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Behind the knife the surgery podcast where we take a behind the scenes intimate look at surgery from leaders in the field.

Welcome back to Behind the Knife. This is Patrick George Off.

Today we're going to talk about an extremely important topic.

End of life care and decision making.

It's something that is a challenge for many surgeons but is rarely discussed and is certainly not taught in much detail.

And we're very lucky today to be joined by Dr. Gretchen Swarsie, associate professor of vascular surgery at the University of Wisconsin in Madison.

She received her MD and master in public policy from Harvard, completed general surgery residency at Mass General and vascular surgery fellowship at the University of Chicago, where she also completed a medical ethics fellowship.

Dr. Swarsie is an expert in surgical decision making informed consent and mass directors and end of life care and she's the creator of the best case worst case tool, which is part of the patient preferences project that she leads out of Madison.

Dr. Swarsie I'm thrilled to have you on behind the night today.

Best case worst case scenarios have played a central part in my practice as a trauma surgeon and intensive is I'm particularly happy to have you on today.

Thanks so much for having me.

Of course, another best case worst case tool helps improve communication between older patients and their surgeons so that patients can avoid unwanted treatment and also make decisions that align with their values, their preferences, and their goals.

And as most of our listeners know, that is definitely not easy to do, which is extremely challenging.

And as surgeons, these kind of discussions are commonplace. So Gretchen, what was the need for the best case worst case tool and how does it help?

It's a great question, Patrick. People have heard me talk before will have heard this story, but I think it's such a good way to describe why best case worst cases important.

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