Today’s surgical environment is a complex multifaceted one that has eroded the traditional doctor patient relationship. Increasingly a discerning public expects surgery to be efficiently performed and be free of complications. Decisions about choosing a doctor are now data driven and the health system must adapt accordingly in order to attract patients. The streamlining of the patient: treatment: outcome continuum can be made better with the use of various standard operating procedures such as the use of guidelines, protocols and checklists with a multidisciplinary team where all stakeholders are actively engaged. This is especially important in developing countries for the potential savings in lives and finances. Still the need for individualization and good clinical judgment remains. The basis of all our decisions however must be evidence-based, and once applied in the best interest of the patient will benefit health care systems. There is good evidence that this is the case, and the only limitation currently is the lack of more widespread implementation.