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American College of Surgeons, Oct. 27-31

The 104th Annual American College of Surgeons Clinical Congress

The annual meeting of the American College of Surgeons was held from Oct. 27 to 31 in San Francisco and attracted approximately 14,000 participants from around the world, including surgeons, medical experts, allied health professionals, and administrators. The conference included hundreds of general and specialty sessions, postgraduate courses, scientific paper presentations, video-based education presentations, and posters focusing on the latest advances in surgical care.

In one study, Yue-Yung Hu, M.D., M.P.H., of the Northwestern University Feinberg School of Medicine in Chicago, and colleagues found that surgical resident burnout is driven largely by mistreatment, including discrimination, harassment, and abuse.

“Thirty-nine percent of surgical residents experience burnout symptoms at least weekly. This is based on a survey of all residents training in programs accredited by the Accreditation Council for Graduate Medical Education with a 99.3 percent response rate, so it’s likely the best estimate of burnout in any specialty to date,” Hu said. “The raw rate of burnout is higher in women. This had been previously reported by other researchers, but no one had yet figured out why. Some have drawn the unfortunate conclusion that women are weaker and can’t ‘hack it’ in surgery.”

Based on previous research, Hu and colleagues included questions about residents’ experiences with discrimination, harassment, and abuse in their survey and found that these are common experiences in residency, especially for women. Two-thirds of women reported gender discrimination, one-fifth reported sexual harassment, and one-third reported verbal/emotional abuse.

“When we control for this mistreatment, the burnout rates between men and women are actually the same. Burnout is therefore not just a problem with the individual, but one of the environment. It is also not one exclusive to women; men also experience mistreatment, and it also drives their burnout,” Hu said. “Burnout has profound personal and professional consequences, and it affects not just doctors but their patients and the health care system. It’s important to address it, especially in training as it’s such a critical stage in the pipeline. Additionally, diversity is known to improve team-based work (like surgery). Improving mistreatment would improve burnout, which would improve surgery as a field.”

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In a prospective, proof-of-principle cohort study, Nikhil Panda, M.D., of Massachusetts General Hospital-Harvard Medical School and Ariadne Labs in Boston, and colleagues evaluated whether metrics derived from smartphone accelerometer data (one type of sensor data from smartphones) could capture differences in physical recovery among patients undergoing cancer surgery.

“We found that smartphone accelerometer data captured decreases in daily exertions activity in patients with a postoperative event (such as a complication, reoperation, readmission — essentially, nonroutine surgical recovery) compared with baseline and at up to six weeks after surgery,” Panda said. “We concluded that within the context of this study, physical activity measured passively, continuously, and prospectively through smartphone accelerometer data can be used to quantify differential recovery trends after surgery.”

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Sirivan S. Seng, M.D., of the Crozer-Chester Medical Center in Upland, Pennsylvania, and colleagues evaluated ways to improve the lives of physicians and patients with the implementation of medical scribes in the outpatient surgical setting.

“Although we didn’t see an increase in overall wait time of patients or time to chart closure/completion, we did see an increased number of patients in the time frame after the scribe was hired. Additionally, we also saw an enhancement in resident involvement,” Seng said. “The main conclusion was that medical scribes will help improve clinic volume and will not detract from the resident experience. It is important to recognize different tools that are constantly rolling out that can benefit not only clinical flow, but also provider wellness as we attempt to mitigate physician burnout due to excessive documentation burden.”

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ACS: Outcomes Worse With Delay in Performing Cholecystectomy

THURSDAY, Oct. 31, 2019 (HealthDay News) — Delaying cholecystectomy for acute cholecystitis for more than 72 hours after admission is associated with an increased length of stay and increased rates of complications and readmission, according to a study presented at the annual meeting of the American College of Surgeons, held from Oct. 27 to 31 in San Francisco.

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ACS: Shorter Work Shifts Aid Acute Surgery Outcomes

THURSDAY, Oct. 31, 2019 (HealthDay News) — Patient outcomes for appendicitis are improved with transition to a shift-based, acute care surgery model with shorter shifts, according to a study presented at the annual meeting of the American College of Surgeons, held from Oct. 27 to 31 in San Francisco.

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ACS: General Surgery Residents Often Experience Mistreatment

TUESDAY, Oct. 29, 2019 (HealthDay News) — General surgery residents, especially women, often experience mistreatment, according to a study published online Oct. 28 in the New England Journal of Medicine to coincide with the annual meeting of the American College of Surgeons, held from Oct. 27 to 31 in San Francisco.

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