Article Commentary: Surgical Workforce in the American South

2011 ◽  
Vol 77 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Anthony Charles ◽  
Katie Gaul ◽  
Stephanie Poley
Keyword(s):  
United States ◽  
General Surgery ◽  
Healthcare Access ◽  
Surgical Care ◽  
Population Expansion ◽  
The United States ◽  
General Surgeon ◽  
Successful Implementation ◽  
Surgical Access ◽  
Surgical Workforce

There exists a geographic maldistribution of surgeons with significant regional characteristics, which is associated with surgical access differentials that may be contributing to existing health disparities in the United States. We sought to evaluate the trends in the surgical workforce in southern states of the United States from 1981 to 2006 using the American Medical Association Masterfile data. Our study revealed that the general surgery workforce growth peaked in 1986 and has had negative growth per capita as a result of the consistent population growth, unlike other regions in the country. Furthermore, the change in the geographic distribution of general surgeons in the South was slightly greater than for surgical specialists between 1981 and 2006. Twenty-nine per cent of all southern counties with a collective population of 7.4 million people had no general surgeon in 2006. The failure of the general surgery workforce to grow with population expansion has resulted in a significant number of counties that do not meet the recommended standards of geographic access to surgical care. An adequate solution to surgical workforce demand is imperative for viable and successful implementation of healthcare reform, particularly in geographic regions with large healthcare access disparities.

Access through Altruism: A Community-based Free Outpatient Surgery Program for the Working Poor in the United States

2017 ◽  
Vol 27 (6) ◽  
pp. 141-144
Author(s):  
HR Nolan ◽  
B Christie
Keyword(s):  
United States ◽  
Outpatient Surgery ◽  
Healthcare Access ◽  
Large Population ◽  
Surgical Care ◽  
The United States ◽  
Community Based ◽  
Uninsured Adults ◽  
One Year ◽  
Working Uninsured

Despite healthcare reform, a large population in the United States is without healthcare coverage. The Surgery for People in Need (SPIN) program offers free outpatient surgical procedures to working, uninsured adults. Taking nearly one year to construct, the program has been operational for three years and has performed 22 procedures. Free surgery programs can improve healthcare access by providing interventions to patients who otherwise have no outlet for surgical care.

Article Commentary: Cancer Immunotherapy for the General Surgeon

2020 ◽  
Vol 86 (4) ◽  
pp. 284-292
Author(s):  
Marc W. Fromer ◽  
Charles R. Scoggins
Keyword(s):  
United States ◽  
Cancer Immunotherapy ◽  
General Surgery ◽  
Cancer Care ◽  
The United States ◽  
General Surgeon ◽  
General Surgeons

Progress in the arena of cancer immunotherapy has been immense in recent years. The fact remains that most of the cancer resections in the United States are performed by general surgeons and not oncologic specialists. A busy practice in general surgery will invariably make it difficult to keep pace with such rapid advancement. This review offers a concise summary of the major concepts and trials that have driven the immunotherapy revolution and their implications for surgeons who deliver cancer care.

Current Trends in Surgical Procedures Performed in Rural General Surgery Practice

2020 ◽  
pp. 000313482094739
Author(s):  
Wade W. Stinson ◽  
Robert P. Sticca ◽  
Gary L. Timmerman ◽  
Paul M. Bjordahl
Keyword(s):  
Hernia Repair ◽  
Surgical Procedures ◽  
General Surgery ◽  
The United States ◽  
General Surgeon ◽  
Case Volume ◽  
Endoscopic Procedures ◽  
Surgical Workforce ◽  
Operative Case ◽  
General Surgeons

