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

What is the job description for surgeons?

What do surgeons do day in, day out? Where are the best practice opportunities?

The job description for surgeons varies depending on what environment they are practicing in. Many surgeons find themselves in a multifaceted career that allows them to put their skills to good use in a combination of workplace settings. Although the workplace settings may vary, one factor remains the same: the surgical profession is one of responsibility and leadership. The surgeon is responsible for the preoperative diagnosis of the patient, for performing the operation, and for providing the patient with postoperative surgical care and treatment. The surgeon is also looked upon as the leader of the surgical team.

During the course of an operation, the surgeon must make important decisions about the patient's health, safety, and welfare. Furthermore, the surgeon must work to ensure cooperation among the other members of the surgical team, which typically includes another surgeon or qualified person who acts as the surgeon's assistant, the anesthesiologist, and operating room nurses.

There are seven major settings in which surgeons can put their education, training, and skills to valuable use: private practice, academic medicine, institutional practice, hospitals, ambulatory surgery settings, government service programs, and the uniformed services.

Private Practice

  • Centers around patient care
  • Provides for more professional independence
  • Allows freedom to decide the organization of the practice, as well as the hours, the hospitals in which the surgeon practices, and the type of patients that are attracted
  • Tends to encourage long-term relationships with patients
  • Requires business management skills and strong professional relationships with referring physicians
  • Includes responsibilities for providing the surgeon's own employment benefits
  • Suits surgeons with a strong and enthusiastic interest in patient-care activities
  • Provides the opportunity to perform ambulatory, or office-based, surgeries
  • Offers the option for managed care contracts

Academic Medicine

  • Combines teaching, patient care, and medical research
  • Places the surgeon in an environment that is known for being in the forefront of scientific breakthroughs and for taking the initiative in developing experimental therapies
  • Focuses on research, thus, these hospitals attract patients with diseases and disorders that are less likely to be found in a traditional private or group practice
  • Suits a surgeon who is interested in a broad exposure to a diverse range of clinical cases
  • Allows surgeons to become part of a research community, where they are expected to conduct clinical investigations; often advancement in this type of practice environment is linked to successful research efforts
  • Emphasizes teaching and provides vitally important leadership and guidance to medical students and residents

Institutional Practice

  • Offers full-time practice that is directly affiliated with a particular hospital or clinic
  • Places emphasis exclusively on patient care; and offers the option of combining patient care with research and educational activities
  • Establishes goals and a mission which should be carefully considered and should match the surgeon's career interests
  • Creates an image that could have an impact on the surgeon's practice, i.e.—internationally renowned institutions attract more complicated and atypical cases than a private practice
  • Offers an established practice with the necessary administrative and business systems already in place
  • Provides health-care coverage, malpractice insurance, and retirement savings programs
  • Allows for a more flexible schedule depending on the number of surgeons on staff who can provide coverage, but could create restrictions on certain activities, such as scheduling vacation time depending on availability of coverage
  • Requires that surgeons abide by certain rules and regulations set forth to make the group function as a whole
  • Suits surgeons who welcome the opportunity to be on the cutting edge of whatever is going on in the field

Hospitals

  • Constitute the central focus for most of the surgeon's work, in spite of the increase in ambulatory surgical care
  • Surgeons spend more time working in the hospital than do physicians on other specialties
  • Provides a variety of career choices for surgeons due to individual hospital diversity including: size, urban or rural, government-sponsored or privately owned, specializing in certain areas of medicine (i.e. cancer treatment), or only serving patients of certain age groups (i.e. children's hospitals)
  • Offers a wide variety of choices for a hospital-based practice, through exposure to different hospital environments during medical school

Ambulatory Surgery Settings

  • Offers an increased opportunity to perform a number of operations. These surgeries share a common feature: the patient arrives at the facility, undergoes the surgical procedure, and returns home to recover from the operation on the very same day
  • Presents surgeons with the opportunity to ensure that their patients receive continuity of care through reorienting their practice
  • Establishes a variety of settings in which ambulatory surgery can be performed: the surgeon's office, an ambulatory surgery department within a hospital, a hospital-sponsored ambulatory surgery center in a separate location from the hospital, or an ambulatory surgery center that is independently owned by a group of surgeons in private practice
  • Affects how often surgeons work based on the surgeon's specialty and nature of the patients' illnesses
  • Provides the opportunity to perform the growing number of procedures that are now considered appropriate for an ambulatory setting: hernia repair, cataract surgery, breast biopsy, and laparoscopy

Government Service Programs

  • Offers is a variety of practice opportunities available through the federal government's Public Health Service (PHS), which consists of eight governmental agencies: National Institutes of Health; Food and Drug Administration; Centers for Disease Control; Alcohol, Drug Abuse, and Mental Health Administration; Health Resources and Services Administration; Agency for Health Care Policy and Research; Agency for Toxic Substances and Disease Registry; and Indian Health Service
  • Presents a variety of opportunities through each of these agencies, which may vary according to a physician's medical specialty
  • Offers an opportunity to treat patients who have limited access to high-quality health care, i.e. those in prisons or on Indian reservations
  • Establishes an organized, uniformed-service fashion with officers, promotions, and pay scales that are similar to those used in other uniformed services
  • Provides an opportunity to perform service in the U.S. or with the World Health Organization in underserved areas around the world
  • Establishes a minimum tour of duty in the commissioned corps, usually two years; however, certain positions are available to students in their second year of health professional training for a period of 31 to 120 days
  • Offers diversity through assignments to different positions and locations, much like an officer pursuing a military career

The Uniformed Services

  • Offers different ways in which physicians can pursue a military career, through different branches of the uniformed services–the Air Force, Navy, or Army
  • Available to graduating doctors for a surgical residency in the military, and to board-certified surgeons to enlist and pursue a military medical career
  • Offers its own unique opportunities that differ by each individual branch of the military: Air Force medicine deals with flight-related disorders; Navy physicians gain exclusive training and practice in the specialties of underseas medicine, and Navy flight surgeons undergo training at the Naval Aerospace Medical Institute and fly with air crews; the Army provides surgical practice opportunities through its worldwide network of hospitals and base facilities and its world-famous research institutes, such as the Walter Reed Army Hospital in Washington, DC
  • Provides additional benefits including a commission in the service; a guaranteed medical practice without having to incur the cost of equipment, supplies, and malpractice insurance premiums; subsidized housing and living expenses; assignments in different parts of the US and abroad; free relocation services; guaranteed paid annual leave; and generous retirement benefits after 20 years of service
  • Offers surgeons who wish to maintain a full-time civilian medical practice additional career opportunities that are available to them through their local branch of the National Guard or another branch of the military reserve
  • Requires a time commitment from surgeons who serve in the military reserve of attending an annual two-week medical training session, a monthly weekend drill session, and any other additional service that may be deemed necessary by a declaration for the deployment of the reserve armed forces
  • Presents surgeons who serve in the military reserve with benefits such as commission as an officer, salary compensation based on grade or rank, retirement benefits after 20 years of service, the opportunity to attend medical military conferences, assistance for qualified physicians in repaying guaranteed student loans, stipend programs that grant payments to qualified physicians who are in certain residency programs, and a stimulating perspective of medicine apart from the daily civilian medical routine.