Challenging the Status Quo Can Help Protect Patients

For trauma surgeon Paula Ferrada, MD, FACS, FCCM, the words “We have always done it this way” can signal a barrier to better care.

“Dr. Ferrada is an ACS Governor, Chair of the Department of Surgery at Inova Fairfax Medical Campus, and Division and System Chief of Trauma and Acute Care Surgery for Inova in Falls Church, Virginia.”

In her TEDxChantilly HS talk, “The Most Dangerous Sentence,” Dr. Ferrada draws on lessons from trauma resuscitation to explain why questioning established practices is essential to patient safety.

Her message reflects the ACS commitment to improving patient safety, surgical quality, and the culture of surgery, highlighting how everyday leadership and communication can support better care.

Dr. Ferrada describes the challenges of reconsidering the traditional airway-first sequence of trauma resuscitation for patients with severe bleeding. Based on experiences that began while observing her father’s work as a trauma surgeon in Colombia, she recounts resistance to prioritizing circulation over a familiar approach.

Her broader message concerns the culture surrounding clinical decisions: Progress requires teams willing to examine assumptions, learn from evidence, and collaborate across disciplines.

That willingness depends on how leaders respond when someone raises a concern. When complications occur, Dr. Ferrada urges teams to focus on how systems can prevent future harm.

“If you're shaming and blaming people, people are not going to tell you what's going on,” she says.

Blame, ridicule, and dismissiveness can discourage team members from sharing information or interrupting a potential error. Technical excellence alone, she argues, cannot compensate for a culture that makes people afraid to speak.

Nurses, respiratory therapists, medical students, and other team members bring perspectives that can improve care. Leaders must create environments where those contributions are welcomed without fear of retaliation.

“And in order for us to get it right, no person in the room needs to be more important than the mission, which is saving a life,” Dr. Ferrada says.

She closes with a challenge for surgeons: When someone says a practice has always been done a certain way, have the courage to ask whether a better way exists.

Watch Dr. Ferrada’s TEDx talk.