Background The procedures that rural general surgeons perform may be changing. It is important to recognize the trends and practices of the current rural general surgeon in efforts to better prepare general surgeons who desire to enter a practice in a rural environment. The aim of this review is to detail the recent operative case volumes of 6 rural locations in the upper Midwest where general surgery is practiced. Methods The Enterprise Data and Analytics department of Sanford Health compiled all surgical procedures performed within the Sanford Health System between January 1, 2013 and August 31, 2018. Procedures performed by a total of 58 general surgeons in locations of under 50 000 people are included in this review. Results From January 1, 2013 to August 31, 2018, 38 958 surgical procedures were performed in rural locations. Endoscopic procedures made up 61.6% of a rural general surgeon’s practice. Cholecystectomy (6.3%), hernia repair (6.3%), and appendectomy (3.7%) were the principle nonendoscopic procedures performed by rural surgeons, comprising 16.3% of the case volume. Added together, endoscopy, cholecystectomy, hernia repair, and appendectomy made up 77.9% of the rural general surgeon’s caseload. Vascular procedures (2.5%), breast procedures (1.8%), obstetrics (0.4%), and urology procedures (0.2%) are also included in this review. Conclusions Rural general surgeons are vital to the surgical workforce in the United States. Recognizing a trend that rural general surgeons perform less subspecialty procedures and more endoscopic procedures will provide direction for those interested in pursuing a career in rural general surgery.

scholarly journals Clinical impact of pharmacist-led antibiotic stewardship programs in outpatient settings in the United States: A scoping review

2021 ◽  
Author(s):  
James St. Louis ◽  
Arinze Nkemdirim Okere
Keyword(s):  
United States ◽  
Usual Care ◽  
Antibiotic Stewardship ◽  
The United States ◽  
Controlled Trials ◽  
Antibiotic Prescribing ◽  
Successful Implementation ◽  
Pharmacist Interventions ◽  
Outpatient Settings ◽  
The Impact

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To provide an overview of the impact of pharmacist interventions on antibiotic prescribing and the resultant clinical outcomes in an outpatient antibiotic stewardship program (ASP) in the United States. Methods Reports on studies of pharmacist-led ASP interventions implemented in US outpatient settings published from January 2000 to November 2020 and indexed in PubMed or Google Scholar were included. Additionally, studies documented at the ClinicalTrials.gov website were evaluated. Study selection was based on predetermined inclusion criteria; only randomized controlled trials, observational studies, nonrandomized controlled trials, and case-control studies conducted in outpatient settings in the United States were included. The primary outcome was the observed differences in antibiotic prescribing or clinical benefits between pharmacist-led ASP interventions and usual care. Results Of the 196 studies retrieved for full-text review, a cumulative total of 15 studies were included for final evaluation. Upon analysis, we observed that there was no consistent methodology in the implementation of ASPs and, in most cases, the outcome of interest varied. Nonetheless, there was a trend toward improvement in antibiotic prescribing with pharmacist interventions in ASPs compared with that under usual care (P < 0.05). However, the results of these studies are not easily generalizable. Conclusion Our findings suggest a need for a consistent approach for the practical application of outpatient pharmacist-led ASPs. Managed care organizations could play a significant role in ensuring the successful implementation of pharmacist-led ASPs in outpatient settings.

scholarly journals Contents and features of intramural (in-school) sports in the USA

2020 ◽  
pp. 143-147
Author(s):  
I. Turchyk ◽  
R. Chopyk ◽  
N. Kizlo
Keyword(s):  
United States ◽  
Physical Education ◽  
Information Technologies ◽  
The United States ◽  
Theory And Practice ◽  
Successful Implementation ◽  
Intramural Sports ◽  
School Sports ◽  
Motor Activities ◽  
The Usa

The study and generalization of foreign experience is a value for Ukraine, which has set itself the task of integration into the world community and can be an important source of thorough thinking and creative use of positive ideas in domestic theory and practice of physical education and sports. This article analyzes the content and features of the organization of intramural (in-school) sports in the United States. The study found that intramural sports in the United States are an integral part of the overall education program, which provides an opportunity to involve children with different levels of development of motor skills and qualities in motor activities outside of physical education lessons. Participation in intramural sports programs is voluntary. It is determined that the intramural sports program in the United States is characterized by certain features that must be taken into account for its successful implementation. It was found that, first of all, American specialists determine the direction (nature) of the sports program and possible types of physical activity, taking into account the wishes of students; it is important to properly plan and compile a quality schedule for classes in compliance with the capacity of existing sports facilities; it is obligatory to observe the rules of admission of students to classes and competitions, as well as their annual medical examination; implementation of the sports program is carried out with the use of modern information technologies; the accounting and evaluation of the program is constantly carried out; proper administration and quality arbitration are of great importance; special attention is paid to the competition procedure itself and the determination of winners; a special place is given to the financing of programs and their support and promotion.

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