have courage to make use of your own understanding!" demanded Kant. Excellent surgeons use their own understanding because the individuality of treatment situations requires individualized solutions instead of rigid rules. Obviously, a major source of individuality is the will of the patient. However, according to Clausewitz individuality results from three independent forces that rule a field of action. The first force is violence which is brought about by the threat of death rooted in the disease and which establishes the reign of emotions in the surgical field. The second force is uncertainty which turns decisions into an estimate of probabilities. The third force is politics which makes medicine an instrument of the political will. The strategic thinker understands the conflict of these forces as a process with the challenge to find an individual optimum. In this article strategic thinking is developed as a highly effective method that allows linking of individual purposes of patients with the rationality of medicine. The strategic thought style is the foundation of individualized medical decision making methodology which opens the way to surgical excellence.