Acute Care Surgery in the US – A Review and Personal Experience

Pascal Fuchshuber; Chris Solis

doi:10.55791/wkg1ed19

Authors

Pascal Fuchshuber Author https://orcid.org/0000-0001-9978-0534
Chris Solis Author

DOI:

https://doi.org/10.55791/wkg1ed19

Keywords:

acuta care, trauma surgery, critical care, emergency surgery

Abstract

Acute care surgery is a new specialty created in response to the erosion of traditional general surgery and trauma surgery models. Multiple surgical societies have successfully developed the definition, designation, and training of an Acute Care Surgeon over many years. These are applicable worldwide. In the US, most larger hospital systems have successfully implemented acute care surgery, but rural and economically challenged areas remain underserved. Acute care surgeons in the US are generally employed either by the Hospital or a medical group. The profession provides a perfect work-life balance and, therefore, has become very attractive for the younger generations and surgeons who want to step down from exhausting full-time practices at the end of their careers. In the US, it is an entirely accepted specialty with dedicated and verified fellowship training.

Author Biographies

Pascal Fuchshuber

Sutter East Bay Medical Group, Lafayette, California, USA
University of California San Francisco – East Bay Oakland, California, USA
Chris Solis

Sutter East Bay Medical Group, Lafayette, California, USA

References

https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/press-releases/2023/emergency-general-surgery-verification-program-verifies-first-five-hospitals/

Kutcher ME, Sperry JL, Rosengart MR, Mohan D, Hoffman MK, Neal MD, Alarcon LH, Watson GA, Puyana JC, Bauzá GM, Schuchert VD, Fombona A, Zhou T, Zolin SJ, Becher RD, Billiar TR, Forsythe RM, Zuckerbraun BS, Peitzman AB. Surgical rescue: The next pillar of acute care surgery. J Trauma Acute Care Surg. 2017;82:280-286. doi: 10.1097/TA.0000000000001312.

Kashuk JL, Klein Y, Bacchus H, Kluger YS. Acute care surgery: what's in a name? A new specialty comes of age. Isr Med Assoc J. 2013;15:147-51.

Richardson JD, Spain DA, Livingston DH. Trauma and acute care surgery: The evolution of a specialty. J Trauma Acute Care Surg. 2022 Feb 1;92(2):242-249. doi:10.1097/TA.0000000000003456.

Institute of Medicine of the National Academies. Hospital-based emergency care at the breaking point. Washington (DC): The National Academy Press; 2007.

Green SM. Trauma surgery: discipline in crisis. Ann Emerg Med. 2009;53:198-207. doi: 10.1016/j.annemergmed.2008.03.023.

Richardson JD, Miller FB. Is there an ideal model for training the trauma surgeons of the future? J Trauma. 2003;54:795-7. doi: 10.1097/01.TA.0000056156.20400.E5.

Esposito TJ, Rotondo M, Barie PS, Reilly P, Pasquale MD. Making the case for a paradigm shift in trauma surgery. J Am Coll Surg. 2006;202:655-67. doi: 10.1016/j.jamcollsurg.2005.12.008.

Moore EE. Acute care surgery: the safety net hospital model. Surgery. 2007;141:297-8.

Committee to Develop the Reorganized Specialty of Trauma Surgical Critical Care and Emergency Surgery. Acute care surgery: trauma, critical care, and emergency surgery. J Trauma. 2005;58:614-6.

Jurkovich GJ. Training in trauma and emergency surgery. Am Surg. 2007;73:157-60.

Jurkovich GJ, Davis KA, Burlew CC, Dente CJ, Galante JM, Goodwin JS 2nd, Joseph B, de Moya M, Becher RD, Pandit V. Acute care surgery: An evolving paradigm. Curr Probl Surg. 2017;54:364-395. doi: 10.1067/j.cpsurg.2017.05.001.

Mandrioli M, Inaba K, Piccinini A, Biscardi A, Sartelli M, Agresta F, Catena F, Cirocchi R, Jovine E, Tugnoli G, Di Saverio S. Advances in laparoscopy for acute care surgery and trauma. World J Gastroenterol. 2016;22:668-80. doi: 10.3748/wjg.v22.i2.668.

Ietto G, Amico F, Pettinato G, Iori V, Carcano G. Laparoscopy in Emergency: Why Not? Advantages of Laparoscopy in Major Emergency: A Review. Life (Basel). 2021;11:917. doi: 10.3390/life11090917.

Søreide K. Trauma and the acute care surgery model--should it embrace or replace general surgery? Scand J Trauma Resusc Emerg Med. 2009 Feb 4;17:4. doi: 10.1186/1757-7241-17-4

Ross SW, Reinke CE, Ingraham AM, Holena DN, Havens JM, Hemmila MR, Sakran JV, Staudenmayer KL, Napolitano LM, Coimbra R. Emergency General Surgery Quality Improvement: A Review of Recommended Structure and Key Issues. J Am Coll Surg. 2022;234:214-225. doi: 10.1097/XCS.0000000000000044.

Knowlton LM, Minei J, Tennakoon L, Davis KA, Doucet J, Bernard A, Haider A, Scherer LRT 3rd, Spain DA, Staudenmayer KL. The economic footprint of acute care surgery in the United States: Implications for systems development. J Trauma Acute Care Surg. 2019;86:609-616. doi: 10.1097/TA.0000000000002181.

https://bulletin.facs.org/2017/05/2016-acs-governors-survey-will-acute-care-surgery-change-the-surgical-landscape/ 2016 Juan C. Paramo, MD, FACS, et al.ACS Governors Survey: Will acute care surgery change the surgical landscape?

Bernard A, Staudenmayer K, Minei JP, Doucet J, Haider A, Scherer T, Davis KA. Macroeconomic trends and practice models impacting acute care surgery. Trauma Surg Acute Care Open. 2019;4:e000295. doi: 10.1136/tsaco-2018-000295. PMID

Geographic Diffusion and Implementation of Acute Care Surgery An Uneven Solution to the National Emergency General Surgery Crisis Jasmine A. Khubchandani, MD, et al. JAMA Surg. 2018;153:150-159.

https://www.aast.org/acute-care-surgery-overview

(https://med.uth.edu/surgery/education/fellowship/acute-care-surgery-surgical-critical-care-trauma-fellowship-programs/)

van der Wee MJL, van der Wilden G, Hoencamp R. Acute Care Surgery Models Worldwide: A Systematic Review. World J Surg. 2020;44:2622-2637.