How to protect patients while doctors learn is a conundrum faced in all areas of medicine. For example, studies have shown that surgeons' outcomes improve up to four years after their first hospital appointment. Some have argued that neophyte surgeons during this period should take on only the most straightforward cases. Yet every doctor eventually has to perform a procedure for the first time. It isn't only doctors who face this quandary. Hospitals too have their own learning curves. Medical teams work better together with practice. The first few cases of a new procedure frequently have subpar results.