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Update on the status and future of acute care surgery: 10 years later

Lissauer, Matthew E. MD; Schulze, Robert MD; May, Addison MD; Esposito, Thomas MD, MPH; Duane, Therese M. MDfor the EAST Acute Care Surgery Ad Hoc Committee

Journal of Trauma and Acute Care Surgery: June 2014 - Volume 76 - Issue 6 - p 1462–1466
doi: 10.1097/TA.0000000000000226
Original Articles

BACKGROUND Ten years ago, the specialty of trauma surgery was considered to be in crisis. Since then, the Eastern Association for the Surgery of Trauma (EAST) created a position paper, and acute care surgery (ACS) has matured. A repeat survey of EAST members is indicated to evaluate the progress of ACS.

METHODS A survey was e-mailed to EAST members. Results were evaluated and compared with the previous position paper and survey.

RESULTS The response rate was 15%. More than three fourths of the respondents were male, and just less than one fourth of them were female. More than half of the respondents were in practice for less than 10 years. Seventy-three percent were involved in research, although only 16% were allotted protected time. Most respondents felt that reimbursement for their effort was inadequate: 54% thought reimbursement was fair for trauma care, 59% for critical care, 49% for nontrauma ACS, and 62% for general surgery. The biggest incentive to a career in ACS was that it was a challenging and exciting activity; the biggest disincentive was working at night. Seventy-two percent expressed satisfaction with their career profile, and 92% were either very or somewhat happy with their career. Sixty-six percent did feel either somewhat or very burned out. Surgeons were interested in learning more about contract negotiation, business/managerial issues, and billing/coding. Compared with the previous survey, overall career satisfaction seems stable.

CONCLUSION Most surgeons are satisfied with a career in ACS. There are still some facets of the career that warrant improvement. Focus on surgeon satisfaction may lead to enhancements in patient care.

From the Division of Acute Care Surgery (M.L.), Rutgers - Robert Wood Johnson Medical School, New Brunswick, New Jersey; Section of Acute Care and Trauma Surgery (R.S.), Boston University School of Medicine, Boston, Massachusetts; Division of Trauma and Surgical Critical Care (A.M.), Vanderbilt University Medical Center, Nashville, Tennessee; Division of trauma, Critical Care and Burns (T.E.), Loyola University Medical Center, Maywood, Illinois; Division of Trauma, Critical Care, Emergency Surgery (T.D.), The Medical College of Virginia/Virginia Commonwealth University School of Medicine, Richmond, Virginia.

Submitted: October 6, 2013, Revised: January 14, 2014, Accepted: January 16, 2014.

A portion of the survey data was presented as a special session entitled “Updates in acute care surgery: re-evaluating our perceptions 10 years later” at the Eastern Association for the Surgery of Trauma Annual Scientific Session, January 18, 2013.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (

Address for reprints: Matthew Eric Lissauer, MD, University of Maryland Medical Center, 22 South Greene St, Baltimore, MD 21201; email:

© 2014 Lippincott Williams & Wilkins, Inc.