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Grave Concernstraumafirstname.lastname@example.org email@example.com
Tue, 18 Jun 2002 12:41:02 EDT
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I never thought I would be writing a memo like this one. Many of us have been expressing our opinions on this web site, but I have been seeking information and communicating elsewhere. The expressions on this web site are not and will not be welcome to those agencies that are moving full steam ahead. The news networks and newspapers have decided that what will be the end game. I heard comments even this morning which made fun of the any surgical mentality comments. We are being compared to reactions to death and grief as written by Elizabeth Kubler Ross. We are seen to be in a "bargaining" phase rather than an adjustment phase. Surgical training programs for county hospitals may be a thing of the past as many deans, chairs of surgery, surgical chiefs at VA hospitals are saying, we need to get to a 40 hour work week for students, residents and staff. Punch a clock. We are in conflict with many of the various regulatory agencies. The ACS COT VRC requirements are totally incompatible with the new ACGME, AMA, AAMC, regulations. We are witnessing Catch 22 and we will NOT win this one. I recommend that we all TRY to use the manpower we have and try to work our the math for providing the care required while still accomplishing the punch card for the surgical RRC. SOMETHING in our educational and service programs will have to go. For many cities, it will be the trauma program at the county hospital which will go first as that requires in house 24/7 coverage. It will be impossible to cover both elective and emergency surgery. Surgical critical care will also be one of the early causalities. Surgeons will become tradesmen with the workup and follow up provided by others, often non MDs. If we can work out the numbers and the required call, then bully for us and let us share the math. If we cannot work out the math within the ACGME guidelines then we need to change some of the other regulations such as ACS COT VRC, might need to change. We can then be part of those changes. I am convinced this AM that this is part of a national programed activity, and unless the ACS, ABS, or others step forward with a BIG stick, this month, surgery as we have known it will no longer exist. The voices on this web site are the minority. The lawyers, hospital administrators, ACGME, AMA, AAMC, congress, etc have decided that work hours and "unsafe" doctors will be a major agenda. Let us stop the bargaining and denial and figure out how to maintain the quality, the education, and the math. k