The NHS commitment to carry out routine operations within 18 weeks of referral by a GP should be reviewed, the new president of the Royal College of Surgeons said.
Orthopaedic surgeon Clare Marx told the BBC that the blanket benchmark may be inappropriate and more flexibility could be required to deal with individual conditions.
"I would like to think it would be sustainable - people don't like to wait," she told the BBC.
"But we need to think: is 18 weeks too long for some, and possibly could other people wait longer than 18 weeks?"
The deadline, first announced by Tony Blair in 2007 and now enshrined in law in the NHS constitution, has become a political touchstone backed by the main parties.
The Department of Health said there were no plans to alter the policy.
A spokeswoman said: "Ensuring patients get excellent care and don't have to face long waits are equally important parts of the treatment they receive.
"Under this Government the NHS has ended the scandal of thousands of people waiting more than a year for operations, despite record demand."
But The Patients Association backed the call for a rethink.
"Whilst we do believe a gold standard waiting time needs to be established, it is unfair and unjust for it to be applied to all patients," chief executive Katherine Murphy told the BBC.
"Clinicians must have the authority to treat patients quicker if their condition requires it."
Ms Marx also suggested surgeons needed to be more aware of the financial costs of their work.
"One of the really good things is we've worked in a system that didn't ask us to think about money and that was probably a mistake," she told the BBC.
"I don't think we have been good enough - we need to be educated in what things cost."
Ms Marx told BBC Radio 4's Today programme: "We think that having the target has been useful but just simply using it as a blunt instrument is not the way forward.
"We think that waiting lists, which are the very essence of the tension between the financial constraint and the increasing demand, is an area where now there needs to be a conversation about how we look at it in the broad and where we can actually manage it better.
"We obviously want to try to stick to that 18-week target.
"There is no question that people, in some cases, are in a lot of pain - and I'll give you examples of hip or knee replacement - where every day is an additional burden and I think we really have to look at whether or not these individuals are properly prioritised."
She went on: "But for example if we had somebody who, for instance, had a gall bladder problem who might just have some indigestion, they might be able to wait a little bit longer (than someone) who had a gall bladder problem and was very sick with it.
"So within even small areas, never mind different operations, there is a need to get clinical priority and the assessment of the individual patient at the heart of the management of that waiting time."
Ensuring more operations could be done at the weekend was one key to making sure waiting times were better managed, she suggested.