APDS Lecture 2005-10-18

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Health & Medicine

What Will a General Surgeon Be in 2010? Frank R. Lewis MD Executive Director, American Board of Surgery Association of Program Directors in Surgery San Francisco October 18, 2005

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Myth and Reality in General Surgery H. Brownell Wheeler, MD ACS Bulletin 78:21-27; 1993 2 3.0 81 Carotid CR - 1989 GS-Avg/yr Total (000) Operation 44 20.2 536 Cholecystectomy 42 14.7 391 Groin hernia 27 11.4 303 Appendectomy 11 3.0 79 Incisional hernia 10 3.2 86 CD Explor 5 3.4 91 Hemorrhoidectomy 24 3.9 103 Laparotomy 15 4.6 122 Mod rad mastect 35 7.6 203 Colon resection

Myth and Reality in General Surgery (2) H. Brownell Wheeler, MD ACS Bulletin 78:21-27; 1993 7 1.3 35 Blood vessel rep CR - 1989 GS-avg/yr Total (000) Operation 11 2.8 75 Fem Pop Bypass 6 2.6 68 Colostomy 11 2.5 65 Thyroid 3 1.3 34 Abd aneurysm 3 1.3 35 Splenectomy 4 1.3 35 Partial gastrectomy 4 1.9 50 Intestinal anast -- 2.0 52 Umbilical hernia 8 2.3 62 SB Resection

Myth and Reality in General Surgery (3) H. Brownell Wheeler, MD ACS Bulletin 78:21-27; 1993 0 0.2 4 Cancer of tongue CR - 1989 GS-Avg/yr Total (000) Operation 2 0.6 15 Abd-perineal res 0 0.5 14 Radical neck dis 0 0.5 13 Rectal prolapse 0 0.2 4 Pancreat cyst drng 0 0.2 5 Adrenalectomy 0 0.2 6 Cancer of lip 2 0.3 8 Total gastrectomy 2 0.3 9 Parathyroidectomy -- 0.4 10 Anterior resection

Myth and Reality in General Surgery (4) H. Brownell Wheeler, MD ACS Bulletin 78:21-27; 1993 0 <0.08 <2 Pelvic exenteration CR - 1989 GS-Avg/yr Total (000) Operation 0 0.1 3 Partial hepatect 0 0.1 3 Portal syst shunt 0 0.1 3 Ilioanal anast 0 <0.08 <2 Liver abscess drn 0 <0.08 <2 Panc-jejun-ostomy 0 <0.08 <2 Panc-duod-ostomy 0 0.08 2 Pancreatectomy 0 0.08 2 Esophagectomy

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US Healthcare System Earns C+ for Patient Safety Robert Wachter, M.D. Health Affairs November 30, 2004 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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