Friday, April 14, 2006

Overdue Summary....
Sorry for the long pause.
The 2006 edition of Trauma and Critical Care in Las Vegas was probably the best permeation of that meeting that I have attended. The lectures and panel discussions were excellent. One session was held on difficult surgical exposures (subclavian vessels, esophagus) and I will be able to apply the lessons learned to my patients. Another session dealt with disasters. Dr.Karim Brohi who moderates the trauma.org listserv discussed the responses to the London subway bombing from the unique perspective of someone who was there. Dr. Norman McSwain and Dr. Scott Norwood described the aftermath from Katrina from New Orleans and Baton Rouge. And as usual the case presentation discussion provided insight as to how the "big dogs" in the field handle things.
And occasionally the subject of the 80-hour workweek came up. My esteemed colleague to the west nonwithstanding, the limits, with one exception, were warmly received and were thought to be "overdue". Perhaps this is due to the "trauma/emergency surgery" or "surgical hospitalist" model that many of these physicians practice under at their facilities. The only objection came from Dr. Mattox himself, expressing concerns over the increasing "tradesman" mentality that was creeping in. With the commoditization of medical care that has occurred, I can't be surprised if the physicians begin to act like commodities.
Anyway, I am giving some serious consideration to an alteration of my career pathway. I am discussing with the various stakeholders about taking a year to go and do a trauma/critical care fellowship. My reasons include a desire to improve myself professionally and the desire to take my local program to the "next level", goals which would be easier to accomplish with the additional training and exposure. I also believe that I can get myself and my program taken more seriously if I go through with it. I am also unfortunately "falling out of love" with general surgery and would be happier limiting my practice. I would be a "non-traditional" fellow for the most part, but not too much. I'll keep you updated as the process continues, or doesn't, as the case may be.
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