American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Acute care surgery needs rebranding

OCTOBER 24, 2017
Clinical Congress Daily Highlights, Tuesday Second Edition

Acute care surgery — despite its storied history and contributions to the evolution of surgery — is experiencing a “workforce crisis,” said this year’s Scudder Orator, L. D. Britt, MD, MPH, DSc (Hon), FACS, FCCM, Henry Ford Professor and Edward J. Brickhouse Chairman, East Virginia Medical School, Norfolk, VA.

Dr. Britt began his Tuesday presentation by tracing the contributions of former Scudder Orators and historical leaders in the field of trauma surgery. To emphasize this important influence, he quoted Kenneth L. Mattox, MD, who wrote in 2000 that “advances in medicine are often a function of advances in trauma ... . When trauma care has made quality advances, medicine and society have benefitted.”

Specifically, Dr. Britt described the area of acute care surgery, a specialized field that includes trauma, critical care, and emergency general surgery. He outlined its aim as a specialty developed to address the needs of surgical patients who are injured and critically ill.

However, despite the foundation set by past leaders in trauma surgery, Dr. Britt noted a lack of interest in trauma and critical care, leading to shortages in the workforce. He identified reasons for the crisis, which include poor reimbursement, lack of fellows, dwindling specialist coverage, and more complex and elderly patients.

Dr. Britt proposed that this workforce crisis could be solved through a “rebranding” of acute care surgery, allowing young physicians to better understand and appreciate the role of acute care trauma surgeons. He urged broadening support for acute care surgery among U.S. surgical leaders, specialties, and other organizations and stakeholders.

In short, he stressed that acute care surgery needs to be viewed as a critical and essential service across all specialties, and that steps must be taken to ensure that the patients of tomorrow have access to quality trauma care. “Let us hope that acute care surgery will not be added to the list of missed opportunities to capture market and to gain universal recognition.”

Additional Information:
The Named Lecture, Trauma: Still the Cornerstone of Acute Care Surgery, was held October 24, at the 2017 Clinical Congress of the American College of Surgeons in San Diego, CA. Program, webcast and audio information is available online at

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