I have a particular interest in hand trauma where the patient’s values clearly need to be central to the decision making process. I am keen to facilitate an improved and deeper application of the principles of Values Based Medicine. I am also on the board for the British Foundation for International Reconstructive Surgical Training. Working across cultures adds complexity to the process of getting to understand the values held by a patient, but in this context it becomes even more important to ensure that the treatment offered serves to fulfill the patient’s values and needs.