Bassett healthcare rural surgery experience.

The surgical training at Bassett is naturally broader than in many university settings, with a survey showing that nearly 70% of graduates who practice general surgery remain in a rurally designated area. Rural surgery experience falls into 3 categories: undergraduate, graduate, and postgraduate. The general surgery training program has no competing fellowships or subspecialty residencies; residents get significant experience with endoscopy; ear, nose, and throat; plastic and hand surgery; and obstetrics and gynecology. The rural setting lifestyle is valued by the students, residents, and fellows alike. It provides an ideal setting for recognizing the specific nuances of small-town American life, with a high-quality education and surgical experience.

General surgery contributes to the financial health of rural hospitals and communities.

Rural hospitals and communities often profit from the ability to provide surgical services. There can also be substantial financial costs for individuals, hospitals, and communities associated with not having access to surgical care in rural areas. Despite these advantages, limitations that include a shortage of rural general surgeons and other surgical staff and financial constraints prevent some rural institutions from offering surgical services. Few concrete data are available on this subject, and more research is needed to confirm anecdotal reports regarding the positive economic impact derived from general surgical services. It is especially important to examine and quantify the direct and indirect financial contribution that a general surgeon makes to a rural hospital and community.

Comparison of urban and rural general surgeons: motivations for practice location, practice patterns, and education requirements.

BACKGROUND: The purpose of this study is to determine the differences between rural and urban surgeons with regard to practice patterns, factors in choosing a practice location, and educational needs. STUDY DESIGN: A list of surgeons obtained from the American Medical Association was examined using the Office of Management and Budget definition of rural. Seventeen hundred rural surgeons were mailed surveys; 421 responded. One hundred fourteen urban surgeons were contacted by telephone. Questions were designed to measure job and community satisfaction, factors influencing their decision to practice in their current location, spectrum and volume of cases, and their perceived educational needs. RESULTS: Age distribution did not differ markedly between urban and rural surgeons. Motivation to practice in their current location varied considerably between urban and rural surgeons. Both groups equally rated quality of life as the leading factor influencing their current practice location. Urban surgeons rated other factors, such as income, practice growth, hospital facilities, and proximity to family, higher than rural surgeons. Practice patterns and educational needs also varied between the two groups. Rural surgeons performed more procedures per year with more variety in procedure type. Both groups felt that additional training in advanced laparoscopic techniques would be helpful, and rural surgeons felt that additional training in the surgical subspecialty areas was important. CONCLUSIONS: Although rural and urban surgeons do not differ in age or the importance of lifestyle in deciding career location, different factors do impact their choice of location. Practice pattern and educational needs varied markedly between rural and urban general surgeons.

Surgical clips to help identify anatomy after a Nissen fundoplication.

Laparoscopic fundoplication has had a remarkable growth in the treatment of gastroesophageal reflux disease. But a failure rate of more than 5% has led to increasing numbers of patients with recurrent symptoms presenting for corrective surgery. A simple technique of placing surgical clips on the sutures used to place the wrap helps identify the anatomy during contrast studies and helps plan for corrective surgery.