The crucial question for larger communities is whether acute
care surgery only benefits suburban and rural communities
and smaller hospitals. Acute care surgeons and the acute
care surgery model of staffing emergency rooms can
improve patient access to on-call emergency surgeons.
center—167 by in-house acute care surgeons and 127 by
traditional house-call surgeons. 8 The study’s researchers
found no statistical difference in the time these individuals needed to complete the consultation, but the acute care
surgery model resulted in significant decreases in time from
consultation to operating room, and in complication rates,
rupture rates, as well as overall length of stay.
The effect of acute care surgeons on other general
surgeons also is positive; they complement each other.
As previously stated, practice models are changing, and
current graduating physicians place more emphasis on
workload and lifestyle. To satisfy their desire for work-life
balance, an increasing number of general surgery graduates
continue their training to obtain subspecialty fellowships,
which creates a potential shortage of practicing general
surgeons. The availability of acute care surgeons to care
for many of the emergency surgery patients will encourage
more trainees to enter the field of general surgery because
they will be able to maintain an elective practice with more
consistent office hours and surgery schedules that are not
disrupted by emergency consultations and add-on operations. In return, as an acute care surgeon, I experience the
satisfaction of helping patients in their time of need, dealing with the diagnostic dilemmas of the presentation to
the emergency room, and performing various complex
procedures—all before I go home when my shift is done. ♦
The author would like to acknowledge the guidance and men-torship of Frederick B. Rogers, MD, MS, FACS, trauma program
medical director, Lancaster General Health, PA, and John Fildes,
MD, FACS, foundation professor; acting chair, surgery; chief,
division of acute care surgery; and program director, acute care
surgery fellowship, University of Nevada School of Medicine,
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the United States Health System. Hospital-Based
Emergency Care: At the Breaking Point. Washington,
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Available at: http://healthleadersmedia.com/page-1/
Within-Decade-AAMC-Says. Accessed September
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Complexities of Physician Supply and Demand:
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surgeon’s perspective. Surg. 2007;141( 3):293-296.
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surgery model improves outcomes in patients with
appendicitis. Ann Surg. 2006;244( 4):498-504.