Protocols and pathways are supposed to make patient care more efficient and cost-effective. Protocols promote uniformity in patient management and hopefully promote safety. However, protocols and pathways can cause doctors to stop thinking.
As an example, my patient had an extended right hepatic lobectomy and bile duct resection for cholangiocarcinoma. He was older and also had a slightly enlarged prostate. His operation went well and his postoperative course was smooth except