Although total parenteral nutrition (TPN) became indispensable in the management of certain conditions approximately ten years ago and is now increasingly used even when dispensable, some patients are still plagued by technically inept application of the method, as is discussed elsewhere in The Journal (p 1906). The remedy, says Dr Nehme, is the team approach. His data seem unequivocally in favor of the informed group, compared with the single practitioner who, at least in this study, was sometimes uninformed or inattentive. Others have also described superior performance after forming a group,1,2 which can accumulate experience more rapidly than an individual, provide a wider background of knowledge, offer formal training, and create the opportunity to conduct controlled trials. At the least, records are kept, and errors are less likely to be ignored when the hospital has a team.
This is not to say that a well-trained physician or surgeon, attentive